Many people have been intrigued by a TV advert for Persona Synthetics inviting them to experience ‘the new generation synthetic human’. This was actually a clever marketing ploy for Channel 4/AMC series Humans. The programme deals with themes that are familiar to any SciFi fan by asking us to consider whether the monsters in our society are cyborgs or in fact humans? It also deals with aspects of digital healthcare that pose serious questions about the future of personalised health care.
Humans is a remake of popular Swedish series Äkta människor or ‘Real Humans’. Creator Lars Lundstrom was inspired by an imagined world where there would be “robot servants that you could also have sex with”. “I was fascinated by what would that do to human relations,” he said – “would it mess them up or help them?”. The story begins with ‘The Hawkins’ family going to purchase a ‘Synth’(synthetic) to help in their chaotic middle-class family home. They select an unsettlingly human-like female cyborg and name her ‘Anita’.
Many sub-plots and events in the unfolding story explore human fears of relative inadequacy and the acceptability/ethics of personal and emotional relationships between people and cyborgs. Laura, juggling her career and parenting responsibilties worries that Anita is more ‘motherly’ than her. The males in the family swiftly become sexually involved.
However two intertwining storylines that relate to healthcare are particularly interesting. The first involves a detective investigating ‘rogue’ synth attacks on humans. He is tormented by jealousy of the young male synth ‘physio’ who has been sent by the insurance company to help his girlfriend with mobility problems. She often rejects her boyfriend explaining simply ‘He (the synth) just knows what I need’.
The other more compelling story arc involves retired scientist ‘Dr George Millican’ (William Hurt) and ‘NHS synths’ who some commentators have described as ‘prescription terminators’ – a cultural reference to ‘The Terminator’ franchise also featuring ‘cyborgs’. The doctor has a paternal relationship with obsolete synth Odi, a young man who has stored all of his memories lost after a stroke. It’s a comfortable relationship, but one which is disrupted by the arrival of a new model synth, ‘Vera’. The new synth (Rebecca Front) is reminiscent in character of Nurse Ratched, symbolising unchecked and unaccountable medical authority. Where Odi is sweet and gentle, Vera is officious and unnerving. Her phrase ‘I’m here to take care of you’ is chilling rather than reassuring.
This storyline in particular embodies the dystopian view of future digital healthcare as the cyborg subjects the human to a highly regulated regime of medication, exercise and diet regardless of his personal wishes. When the synth links the presence of ‘mould on the skirting board’ with a reoccurrence of George’s bronchitis, we find out that “the health service contract you have agreed to allows me to access your medical records”.
George is ‘fed, medicated, made to exercise. Everything a spaniel might expect. Under such tight controls he’s practically a pet to state healthcare, kept alive not because he’s adorable but because on some Trust’s balance sheet somewhere his survival will be a data point that proves the NHS made a sound investment by purchasing half a million Synths to act as prescription Terminators’.
In this fictional world the patient has little autonomy as any non -compliance or variation in medication is reported directly to the GP and the local health authority is regarded as the primary user of the synth (and thus can give various permissions that outweigh the wishes of the patient).
In the real world for many, the ‘quantified patient’ opens up potentially endless opportunities. Smart sensors can monitor heartbeats, sleep and steps taken. They allow patients to monitor their activity and health care providers to judge their achievements. Wearable fitness technology is already being used to incentivise consumers. Oscar, a new health insurance company in New York is issuing customers with ‘Misfit’ fitness trackers
The potential of smart wearable technology to track patients has been hailed as revolutionary and is assumed to bring great benefits.
Driven by the quantified self, emerging patient driven healthcare models are contributing to shaping a positive future for healthcare with the patient at the epicenter. Rather than a physician reacting to an event that occurred to a patient, the SWS distributes responsibility to the patients which can lead to more personalized medicine.
Developments in individualised diagnosis and treatment generate fresh societal challenges for regulation and pose new burdens on the individual.
The idea of the ‘quantified self’ and the myriad social meanings of ‘self- tracking’ are of considerable interest to Sociologists because of their complexity:
Self-tracking is not simply about quantified (or quantifiable) information. Many self-trackers record non-quantifiable data as part of their practice, including journaling accounts of their daily activities, emotional states and relationships, collecting audio data or visual images and producing visualisations that centre on their aesthetic or explanatory properties rather than their representation of numbers.
Trackable technology is becoming more ubiquitous but where might it lead us? Humans is an entertaining and fairly gripping series but it also raises issues that should concern us all regarding the future of healthcare (privacy, ethics, surveillance and the role of commercial imperatives versus patient autonomy). It may be fictional television but the future it depicts of personalised healthcare where the state ‘knows best’ and the patient is powerless and at the mercy of insurance companies is perhaps more possible than we might like to believe.
Humans airs on Channel 4 Sundays at 9pm