Imagine the Medical Metaverse From the History of Informed Consent

First of all, the medical world needs the metaverse just like a fish needs water. If the metaverse is a mirror image of the real world, then it is time for us to think about how to construct the entire metaverse.The real world is cruel and blurred, and we feel uneasy. In the medical world, there is so much insecurity and anxiety that no amount of luxury and advanced medical equipment can bridge the gap between people’s hearts.When we study the history of medical development, we will discover the budding metaverse that has been suppressed for a long time.

In the 1950s, the informed consent form appeared. Medieval doctors believed that in order to obtain a good treatment effect, not only the authority of the doctor, but also the obedience of the patient were needed.In 1914, the speaker Mary Schloendorff was treated in a New York hospital due to an upset stomach. After a few weeks in the hospital, she was diagnosed with fibroids. The doctor advised her to have an operation, but Schloendorff strongly opposed it. However, Schloendorff agreed to perform an examination under ether anesthesia, and the doctor took this opportunity to perform surgery on her to remove the tumor. Later, Schloendorff developed gangrene on her left limb and eventually resulted in several amputations of her fingers. Therefore, Schloendorff took the New York Hospital to court. The court found that the doctor’s actions constituted personal injury without the consent of the plaintiff. The justice in charge of this case, Benjamin Cardozo put forward the following point: every sane adult has the right to decide how to dispose of his body; if a surgeon performs an operation without the patient’s consent, it constitutes an atrocity and the doctor is responsible for the damage. Cardoso’s point of view has also become one of the most basic elements in the concept of informed consent, that is, patient autonomy. We can see that medical treatment for thousands of years has been in a dark age, and informed consent has only been proposed in the last century.

The term informed consent first appeared in a case in the United States in 1957. A patient with arteriosclerosis named Martin Salgo underwent an aortic angiography examination after anesthesia, and found that his lower limbs were paralyzed when he woke up. Salgo said that he didn’t know that there was such a risk before undergoing the examination. This was the doctor’s negligence! The final decision of the court was: Salgo’s doctors have the responsibility to inform the patient of all the facts related to receiving the recommended treatment so that the patient can make an wise choice. The judge in charge of this case, Bray, proposed the term informed consent. In the principle of respect, in addition to respect for the life value of patients, the more important thing is to respect the autonomy of patients in medical treatment. Patients have the right to make a rational decision on how to deal with their disease after they are fully aware of the relevant information. Its ethical foundation lies in emphasizing the irreplaceability of personal autonomy. Even in major choices concerning life and death, everyone should be given sufficient time, dignity and opportunities to make voluntary decisions.

Time goes by and the camera switches to the 21st century. Mr. Eric Top, the author of “the patient will see you now” mentioned that 83% of Americans did not see what their medical records looked like until they died. This is a sad situation. We wasted 50% of the medical resources on the planet due to the mistrust between doctors and patients. In other words, a new harmonious relationship can bring about a rapid reduction in costs (we know that China’s total annual medical expenditures Around 5 trillion).The doctor-patient relationship is indeed unequal, but can technology alone bridge the gap? If there is a technology that can make up for it, then we hope it is the metaverse. We solve the problem of human existence by building a high-dimensional space like the metaverse. In the medical metaverse, the world is not just games and illusions, but a mapping of the real world. This kind of mapping is not a one-to-one information mapping, but a reverse effect on the real society after high-dimensional reconstruction. Then in the real relationship, with the advancement of science and technology, we have gained a new understanding of the real relationship, at least the new crown epidemic has given birth to a telemedicine partnership.The metaverseuniverse is not a patch of the real world, although it may be understood by most of us. We now realize that all the data of our body can be quantified, but there is nowhere to put it. We urgently need a space for us to control completely and autonomously.Technical control is more important than legal documents, because we may face virtual doctors in 80% of the disease treatment process in the future. For example, AI will become the chief therapist. We cannot see physical doctors that are materialized. What most people may see is a virtual doctor, an AI doctor with rich expressions, personalities and nicknames on the screen.They are supported by a powerful cloud computing engine. They are extremely smart and bodhisattva, and can accompany humans to conquer Mars and even the Milky Way. These AI doctors may greet us as soon as we wake up after 300 years of interstellar hibernation, and give us a body monitoring report in a few seconds. The meticulous care of AI doctors has surpassed physical doctors and made up for the lack and indifference of human medical technology. More importantly, when we face AI, we still have autonomy and we need AI to respect our lives.In the process of linking assets, value, and energy transfer, we need an asset that can be autonomous and compromised by both carbon-based life and silicon-based life with the greatest common divisor. These assets may be generated in the course of our life movement. It is the value asset generated by data sharing or analysis. These assets began to emerge with the movement of the metaverse. In the process of initial generation of these assets, even if they are suppressed by the real world, their original value still exists. For example, the process of adding value to the data of individual life units in the metaverse will inevitably affect the real life style. In order to be able to pay enough medical insurance in 2157, people will choose to realize asset appreciation through data sharing and automatically incorporate it into the medical insurance system of that time in exchange for AI’s services to humans. Otherwise, AI may provide an option-distribution Go to a foreign planet to do coolies to get medical services. We will find that computing power will protect life, but we need to provide value exchange. There is no free lunch in the world. We can think about the dark scene of “The Matrix “ and know that we need to respect AI. (There is an answer in “The Matrix Prequel”). The attraction of Metaverse to doctors lies in the doctor’s vigorous pursuit of self-identity and personal value. The value of this identity and the accumulation of IP will inevitably be linked to the economic system. Doctors are the promoters of AI algorithms in the future. The AI algorithms released by them and engineers will be issued in accordance with the NFT method. They will cherish every asset issued in Metaverse, just like artists issuing their own digital assets. If these digital assets are combined with quantum communication technology, it is easy to achieve ultra-long-distance collaboration and transactions in the universe. For example, a doctor on the earth can support someone on the “Enterprise” spacecraft that is roaming in the Alpha Nebula in Andromeda for telemedicine services, the distance of service may have exceeded 100,000 light years. The current doctor is still struggling whether it can achieve thorough “free practice”, the essence of the extremely pursuit of the identity is metaverse. The doctor’s identity and the identity of the patient will be weakened in the metacularity, forming a more equal relationship, and its opposite state will be weakened. Patients can actively participate in their own treatment, this positive attitude first establishes on the basis of personal data authentication, and they themselves may be the contributor of the medical project. A truly effective medical universe, personal attitude should be positive, and we are full of negative and vigilant in the real world. We need to have a new social relationship. If we are analyzed on both sides of the analysts, we will find that each complaints and regret, will issue “I am very kind…..but…”. This kind of misconduct and extremely embarrassing situation can only use traditional economic value-added methods to evaluate the development of the medical industry. For example, the news that anti-cancer drugs have hundreds of billions of market space can only make people dumbfounded. It is problematic to blindly pursue this motivation for medical output value. The humanistic brilliance of the ancient Chinese book “Great Doctor Sincere” can still illuminate the modern medical metaverse. “Therefore, doctors cannot rely on their own expertise to seek for wealth, as long as they have the idea of relieving other people’s sufferings, (accumulate merits) in the underworld, they will feel a blessed person.”

We will soon enter the world of carbon-based life and silicon-based communion, and the metaverse is a necessary element. metaverse cannot be absent from the medical world. In the process of the fusion of silicon-based and carbon-based, what type of people dominate the medical world? What type of people will gradually occupy the mainstream? In what way are these types of people selected, shaped, liberated, and suppressed? What kind of “human nature” does the behavior and character we observe in a certain society during this certain period of time reveal? “All interests and powers, passions and prejudices, hatred and hopes tend to obtain a certain ideological mechanism, relying on competing with the slogans, symbols, doctrines and demands of other interest groups. As public communication expands, With continuous acceleration, its effectiveness becomes more and more diminished under repeated repetition. Therefore, the demand for new slogans, beliefs and ideologies is continuous.”

What spirit should our generation give to the medical metaverse, and how should it be realized? Have we thought about it?