Rene Magritte’s The Treachery of Images is a painting of a pipe that highlights its own nature, or the fact that it’s a representation of a pipe and not an actual pipe. This kind of meta-reflection inspired some backlash, to which Magritte would respond with “Could you stuff my pipe?”
Magritte’s pipe positions perception as the distance between reality and ourselves, as well as the double edged sword of scaled representations, i.e., maps and other scaled models of topography and other structures. French philosopher Jean Baudrillard takes this one step further, insisting abstraction has moved beyond that of 1:1 mirror representations.
This kind of ‘simulation’ is neither a referential being nor a substance – more simulacrum than reproduction. For Baudrillard, simulacra move beyond being a ‘copy’ of the real, existing in a ‘hyperreal’ truth of their own.
What if we envision electronic health records – particularly the way they represent patients – as hyperreal in their own right?
Baudrillard and Simulacra
Viewing EHRs from a Baudrillardian perspective is perhaps the most imaginative philosophical interpretation on the subject.
First, doing so requires understanding his idea of hyperreality, a concept used in semiotics to describe the inability of consciousness to distinguish reality from a simulation of reality, particularly within technological objects and networks.
In other words, Disney World’s Main Street USA is a hyperreal version of small-town streets in Middle America – behind all the cardboard, where park employees function, the reality is much different than how one perceives it as a tourist.
From this angle, patients in EHRs are hyper realized patients or avatars of their actual selves. The first step to realizing this lies in the operant of the EHR, who ‘lives’ with the patient every time he/she manages information within the system.
There are several positive aspects of this view. Living with the patient means more thought is invested into the patient’s condition(s) and adds another layer to patient engagement.
In this sense, patients should be happy about EHRs as well, seeing as a doctor gets to know his/her patients not only personally but as a conglomeration of symptoms and signs. This makes patients top of mind and possibly leads to greater satisfaction and improved health conditions.
There are several cons to a hyper realized vision of patients in EHRs, however. Hyperreality tricks consciousness, detaching EHR operators from real emotional engagement.
This results in a sort of artificial simulation, and the potential for infinite reproductions of patient profiles that do little in the operator’s mind beyond simply listing information.
This marks the end of our Philosophy of EHR series, but feel free to check out the past three entries below!
Philosophy of EHR: Patient Control and Privacy Debate
Philosophy of EHR: Form and Function
Philosophy of EHR: Network of Actors
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