AAAmanda Askell 是 Anthropic 的哲学家和伦理学家。她这三条连在一起看，其实是在讲一个很实在的问题：AI 时代，我们到底该不该做更多医学扫描？
主流反对意见是「偶然发现会带来不必要的焦虑和过度治疗」。但 Amanda 觉得问题不在扫描本身，而在于你看到异常之后怎么应对——如果没有症状，完全可以先观察。
她进一步指出，我们现在「看到什么就要处理什么」的习惯，是因为以前扫描很少做、只在有明确需要时才做。如果扫描变成常规，临床规范自然也会跟着调整。
最后她讲了自己的故事：慢性疼痛三十多年，直到一次 MRI 才发现一个先天性问题，手术之后就治好了。言下之意很清楚——不做扫描的代价，可能是几十年的无谓受苦。
Amanda 说，「不应该做更多医学扫描，因为偶然发现会造成大量伤害」这个观点让她不太认同。她认为问题不在扫描，而在发现之后的应对方式。如果扫描发现了什么但没有任何症状，完全可以不管它。
她接着回应了一个反驳：「但事实上人们做不到无视。」她的回答是：我们目前「看到就处理」的习惯，是因为直到最近，只有在有明确需要时才会做扫描。如果进入一个更频繁扫描的新范式，处理信息的规范自然会随之调整。
她最后分享了自己的亲身经历：大半辈子都在忍受慢性疼痛，直到一位医生对疼痛部位做了 MRI，发现了一个先天性疾病，手术修复后疼痛消失。她现在忍不住想：自己是不是因为医生担心她「太笨、看到扫描结果会恐慌」，才白白疼了三十多年。
Amanda Askell, philosopher and ethicist at Anthropic, opens with a pointed counterargument to the common view that more medical scans cause net harm through incidental findings.
Her position is that the problem is not the scan itself but the clinical response to unexpected findings. If something shows up but the patient has no symptoms, the rational move is to monitor, not to intervene aggressively.
She follows up with a systems-level observation: our current norm of 'acting on everything we see' was formed in an era when scans were rare and symptom-driven. If scanning becomes routine, clinical norms will adjust to handle incidental findings more sensibly.
Her personal post adds weight: she had chronic pain for 30+ years until an MRI found a congenital condition that surgery fixed. The subtext is clear — the cost of not scanning can be decades of unnecessary suffering.
The view that we shouldn't do more medical scans because incidental findings cause a lot of harm doesn't sit well with me. It seems like the issue it points to isn't the scan but the response to it. If you see something on a scan but have no other symptoms, you could ignore it.
A counter to this is "yes but people *don't* ignore it". But not ignoring things on scans is our norm because, until recently, we only did scans if there was a clear need. If we move to a scan-more-often paradigm, the norms of what we do with that information will surely adjust.
I had chronic pain for most of my life until a doctor did an MRI of the pain source and found a congenital condition that was then fixed with surgery. Now I'm wondering if I had 30+ years of pain because doctors worried I was too stupid to be in the presence of scan results.
