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arXiv · 2512.11814

Totalitarian Technics: The Hidden Cost of AI Scribes in Healthcare

Hugh Brosnahan
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Abstract

Artificial intelligence (AI) scribes, systems that record and summarise patient-clinician interactions, are promoted as solutions to administrative overload. This paper argues that their significance lies not in efficiency gains but in how they reshape medical attention itself. Offering a conceptual analysis, it situates AI scribes within a broader philosophical lineage concerned with the externalisation of human thought and skill. Drawing on Iain McGilchrist's hemisphere theory and Lewis Mumford's philosophy of technics, the paper examines how technology embodies and amplifies a particular mode of attention. AI scribes, it contends, exemplify the dominance of a left-hemispheric, calculative mindset that privileges the measurable and procedural over the intuitive and relational. As this mode of attention becomes further embedded in medical practice, it risks narrowing the field of care, eroding clinical expertise, and reducing physicians to operators within an increasingly mechanised system.

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Hugh Brosnahan. 2025-11-26. Totalitarian Technics: The Hidden Cost of AI Scribes in Healthcare. https://doi.org/10.1007/s11019-025-10312-4

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