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A Hippocratic Oath for technology

Joshua Landy, MD
Health Technology
May 22, 2018
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Modern technology needs to do better. This is the message delivered by every CEO after every Silicon Valley scandal in recent memory. This time, they should really do it. Medicine can show them how.

Let’s have the professionals building our future abide by industry-wide standards, just as doctors do. As both a startup founder and a physician, this idea makes intuitive sense to me. Drawing on my experience treating patients and running a digital platform, here’s what a Hippocratic Oath for tech might look like.

First, it shouldn’t say “first do no harm.” Not that I’m in favor of doing harm, but those famous words are not actually in the oath most doctors take. Like most medical students across North America, I swore the Oath of Lasagna. (Yes, really.) Dr. Louis Lasagna was the dean of Johns Hopkins School of Medicine in the 1950s when he took it upon himself to modernize the 2,400-year old text first laid down by Hippocrates. Gone were the injunctions against abortion and removing kidney stones; kept were the pledges to treat the patient as a human and not abuse our positions for material gain. And therein lie the sort of commitments Silicon Valley should make.

Here are five key segments of the Oath, with the small iterations necessary to make them tech-friendly.

1.  “I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know.”

Just find-and-replace “the world” with “Cambridge Analytica.” Privacy is at the core of today’s turmoil, and it’s here that medicine leads the way. You know you can tell your doctor anything, and that confidence is what makes medicine possible. If you swap out the word “patients” for  “users,” and you’ve basically got Apple’s response when the FBI comes calling with a locked iPhone.

2. Above all, I must not play at God.

Historically, doctors have held a huge amount of power. Acknowledging power is what the oath is all about.  We can take this phrasing and change “God” to “God-mode.” Fans of the HBO show Silicon Valley will know God Mode as the screen that gives app developers a deity-like view of all their users around the world. We all know that any of the major tech platforms could pull up our files at any moment, gathering all their engineers around to scrutinize what we’ve searched and where we’ve been. We reassure ourselves with the knowledge that we’re not that important — but it would be nice if we knew this information was deemed sacrosanct.

3. I will prevent disease whenever I can, for prevention is preferable to cure.

The pessimist’s history of the internet is the story of message boards degenerating into cesspools, governed by Godwin’s Law and not much else. At that point, the problem becomes how we heal these communities. A public health approach would advise us not to break them in the first place. There are many positive communities out there, and in each case, clear rules and enforcement are how they stay positive. In tech, that’s design that defaults to decency.

4. I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

Users are people, too. People can’t do their jobs if they’re distracted by social networks, and parents can’t talk to their kids if they’re playing games. We have the power to ruin their lives, and if we don’t see that as an ethical dilemma, we’ll eventually see it as a financial one. This thinking echoes the way Facebook announced changes to its Newsfeed earlier this year, warning that total time spent on the platform would drop as the company focused on meaningful, human engagement.

5. If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter.

The standard pitch for any tech company promises to change the world. They don’t say that they expect to be held accountable for those changes. Maybe they should. The modern technology company was born convinced it deserves respect, attention, and good faith. To come of age, they have to earn it. And they can start by sharing and committing to an oath like this one.

Joshua Landy is a critical care physician and co-founder, Figure 1.

Image credit: Shutterstock.com

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