Robots, drones and AI, oh my: Navigating the new frontier of military medicine 

In the rapidly evolving landscape of military medicine, the integration of autonomous drones and robotic technology marks a turning point, heralding a transformative era in battlefield care.  

This shift, exemplified by the development of advanced unmanned aerial vehicles (UAVs) like the DP-14 Hawk, alongside the increasing use of robotic surgery on the battlefield, brings the promise of unparalleled advancements in medical response. However, responsibly realizing the full potential of these technologies demands not only a commitment to technological innovation but a vigilant approach to addressing ethical challenges and cybersecurity threats, as well as maintaining the indispensable human element in medical decision-making. 

From the first use of uncrewed balloons in warfare in 1849 to the contemporary applications of UAVs in diverse fields like precision farming, environmental monitoring, and epidemiological surveillance, the journey of drone technology has been marked by continuous innovation and adaptation. In military medicine, the U.S. Army’s exploration of drones for roles beyond traditional ground response teams reflects a recognition of their untapped potential. These advanced systems, capable of the rapid and reliable transportation of medical supplies as well as performing remote medical assessments, are reshaping the way medical aid is delivered to and within conflict zones. 

The introduction of robotic technology into military medicine adds another layer of complexity and opportunity. Robots, increasingly utilized in surgical procedures for their precision and reliability, present new possibilities for medical care in environments where traditional human-operated surgeries might be impractical or hazardous.  

An example of such an environment is remote combat zones. Here, robotic surgery systems, such as those developed with funding from DARPA, could be compact enough to travel with troops into these zones in the back of an armored vehicle. This technology allows doctors to perform surgery on the battlefield without endangering themselves, addressing the critical need for immediate medical intervention in hostile and isolated conditions. 

However, the deployment of these autonomous systems in military operations is not without challenges. The risk of automation and algorithmic bias, where there’s a tendency to over-rely on automated systems at the expense of human judgment, is a significant concern.  

Algorithmic bias in this context refers to the limitations and potential errors in the programming of automated systems that can lead to unintended decisions or actions. It occurs when these systems, based on their algorithms, make decisions that might not adequately account for all variables or scenarios in real-world situations. The tragic incident involving the Patriot missile system in 2003 during the U.S.-led invasion of Iraq highlights this risk. The system, operating autonomously, misidentified a UK Tornado fighter jet as an enemy missile, resulting in the deaths of two crew members due to friendly fire.  

This bias — that is, the tendency to depend too much on the programmed decision-making of autonomous systems — can be particularly problematic in such environments, where the consequences of errors are magnified. While current military strategy primarily uses autonomous systems to complement and enhance human capabilities, especially in tasks where human presence is risky or inefficient, it is crucial to maintain vigilant human oversight. This approach ensures that automated systems serve as a force multiplier rather than a substitute for human decision-making in complex military operations. 

Furthermore, the use of drones and robotic systems in evacuating and treating injured soldiers presents both strategic advantages and potential risks. These systems’ ability to reduce the risk associated with sending manned medical assets into combat zones, and their capacity for long-duration operations, offer clear benefits. However, challenges such as the threat of cyberattacks, adversarial AI, potential airspace overcrowding, and resistance to replacing human medics with machines must be carefully navigated. 

The strategic integration of drones and robotic technology in U.S. Army medical operations signals a paradigm shift in how medical assistance is rendered on the battlefield. While this technology offers reliability, consistency and a reduction of human error, it also poses new ethical and security challenges that must be addressed.  

The future of military medicine lies in harnessing these technological advancements while maintaining the ethical integrity and human touch essential to medical care. As we navigate this new frontier, a balanced approach that embraces innovation and upholds our responsibilities to security, ethics, and humanity is crucial. 

Joshua Steier is a technical analyst at the nonprofit, nonpartisan RAND Corporation.