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Risks of automation in medicine – a review article for the obstetrics case

6. "Machines are intrinsically superior to humans" . This justification might seem surprising initially, but it is one of the most frequently suggested. Machines are said to have reproducibility, absolute consistency over time, whereas cliniciansΒ΄ "performance" does not possess those attributes [20]. Human intelligence is presented as "error-prone",, subjective and altered by fatigue, whereas machines introduce reproducibility, absolute consistency over time and never get tired [20]. Overall detection rates of fetal malformations are described as "low" due to the "human factor" [22], even when cited studies report prenatal detection "already accounting for 50% or more of critical congenital heart defects detected in many programmes" and as "increasing", with some very high rates in certain areas (87% in France). Intraobserver variability in foetal biometry measurements is described as "high" [22] when the reference study reports 3.0% to 6.0% differences. This narrative is not specific to obstetric medicine, as outperformance claims over humans have become common, as in this title: "ChatGPT with GPT-4 outperforms emergency department physicians in diagnostic accuracy: retrospective analysis" [23]. As Drogt et al. rightly note: "these outperformance claims often lack specificity, contextualisation and empirical grounding" [24]. Even so, the idea that machines surpass clinicians’ intelligence and skill is repeated and used as a major implicit argument for automation. This systematic depreciation of human performance may deter students from engaging in clinical training, affect doctors' morale and lead to unrestrained automation.