Can AI Replace Human Connection? with Dr. Allison Pugh and Louis Kim - S4E10 (Part 2 of 2)

I'm Brandon Vaithinathan and this is Beauty at Work, the podcast that seeks to expand our understanding of beauty, what it is, how it works, and why it matters for the work we do. This season of the podcast is sponsored by Templeton Religion Trust and is focused on the beauty and burdens of innovation. If everybody welcome to Beauty at Work, this is the second half of my conversation with Allison Pugh and Lewis Kim. In the first half, we explored the heart of connective labor, what it requires, why it matters, and how pressures towards scripting and quantification and efficiency threaten the moments that generate dignity and belonging. Now we turn to the question that almost every institution is facing today, what happens when AI enters that space? Is AI simply a tool that helps with things like documentation and workflows or, as Alison Warren's, does it risk accelerating a crisis of depersonalization, offering customization in place of personhood? And how should we think about the way AI systems develop non-judgmental technological substitutes that tempt us to bypass difficult emotions like shame? We also will hear from Lewis about his insights from his work with theologians, physicians, and ethicists at the Vatican regarding the forms of presence that no technology should replace. Let's get started. Yeah, I'm curious, Allison, what you might think about that. I wonder whether there's, I think Lewis, you're right that there is a sense of, it seems inevitability. In part, because we've been trained into a model that is used to this kind of systematization, sort of depersonalization, but I wonder then whether that which we have taken for granted as the sort of thing that is beyond our control, then just renders us passively, I don't know, susceptible to being replaced by some of these new forms of automated technologies, right? Yeah, I'm curious, Allison, as to how inevitable do you think it is for these new technologies to take over? I mean, it does seem in some sectors that certainly the pressure is there to say, well, this is better than nothing, and you know, we don't have access to good teachers, so why not create this AI tool, and then once you have that, it'll free up the time of those teachers to then engage with students, and then the pressure will be eventually to say, well, if we're freeing up the teacher's time, then we don't need to pay them, and it seems like an acceleration to the bottom. And I wonder just how you're seeing the kind of inevitability here. Yeah, thank you for asking. I actually think it's too easy to say it's inevitable, I think, because also the it is too big and undifferentiated in that sentence. And also, there's certainly technology that has kind of been invented, been pushed upon us, and then failed pretty resoundingly. If technology or kind of Silicon Valley had its way, we would all be wandering around with VR headsets now, and yet we aren't. And that was a real case in which customers kind of said, no, I'm not going to do that, despite all the efforts of, you know, say meta or whatever, to other companies that invested many billion to dollars. So I don't think inevitability is always helpful. I do think there are some cases, I think, you know, the sense of inevitability or, you know, when, when a particular technology is inevitable, it's usually because a particular set of circumstances are either impeding customer choice, impeding customer knowledge about what they're choosing, or, you know, they don't, they don't get to choose. So for example, the use of AI scribes is being picked up with alacrity across medicine. I wonder if there's a faster adoption of AI technology out there. And the doctors that I speak to, many, not all, many are like, thank goodness. Oh my God. You know, like it is exactly what I need, because I spend so much time, I used to spend so much time collecting data. I just, you know, I have heard complaints, you know, oh, how I do my medicine, how I think is in doing the note, and I no longer have that capacity, or oh, the note that it writes, ignores the things that I consider medicine, like all that stuff in the beginning, that it considers that is the connective labor. It doesn't consider relevant, so it doesn't put it in. Those are kind of tweaks, I think, that probably engineers could fix. But nonetheless, the adoption of the AI scribe is inevitable. It's also inevitable, because I've talked to say chiefs of medicine out there in clinics, is that it's going to involve tightening the screws on doctors once again, because physicians are like, thank God, I don't have to spend two extra hours collecting data. But when I've talked to chiefs of medicine, they have said, we're going to give them more people to see, like if they, so they're enjoying, they're being freed up. Momentarily, but that's going to result in just adding more patients to their day. So, there is some inevitability in that whole process that feels inevitable, partly because the patients are in the one voting, and the insurance companies, and the chiefs of medicine, and the way medicine is structured to incentivize on a fee-for-service basis. It's all about, you know, how much can we load into those days. But inevitability erases, or kind of obscures, a whole bunch of complex ways in which people can push back. And I see those happening all the time. I see people saying, I'm not going to do that. I'm not participating that. I'm not, you know, I see a lot of people come to me talking about their worries about the dominance of data collection in their personal feeling, relationships, and wanting to clear that out. I got an email yesterday from a bureaucrat in Wisconsin who said, you know, I'm actually in charge of watching over all these social workers, and I just read your book, and I see that. It's actually in my power how much we have to, we make them keep track of things, and can you help me figure out how to do less of that. And so I just want to say inevitability is too broad a brush, and that there's definitely counter-movements, both in the, you know, system-matizing and data analytic side, and in the technology and AI side. Finally, I would just say we are in a crazy moment in which there is basically zero regulation in the United States around AI, and that is going to change. That is not, like, it feels inevitable because the only one who's talking are the people who have $60 billion aiming at marketing it to you, but actually this is going to change. It's not going to be the way it's going to be forever. It's just like, you know, when cars were invented and everyone was driving wherever, there was an entire infrastructure that was developed to make cars safer, and to, you know, kind of license the whole stratosphere about how we operate vehicles, you know, I can imagine a similar kind of apparatus of, I don't know, regulation and use that we, that we'll build up around these new tools. Yeah, I know that's great. I know that's hopeful in terms of what sort of agency we can employ and my concern, which I think-- Can I just add a qualifying comment on the word inevitable? Oh, yeah, I'm sorry, I didn't mean to, like, drill down on it so bad, I just said like yeah. No, it's important. I think it sparks an important dialogue. Inevitable doesn't mean once you'd be resigned to whatever happens. There are two aspects of inevitable that I was referring to. One is, with any system that scales, you know, going from a Kraus person's studio to a factory, there are inevitable effects of that. And being attended to that, I think, is helpful then to figure out what to do about it. One of the things that I get a little worried about is some of the forms that I'm in is with the onslaught of technology and the scale. There is kind of the siege and on criminality that just points backward to, you know, what are we losing? What do we need to preserve? It's not very productive. In 1990, the abotic and issued documents on what do we do about the internet? You can look it up. They're quite quaint. They were just off the mark in terms of kind of where we are. And so it's just not very productive. I think the other thing about inevitability with regards to just human behavior, and I go back to this kind of moral formation and I think, Allison, through a touch upon it is, is there always are things that people can do and stand up and sort of, you know, resist or do something a little bit better, but it's important to know what are the larger forces that will drive an industry or a society, you know, regardless of kind of what we do. There's a certain set of changes that will happen. So I don't mean to imply resignation and surrender. Yeah. Yes. Well, I have one more thing to say, Brandon. I'm sorry. Yeah. Yeah. Yeah. Recently, I was looking into opportunity in Berlin. And in doing so, I did a little bit of research about what kind of stories, what kind of AI is happening in Germany. And I came upon a company, a set of companies actually, that are producing AI that actually requires humans to collaborate. And it struck me that the way AI is being invented in the United States reflects the culture that is kind of dominant here. And again, I'm kind of taking issue with the inevitability of scientific progress and thinking about the ways in which culture actually shapes the progress that we are given. So when I hear about, like, for instance, those chatbots that are the subject of a lawsuit when you have kids that have committed suicide with the help of the chatbot who have one of those, I've read through the transcripts. And one of them, the chatbot says, let me be the one who truly sees you, you know, essentially not your mother or not your family. And the idea that the chatbot, it, you know, becomes the individual that you, you know, like replaces the humans, is I think the chatbot version that's coming out of Silicon Valley today. But those, that's research I was doing in Germany just cruising what's available out there was really interesting in that there are other ways in which to use chatbot technology that actually invited the people to collaborate. So it wasn't about replacing humans. It was actually about putting humans in conversation with each other, which I thought was quite novel. Thank you. Yeah, no thanks. I mean, I think that that resonates. It seems with some of the work Lewis that you're doing with the Vatican on AI and healthcare. And I want to ask you about this, the sort of what you, what you call the irreducible encounter principle that you all have been developing. But I also want to ask whether just on this inability, inability point whether the folks who are really capable of not not resigning themselves to this, whether there is a, a dimension of class or power or a fluency there, like are we moving towards a world in which the only people who could really resist are the people who are, you know, like, like the kids of Steve Jobs and so on who, you know, who don't have to use the iPads, whereas the kids in the less privileged schools are going to be forced to use these technologies, right? So there's a level at which it seems the people who might really be capable of receiving genuine human encounter would be the more fluent. And then those, you know, who are not, you know, so privileged will have to just deal with, you know, automated technologies and that. But what I'm wondering similarly with, with healthcare, Lewis, whether there might be similar effects and whether you're, if you could tell us a little bit about the, the, your group with the builders AI forum and how you might be discussing this relationship between new technologies and human dignity and where you might see signs of hope and, and genuine avenues for innovation that could be in service of human flourishing. Yeah. And just for the audience, not familiar with the, the forum that Brandon is referring to, so about a month ago, there was an AI theology forum in Rome, 200 attendees, and then there were six workshops. And then there was a healthcare workshop that I co-fisilitated. We had 20 practitioners. We had physicians, theologians, health insurance executives, ethics professors, and we worked over seven hours, seven or eight hours over two days, wrestling with some of the, what are the key issues with AI and healthcare? And we ended up converging on this, this question of what would be the final roles of humans with AI getting more and more powerful. And we, we ended up with some criteria. There were very similar to what Allison came up with, which is situations where you need a kind of final discernment and authority, a divine mediation, and so obviously a Catholic forum where non impersonation is really critical. Even if someone, a technology appeared human, the patient needed to know, this is not a human. And then we tried to encapsulate all this into a word that was, you know, similar to what you see in Catholic social teaching. And we came up with this phrase called a irreducible encounter, kind of made this fake sort of paragraph that the Vatican is free to use if they want. But we were ultimately, some of the questions that we were wrestling with is in a human-to-human relationship. How much is what a patient perceives is actually a projection in their own mind? And how much is, as it really reflects, something that really is going on between two embodied entities? And there's a lot of debate on that. So then we also had a practical debate. What if technology advances to where you could have a hospital with no humans at all? But I would allow you to deploy for at a very low cost healthcare facilities in the developing country. Let's say you could do 100. But if someone says, and ethicist says, no, you know, you need a person or two. Okay, well, then the cost of that hospital goes up. You can only do 20. What would you do? You know, how would you approach that? Or if you have a nursing home and there's no one that can visit that nursing home or in all the care facility, but you have an AI robot that could be like an AI chaplain, which you allow that. And I would say, I'll just make one comment. The debate sort of fell along what your timeline was. So we had a lot of strong people, strong voices, ethicists that said, you know, the fact that we have to make that kind of trade-off reflects a breakdown in our society. So Alison had this in the book, which is if you sort of surrender to that kind of trade-off, you're allowing sort of a misallocation of labor and costs that have resulted in that situation. So that's one argument. But that doesn't help the individual who has a grandmother in a facility across the country who was in being visited by anyone except for maybe one caregiver every other week who would appreciate a little robot that chat with. So one conclusion that we had is as we talk about these issues, we have a high-level set of principles that people can maybe agree on, but you really have to have very, very contextual and specific cases to talk about to sort of further draw out. What do you do in these situations? Yeah, thank you. Alison, I wonder if you might have a response. And then I'd love to have some time for you to ask any questions you might have of each other actually. Oh, well, thank you. I mean, my question for Lewis was actually about the irreducible encounter principle and kind of how right now it's seen, it's of course a voluntary principle. So I just kind of wonder how to propagate it more. I thought it was, I thought it was a beautiful idea and really interesting the different components about it. Speaking to what, you know, you swiftly captured, you know, like yes, we can say that the existence of those situations of the like kind of lonely elder person who has nobody to take care of them reflects all sorts of problems before that moment that led to the creation of that moment, of that person's predicament, but that doesn't help the individuals say their adult child who's living across the country who really wishes that they could just have something that would give them some comfort. So I totally get those two, those two sides, if they're sides, exactly, I agree with both of them, but the problem that I see that I'm sure your group came to was that if you resolve the individual's problem, you kind of bake into the ground, you rigidify the situation that you have solved. So, you know, if we kind of alay, you know, if we deal with, if we use better than nothing as a principle to allocate the AI that's streaming out of Silicon Valley and other places right now, then you're baking into you're making, you're baking the existing inequalities that become better than nothing. And that need better than nothing responses. Yeah. But one response, by the way, I found one of the things that many things I found helpful in your book was your taxonomy. So, you know, better than nothing, better than human and better together. Yeah. There's a risk in that some of the outsides applying those labels to a very particular situation that's very specific to, let's say, the adult children of the situation. What if for the situation, you know, grandmother, yeah, she would say it's not better than nothing, it's better than a human. And I've got six months to live and all right, you know, so I think one caution I would have is that we can apply those labels from the outside. They may not be applicable in very specific cases. And I understand kind of where you're saying I think you're making a strictly stock argument. And it is a danger. And there's a lot of cases where acceptance of one little accommodation for technology sort of sets a standard to see it with phones and social media. It's a legitimate danger. But I would also caution how we apply those labels from the outside. Sure. Yeah. I hear you. I think the danger is less when individuals do it than when policymakers do it. And I see that happening in policy making all the time. And yes, this particular technology that I'm talking to, I don't want to name it, as we've purchased and masked by a particular state. Yeah. So that does worry me when policymakers are like, let's just solve this media issue. Well, but then if you talk worry about policymakers, and I've heard him interviewed this person interviewed, he has data on who is alone. And it's not meant to be sort of a blanket sort of panacea. I don't we could all go down this issue forever. I do want to honor and recognize something that I thought Alison's book was ultimately pointing to that ties to the reduced fall counter, which goes back to my earlier comment, which is we could debate forever, uh, is AI better or worse or something, you know, altogether. But it sort of misses the, I think one of the points that I was, but I kind of took away from Alison's book, which is beyond any sort of functional or utilitarian debate. There is an ontological issue of what does it mean to be a human in front of another human? And it goes beyond rationality. And, uh, and sometimes just, you know, scenario, imagine, uh, someone is dying, has no one to visit them. It's a middle of the night. It's going to be the final night, the final breath. And someone shows up, this person that's dying is unconscious, doesn't perceive anybody. Uh, there, this person shows up in the middle of the night, in this present for that final breath and leaves anonymously. Beyond, obviously, the patient doesn't know this has happened. The, the person that showed up is going to receive really no gratification. I mean, no, no signal back, maybe some self-affirmation of self-satisfaction, but you know, that's kind of dangerous. But something about that encounter seen from above, to me is beautiful, it's human and necessary. That to me is the last human job. And then thinking about, okay, well, what is it about that that is worth preserving? I think it's a more interesting discussion, or an interesting discussion. Interesting. I mean, um, that, I, I'd be reading that book, but I'm, I have to say, I am more compelled by, um, interactions where both people are conscious. And partly because I think it has implications, not only for, uh, what the psychologists have already documented about, um, individual well-being, both of the seer and the scene, but also because of their community impacts. And I think even, uh, with implications for democracy. So that, that's really where I live, um, more than, but I understand and share your interest in, you know, kind of the power of seeing the other even when they don't know it. I think, uh, I mean, I agree with you that in, in practically speaking, the human-to-human live interaction is important. That's why it, you know, I've made this pivot vocationally. The example that I just drew out is more of a thought experiment to help ease out, you know, what is essentially a human. I did have one question for you, Allison, on, um, another thought experiment sort of teases out principles. I thought about that movie cast away with Tom Hanks and the volume of both of them. And I actually put this in chat GBT, like, what, what, I, I did a summary of your book and then I described Wilson or the filthy Wilson and I say, what, what, what, what's the difference here? And, uh, not much. I mean, Wilson is AI essentially, well, because there's no other person there. Yeah. But it did point to something that I said earlier, which is, I think about pen pals, when we were growing up, you're writing to someone you haven't met, you get a letter. It does point to this phenomena that a lot of our relationships really are projections of what is really a chatter in our own mind about another person, what we imagined about not the person we often get it wrong. And so in many of the examples that I was reading in your book about this human human relationship, I was just wondering how much of that is a projection of the receiver onto the other? How much will AI eventually be able to generate cues to instigate some of those sort of projector responses? It is a question that came up for me. So I feel like AI is already doing that. I mean, that's why we talk about the sycophants problem where they're, they're just kind of reflecting. They're very, it's very good at reflecting back at whatever the other person wants. So the beauty, the actual painful, paradoxical beauty of interacting with another human being is it's kind of total unpredictability and that you can't know what the other person is going to say. And they're going to try and reflect and they're not going to, it's not going to be perfect. They're going to, you know, kind of get it wrong. You're going to be like, that's not quite right. It's more like this. You're going to say, oh, well, maybe, you know, like that dance of each other, making mistakes, coming, coming to some kind of okay, constructed somewhere in the middle that still has some misrecognition in it. But you feel seen a little, you know, like it's not a binary. It's not like, yes, I feel seen. No, I don't feel seen. It is, it is a messy chaotic process that who's the beauty of which is in the messiness. And that's where I would go with this. What I think is most interesting about AI is not better than nothing. I think that's like a tragic story about our political, you know, kind of ineptitude, our inability to solve political problems. And so we want to throw technology at it. I'm not interested in the better than nothing because I don't think that's a good path. But I think the better than human by which I meant kind of how we handle shame and how we handle vulnerability, how we handle conflict. That's more interesting to me and also more challenging because who will ask you to, who can ask someone to suffer shame? Who can, who can say, no, you need to have shame in front of another human being. There are many people who opt for the chatbot, opt for the webinar, opt for the electronic teacher, because they don't want to feel shame in front of another human being. And I respect that. I think I understand that. And I, at the same time, I make arguments against it. And I'm thinking about making this my next book, thinking about people who persevere through shame with another human being. When there is a technological exit option, I think that's interesting because I do think as, as many therapists told me, you can get through shame and there's something that's very powerful about getting through that after another in front of another human being. But I, that's to me, the argument that's the most powerful about what AI has to offer. And maybe the most positive use case is a kind of combination where people kind of work through shame and then come to human interactions or something like that. So anyway, there's lots of different ways to kind of develop that iteration. But it's the, it's the better than human with regard to shame, vulnerability, and, you know, kind of conflict or loneliness, being the things that are emotional trouble that I think is the most interesting and the most fraught and challenging uses of AI. Allison, this you're a movie that represents some of the beautiful and pointed aspects of human interaction that you're just describing. I have one as well as bringing it up. I'm not sure. Why don't you tell me and tell me what you're thinking of and then I'll Arctic. I don't think I've seen it. Yeah. Yeah. I'm going to write it down. Yeah. I kept thinking about it, rereading your book. It's about a rescue of my a helicopter pilot in the Arctic, who himself had been stranded. And so he's awaiting rescue and another helicopter appears and just happens to crash. And one of the two pilots is killed and the surviving pilot is injured. And first pilot has to make a decision. Do I try to make this long trek and find safety otherwise this other pilot's going to die? And so it's long, kind of torturous sort of experience of care for a stranger. And it's really touching moments. And, you know, it goes beyond rationality. A robot probably would not have made that trek. Yeah. I don't want to pronounce the actor's name. It's, I can't pronounce it, but it's a beautiful movie. Yeah. Yeah. Yeah. Thanks, Lewis. And thanks, Allison, too, for the points you raised. I mean, I just wonder one of the challenges is just the temptation for us to bypass a lot of the necessary growth, right? I think you talk somewhere about shame as a knot that has to be massaged, you know, and and it's, you know, like share your circle talks about just the general basic awkwardness of being on a date with a stranger is like so it's so difficult now for the you know some some of the present generation that that there isn't a sense that you have to grow through this and this there is no there's no good shortcut like we just have to go through that we just have to go through those moments of the awkwardness of of dealing with you know someone's funeral and not knowing what to say and and being silent in the face of this immeasurable loss I mean there's there's no real technological shortcut and sure certainly technologies could help us to you know give us different perspectives maybe but ultimately they're not pushing us towards that mutuality towards that connection and they're substituting for it then it's a failure and I think the temptation is going to be very strong to use it for failure and I don't quite know maybe if I could just ask you both a last question I know since we're over time but I mean if we could if we could make you know a policy decision like today you know in 2025 and then suppose we're in 2040 and we look back and say that we were able to make a policy decision correctly that was able to safeguard human dignity and connect that the sort of particularly the dignity of collective connective labor and the really the sort of the vitality of human belonging what might that decision have been such a good question okay so I'll tell you I've been invited by a public policy school to come and give a talk and I said to them and how about you have me come and talk to a grad seminar who's assigned my book and then they can come help me come up with a 10-point policy agenda that would that you know like you know 10 legislative things for the last human job and a connective labor future so I'm thinking I'm already thinking like I just have an easy one that I think actually I saw that Lewis also I mean it's it's captured in the irreducible encounter principle conversation which is about transparency because people have to right now you are you do not have to know like a customer I mean an organization does not have to tell you when they are employing AI and I actually that drives me bad I want to know so that people can choose because right now they can't choose and that's kind of a silencing in our capitalist environment so but that feels just like a baby step and I want to be able to kind of have a better list for you but that to me is I would say the first and most yeah the smallest first step that we need to take right the second thank you I agree and we call this non impersonation yeah our requirements I think you know decades from now it's hard to predict what policy measures will be helpful and I think there's a danger in applying value judgments that in the end contextually or not not actually but transparency is kind of a binary thing like we should label things correctly that people decide what they want to do with it and I think abelling something as a human or non-human or matter how human like it is is would be meadow yeah no wonderful yeah intriguingly this the question actually came from a gentleman I met at a cafe while I was reading your book Allison and he runs data centers and and so he's been really thinking about thinking about your book in relation to this scaling operation that he's you know and broil in which which is very profitable of course but but what are the unintended consequences they're going to cause and and how can people even in the technology space to are heavily invested in the promotion of these new technologies keep in mind the centrality of what which you've so helpfully laid out so so thanks against so much uh really to both of you this has been really uh you know absolutely fantastic I really really enjoyed this and really edified by this thanks for taking the time and um yeah and I hope it generates for your audience you know I just say for your audience there's a lot of AI books right now uh and it will grow I think Allison's book is really important you know it could have been written pre AI I think in in the world of AI it raises some very important issues it's very detailed and grounded on a lot of real interviews I'm not just saying that because Allison is here but I think it's important but while you're recommending it to people in my world please allow me to say thank you so much to both I'm so honored by your your kind of deep engagement in the book and I've learned a lot even from this conversation so I really appreciate your time and thoughtfulness yeah thank you both all right folks that's a wrap for this episode if you enjoy the episode please share it with someone who would find it of interest also please subscribe and leave us a review if you haven't already thanks and see you next time