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Till Malfunction Do Us Part
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become the
de facto
industry standard.
To build momentum, the company is
signing agreements with hospitals and
physician networks to use the Health
Vault system to upload and share their
patient medical records. If enough
patients, hospitals, and physicians
affiliate with Health Vault, Microsoft
could in time find itself in the same
dominant position in HIT that it has
held in personal computing and the
Internet for years (think Windows and
Internet Explorer).
But it’s a long way from here to there.
Not even Microsoft has the reach and
resources to finance a nationwide net-
work on its own if the participants are
unwilling and need compensation to
overcome their natural resistance. Over
the long run, an HIT system will be
built, maintained, and used efficiently
when physicians and hospitals have an
interest in using it in order to maintain
their market share. To get there will
require strengthening the normal sup-
plier-consumer relationship that works
so well to promote productivity and
improve quality in other markets. In
health care, a larger role for direct con-
sumer purchasing of services—instead
of the present near-total reliance on
third-party payments—is crucial. If
consumers begin paying for more med-
ical services with their own money,
they will be in a much stronger posi-
tion to demand the convenience and
higher quality associated with an effi-
cient and reliable electronic system of
recordkeeping and transactions.
The shift to more consumer-directed
financing, however, is not around the
corner. Low deductible employer-based
insurance and Medicare and Medicaid
are so dominant that it will take many
years before alternative arrangements,
like Health Savings Accounts, can have
a significant impact. HIT adoption is
therefore likely to remain an uphill
struggle for the foreseeable future,
necessitating an ongoing campaign of
cajoling and financial support from the
government to overcome the under-
standable if frustrating reluctance of
physicians and hospitals to pay for
an information system that produces
gains for the overall system but losses
for themselves.
—James C. Capretta
is a fellow at the
Ethics and Public Policy Center. He is also
a policy and research consultant for health
industry clients.
Till Malfunction Do Us Part
Predictions of Robotic Intimacy
I
n a recent issue of the journal
lonely. “People engage in a variety
of behaviors to alleviate the pain of
[social] disconnection,” the authors
write, including “inventing humanlike
agents in their environment to serve as
potential sources of connection.” This
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Psychological Science
, researchers
from the University of Chicago
and Harvard reported that people
are more likely to anthropomorphize
animals and gadgets when they are
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finding is hardly surprising, and is not
unrelated to one of the favorite objec-
tives of the budding consumer robotics
industry: manufacturing “companions”
for the isolated elderly.
Japan—the country with the world’s
highest percentage of elderly people
and lowest percentage of children—
has been at the forefront of this domes-
tic-robot trend. In 2005, Mitsubishi
released its “Wakamaru” robot to con-
siderable fanfare. The three-foot-tall
machine, its appearance something
like a yellow plastic snowman, was
designed to provide limited home care
to the aged. It can “recognize” up to
ten human faces, respond to voice
commands, deliver e-mail and weath-
er forecasts from the Internet, wheel
around after people in their homes, and
contact family members or health care
personnel when it detects a potential
problem with its ward.
Despite Mitsubishi’s high expec-
tations, the first batch of one hun-
dred Wakamaru did not sell well. At
$14,500 apiece, Mitsubishi received
only a few dozen orders, and then faced
cancellations and returns as purchas-
ers realized the robot couldn’t clean
or cook, or do much of anything.
Customers were amused to find the
machine unexpectedly “watching tele-
vision” or “dancing,” but were frustrat-
ed by its limited vocabulary and actual
capabilities. Production was called off
after three months, and the remaining
stock of Wakamaru now work as rent-
able receptionists—a common fate for
first-generation humanoid robots, too
expensive for the general market.
In the past decade, other robots
intended for the elderly made their
debuts in nursing homes, including
“Paro,” a furry, white, squawking baby
seal made and sold in Japan. In videos
viewable online, it is plain that nursing-
home residents, including those suffer-
ing from advanced Alzheimer’s, take
comfort in watching, touching, talking
to, singing at, and cleaning Paro. Like
the cats and dogs sometimes used in
therapy—but with less unpredictabil-
ity and mess—Paro’s robotic twitch-
ing and yelping seem to evoke a calm,
warm focus in depressed, lonely, and
ailing patients. Other robots provoke
similar reactions, like “My Real Baby,”
a robotic toy doll. “These are used
to soothe individuals,” according to a
2006 paper by three M.I.T. scholars:
The doll helps to quell the resi-
dent’s anxiety. After a period of
time (usually less than an hour),
[the nursing home director] will
return to the resident, take back
the doll, and return it to her
office. Often, when she takes the
doll back, its mouth is covered in
oatmeal, the result of a resident
attempting to feed it. The reason
that she takes the doll back, she
says, is that “caring” for the doll
becomes too much to handle for
the resident.
It is difficult to fault nursing home
directors who, out of compassion, offer
sad patients the comfort of interacting
with robotic toys. Other uses of today’s
interactive robots seem essentially
benign, too—like the use of “Nico”
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and “KASPAR,” child-size humanoid
robots, as tools for the social training
of autistic children, or the employ-
ment of the industrious robotic guard
dragon “Banryu,” which prowls the
house smelling for smoke and looking
for intruders.
But some analysts predict that we
are nearing a day when human inter-
actions with robots will grow far more
intimate—an argument proffered in
its most exaggerated form in
Love
and Sex with Robots
, a new book that
contends that by the year 2050, people
will be marrying robots. The author,
David Levy, is a British artificial-intel-
ligence entrepreneur and the president
of the International Computer Games
Association. In the book, his Ph.D.
dissertation from the University of
Maastricht, Levy first explains why
people fall in love with one another—a
great and timeless mystery which, with
the aid of social scientific formulae and
calibrated ten-point checklists, he help-
fully distills into twenty-one illuminat-
ing pages. He then sets out to explain
why the blind rascal Cupid might have
as much success—or more—striking
passion between humans and machines.
With such astute observations as “‘like’
is a feeling for someone in whose pres-
ence we feel good,” Levy lays out the
potential for robots to exhibit “behav-
ior patterns” that will induce people to
fall for them, heart and soul:
this goal, such as suggesting a visit
to the ballet, cooking the human’s
favorite food, or making flattering
comments about the human’s new
haircut, then measuring the effect
of each strategy by conducting an
fMRI scan of the human’s brain.
When the scan shows a higher
measure of love from the human,
the robot would know that it had
hit upon a successful strategy.
When the scan corresponds to a
low level of love, the robot would
change strategies.
These made-to-order lovers, Levy
says, will look like movie stars, write
symphonies better than Mozart, pos-
sess a “superhuman-like conscious-
ness,” converse with almost-infinite
intelligence in any given language,
demonstrate surpassing sensitivity to
their owners’ every thought and need,
and at a moment’s notice will be “in
the mood.” Soon to be available for
purchase at a location near you, their
entire virtual existences will be devot-
ed to making even the most luckless
lover feel like a million bucks.
For those who desire absolute sub-
missiveness in a mate, robots, with
their admittedly “unsophisticated” per-
sonalities, will offer the logical solution
(assuming they are not subject to the
same technical frustrations and perver-
sities endemic to all other appliances).
But for those who feel the need for
za-za-zoom, the love-bots of the future
will be programmed to be feisty:
A robot who wants to engender
feelings of love from its human
might try all sorts of different
strategies in an attempt to achieve
Surprises add a spark to a relation-
ship, and it might therefore prove
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necessary to program robots with
a varying level of imperfection in
order to maximize their owner’s
relationship satisfaction....This
variable factor in the stability of a
robot’s personality and emotional
makeup is yet another of the char-
acteristics that can be specified
when ordering a robot and that
can be modified by its owner after
purchase. So whether it is mild
friction that you prefer or blazing
arguments on a regular basis, your
robot’s “friction” parameter can be
adjusted according to your wishes.
to form emotional connections with
them. “They certainly don’t have the
same feelings for you,” Whittaker says.
“They are not like little old ladies or
puppies. They are just machines.”
The very premise underlying the
discipline of sociable robotics, how-
ever, is that a machine can indeed
mean something more. Their develop-
ers capitalize on the natural sociability
of
humans
, our inborn inclinations to
empathize with, nurture, or confide in
something generating lifelike cues, to
create the illusion that a lump of wires,
bits, and code is sentient and friendly.
Take, for example, the famous case of
the cartoon-cute robot “Kismet” devel-
oped by Cynthia Breazeal at M.I.T. in
the 1990s. Breazeal designed Kismet
to interact with human beings by wig-
gling its eyebrows, ears, and mouth,
reasoning that if Kismet were treated
as a baby, it would develop like one.
As she put it in a 2003 interview with
the
New York Times
, “My insight for
Kismet was that human babies learn
because adults treat them as social
creatures who can learn; also babies
are raised in a friendly environment
with people. I hoped that if I built an
expressive robot that responded to
people, they might treat it in a similar
way to babies and the robot would learn
from that.” The
Times
reporter natu-
rally asked if Kismet ever learned from
people. Breazeal responded that as the
engineers
learned more about the robot,
they were able to update its design
for more sophisticated interaction—a
“partnership for learning” supposedly
indicative of the emotional education
Levy admits to finding it a little
“scary” that robots “will be better
husbands, wives, and lovers than our
fellow human beings.” But in the end,
the superiority of machines at pitching
woo needn’t threaten humans: they
can be our mentors, our coaches, our
sex therapists—with programmable
patience, sympathy, and “humanlike
sensitivity.”
While Levy’s thesis is extreme
(and terribly silly), many of its criti-
cal assumptions are all too common.
It should go without saying that the
attachment a person has to
any
object,
from simple dolls to snazzy electron-
ics, says infinitely more about
his
psy-
chological makeup than the object’s.
Some roboticists are very clear on
this distinction: Carnegie Mellon
field robotics guru William “Red”
Whittaker, who has “fathered” (as writ-
er Lee Gutkind puts it in his 2007 book
Almost Human
) more than sixty robots,
advises his students and colleagues not
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of Kismet, whose active participation
in that partnership is glaringly absent
from Breazeal’s account.
It is important, Breazeal emphasizes
in her published dissertation
Designing
Sociable Robots
, “for the robot to
under-
stand its own self
, so that it can socially
reason about itself in relation to others.”
Toward this goal of making conscious
robots, some researchers have select-
ed markers of self-understanding in
human psychological development, and
programmed their machines to achieve
those specific goals. For example, Nico,
the therapeutic baby bot, can identify
itself in a mirror. (Aside from human
beings, only elephants, apes, and dol-
phins show similar signs of self-recog-
nition.) Kismet’s successor, “Leo,” can
perform a complicated “theory of mind”
cooperation task that, on the surface,
appears equivalent to the psychological
development of a four- or five-year-old.
But these accomplishments, rather than
demonstrating an advanced awareness
of mind and self, are choreographed
with pattern recognition software,
which, though no small feat of coding
cleverness, has none of the significance
of a baby or an elephant investigating
himself in a mirror.
Still, many artificial intelligence (AI)
aficionados—including David Levy—
hold that the interior state or lack
thereof is not important; the outward
markers of intelligence should be suffi-
cient indicators of it. AI patriarch Alan
Turing famously proposed in 1950 a
test in which a machine would be
deemed intelligent if a human con-
versing with the machine and another
human cannot distinguish the two.
(The implications and flaws of Turing’s
test were unpacked at length in these
pages by Mark Halpern [“The Trouble
with the Turing Test,” Winter 2006].)
Levy submits that this test be applied
not just to machine intelligence but
also to emotions and other aspects of
personality: If a machine
behaves
as
though it has feelings, who’s to say
it doesn’t? Thus he predicts that by
the year 2025, robots will not only be
fully at home in the human emotional
spectrum, but will even “exhibit non-
human emotions that are peculiar to
robots”—an absurdly unserious claim.
(One robot frequently used in studies of
emotion simulation is “Feelix” the Lego
humanoid, designed to express five of
biological psychologist Paul Ekman’s
six “universal emotions.” Curiously, dis-
gust, the sixth emotion, was deliberate-
ly excluded from Feelix’s repertoire.)
When explicitly defended, all such
claims rest on the premise that human
feelings are themselves nothing but the
product of sophisticated biochemical
mechanics. From the perspective that
physiological processes and responses
to stimuli comprise our emotions, “real”
feeling is as available to robots as to liv-
ing beings. “Every person I meet is . . .
a machine—a big bag of skin full of
biomolecules interacting according to
describable and knowable rules,” says
Rodney Brooks, former director of the
M.I.T. Artificial Intelligence Laboratory,
in his 2002 book
Flesh and Machines:
How Robots Will Change Us
. “We, all
of us, overanthropomorphize humans,
who are after all mere machines.”
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