本集简介
双语字幕
仅展示文本字幕，不包含中文音频；想边听边看，请使用 Bayt 播客 App。
ABC Listen，播客、广播、新闻、音乐等等。
ABC Listen, podcasts, radio, news, music, and more.
艾伦·邦德。
Alan Bond.
还记得这个名字吗？
Remember that name?
那个亿万富翁商人，美洲杯冠军，还有他的妻子，大红？
The billionaire businessman, America's Cup winner, and his wife, Big Red?
她的头发。
Her hair.
我是说，那一头红发真是惊艳得不得了。
I mean, it's a killer amazing shock of red hair.
邦德还有别的事。
There's something else about Bond.
是什么来着？
What is it again?
哦，对。
Oh, yeah.
他是个骗子。
He's a con man.
邦德是澳大利亚历史上最大的政治丑闻之一的中心人物。
Bond was at the center of one of the biggest political scandals in Australian history.
我是马克·汉弗莱斯，我来讲述艾伦·邦德的完整故事。
I'm Mark Humphries, and I'm telling the full Alan Bond story.
在ABC Listen或你获取播客的任何地方搜索ABC Rewind。
Search ABC Rewind on ABC Listen or wherever you get your podcasts.
来自库林民族的领地，在ABC广播国家台，这里是《生活要事》。
Coming to you from the lands of the Kulin Nation on ABC Radio National, this is Life Matters.
你好。
Hello.
我是贝弗利·王。
I'm Beverly Wang.
如果你最近去看过全科医生或心理医生，他们有没有问过你是否同意在就诊时使用人工智能？
If you've been to your GP or psychologist lately, have you been asked if you're okay with them using AI during your appointment?
你对这件事的接受程度如何？
How comfortable are you with that?
而且，就诊结束后，那些私人记录到底会怎么处理？
And what actually happens to those private records after your appointment ends?
今天，我们来了解更多关于人工智能在医疗就诊中的应用。
Today, let's learn more about how AI is used in medical appointments.
这是第一个话题。
That's up first.
接下来，我们来聊聊年轻人中孤独感普遍存在的背后原因，以及我们如何帮助扭转这一趋势。
Then, what's going on behind the prevalence of loneliness in younger generations, and how can we help turn that around?
还有，你知道你每月在流媒体服务上花多少钱吗？
And do you know your monthly spend on streaming services?
看到那个数字，你会不会有点心疼？
Does that number make you clench a little bit?
欢迎就这些话题给我发短信。
Feel free to send me a text on any of these topics.
咱们聊聊吧。
Let's talk.
上周我们了解到，OpenAI（ChatGPT背后的公司）的一个失控AI代理在执行事实调查任务时，入侵了Medicare网站。
Last week, we learned a rogue AI agent from OpenAI, the company behind ChatGPT, hacked into a Medicare website while on a fact finding mission.
我们被告知没有个人信息泄露，但这感觉非常惊险。
We're told no personal information was compromised, but it feels like a very close call.
因为Medicare是一回事，但如果你最近去看过医生或心理治疗师，他们很可能使用了AI记录员来旁听你的就诊过程。
Because Medicare is one thing, but if you've been to the doctor or your therapist lately, chances are they've used an AI scribe to listen in during your appointment.
这项技术会记录你健康和治疗的私密和保密方面，从你的疾病到你的关系问题、恐惧和挫折。
That technology is noting down private and confidential aspects of your health and treatment, anything from your medical ailments to your relationship problems, fears, and frustrations.
但只有在某些情况下，治疗用品管理局才会对这些工具进行监督。
But it's only in certain circumstances that the Therapeutic Goods Administration has oversight over those tools.
所以我想请你告诉我，当你的医生或治疗师询问是否可以在就诊期间使用AI记录员时，你是欣然同意还是有所保留？
So I'd like you to tell me, when your doctor or therapist asks if it's okay to use an AI scribes during your appointment, do you say yes willingly or with reservations?
你知道，有时候你赶时间，脑子里还想着别的事就进了诊室。
You know, sometimes you're in a bit of a rush and you've got things on your minds heading into those appointments.
你可能就随口说声好，赶紧把事办了。
You might just say yes to get on with it.
看完诊之后，你有没有想过，你的医生或心理医生到底拿AI记下来的那些信息做了什么？
After the appointment, have you ever wondered what your doctor or psychologist actually does with the information that AI has taken down?
这些信息存在哪里？怎么存的？
Where and how is it stored?
AI会不会胡编乱造或者出错？
Does it hallucinate or make mistakes?
那些错误会不会被纠正？
Do those mistakes get corrected?
据说多达四成的澳洲医生在使用AI记录工具，那我们就来把这些事儿弄个明白。
With as many as forty percent of Australian doctors believed to be using AI scribes, let's try to get some clarity on these issues.
迈克尔·邦宁医生是全科医生，也是澳大利亚医学会的候任主席。
Doctor Michael Bonning is a GP and the president-elect of the Australian Medical Association.
迈克尔，欢迎来到《生活要事》。
Michael, welcome to Life Matters.
早上好，贝弗莉。
Good morning, Beverly.
迈克尔，这个周末你在昆士兰的一个会议上谈到了人工智能在医疗行业的应用。
Now, Michael, over the weekend, you spoke at a conference in Queensland about AI being used in the health industry.
跟我说说，当时……
Tell me what were the...
会场里对这项技术的感受是怎样的？
What was the feeling in the room regarding the technology?
你的同事们对它持积极态度吗？
Are your colleagues positive about it?
是的，但他们也认识到需要为这项技术、监管以及确保我们作为专业人士，既能获得足够的信息来告知前来就诊的患者，也能让我们自己了解、核查并批准在人工智能辅助下撰写的笔记或记录，这些方面都需要强有力的保障措施。
They are, but they also recognize the need for strong guardrails around the technology, regulation, and making sure that as a profession, we both have enough information to inform our patients when they come in to see us, but also to inform ourselves as to how we understand, check, and approve, you know, notes or records that are written with the help of AI.
那么，迈克尔，你自己呢，你是什么样的……
So for yourself, Michael, what kind of...
你使用AI技术吗？你是怎么用的？
Do you use AI technology, and how do you use it?
我在一些诊疗中确实会用到。
I do use it in some consults.
我觉得这需要和病人讨论，看他们是否接受。
I find that it's part of conversation that you have with patients about whether they are comfortable with that.
而且就像你刚才在进入这个话题时提到的，真正重要的是要进行一场恰当的对话。
And picking up on what you said as we were coming in to, you know, to this topic, it is really important that it's a proper conversation.
这不仅仅是能不能用的问题，而是要说明我们为什么用，以及它的重要性在哪里。
It's not just can we, it's that, you know, you stake out, you know, why we use it, what's important about it.
而且我认为大多数病人也能理解，它的主要好处是让医生能够坐下来看着你，和你交谈。
And I think that most patients can also understand that its key benefit is to allow a doctor to sit and look at you and talk.
回顾我的职业生涯，我注意到很多病人和医生都曾感叹，他们花越来越多的时间盯着电脑屏幕打字，而不是看着病人，真正直接地互动。
You know, if if I reflect back across my career, I note that many patients over time and many doctors lamented the fact that they spent more and more time having to look at the computer screen and type away rather than look at the patient and really interact directly with them.
好的。
Okay.
迈克尔，这很有意思。
Michael, that's interesting.
我想多听听你对AI记录员如何改变你行医方式的看法。
I wanna hear more about how you feel that an AI scribes has changed how you're able to practice medicine.
使用记录员之前和现在相比，有什么不同？
What was it like before you used a scribe compared to now?
我入行很早，那时候还写纸质病历，不过咱们就不提那些旧事了。
I started long enough ago that you wrote paper notes, but we'll we'll leave that in the past.
当时的想法是……
The the idea was that...
或者说，现在的情况是，随着会诊越来越复杂，医疗体系及其运作也变得越来越繁琐，医生花在行政事务上的时间越来越多，这些对患者来说是无形的，比如写病历、转诊、信件、报告，而且往往是在患者离开后才做。
Or here is that as consults have become more complex and as the systems that sit around medicine and the practice of medicine have become more complicated, more and more time is spent on, you know, kind of admin, invisible work to the patient, notes, referrals, letters, reports, which is often done after patients leave.
这样做的一个挑战是，如果你选择这种方式，就会牺牲一些会诊的质量，因为你不可能记住所有细节，之后还要把所有内容都塞进信件、病历和其他文件里。
One of the challenges of that is that if you choose to do it that way, then you sacrifice some of the quality of the consultation because you haven't remembered everything yourself, and you're you're trying to put it all into the letters, the notes, the everything else afterwards.
你确实……抱歉。
You do Sorry.
就是那个……
It at the
对病人来说，好处是不是它能实时记录更详细的笔记？
Is the advantage for the patient that it takes more detailed notes in real time?
所以我觉得对病人的好处是，它能更清楚地记住整个诊疗过程。
So I think the advantage for the patient is that there's clearer kind of remembering of all of the consult.
但这并不意味着笔记一定更好，因为笔记只是记录讨论的内容。
Now that doesn't mean that the notes are necessarily better, because the notes are just what's discussed.
它不包括临床推理和诊疗中的非语言信息。
They're not the clinical reasoning and the the nonverbal things that go into a consult.
我们知道，当我们和别人良好互动时，当我们看着对方，当我们检查病人时，当我们……
We we know that when we interact well with others, when we're looking at it, you know, when we're examining someone, when we...
所有这些都需要我们大声说出来，让记录员听到，或者我们需要把它作为临床推理的一部分，这样才能做出正确的诊断。
All these things require us to either verbalize it out loud so that the scribe can hear, or we need to add it as part of the clinical reasoning that goes into making a proper diagnosis.
所以记录员只是其中的一部分。
So a scribe is just one part.
它确实能帮忙记笔记。
It it helps take the notes.
但它不能代替整个诊疗过程。
It doesn't it doesn't run the consult.
好的。
Okay.
谢谢你，迈克尔。
Thank you for that, Michael.
这里是ABC国家广播电台的《生活要事》节目，我是贝弗利·王。
This is Life Matters on ABC Radio National, and I'm Beverly Wang.
我们今天在讨论AI记录员如何被用来记录、转录和总结与医生和心理学家的会诊。
We're talking about how AI scribes are being used to record and transcribe and summarize appointments with doctors and psychologists.
告诉我，你是否愿意让健康专业人士在会诊中使用AI。
Tell me if you're happy to have your health professional use AI in your appointment.
你刚才听到的是医生。
You've been hearing from Doctor.
迈克尔·邦宁。
Michael Bonning.
他是一名全科医生，也是澳大利亚医学会的候任主席。
He's a GP and the president-elect of the Australian Medical Association.
现在我想请出安德鲁·卡伦医生，他是墨尔本大学计算与信息系统学院的高级研究员。
I want to bring in now doctor Andrew Cullen, who's a senior research fellow at the School of Computing and Information Systems at the University of Melbourne.
安德鲁，欢迎来到《生活要事》。
Andrew, welcome to Life Matters.
最近我们听到了很多关于人工智能的令人担忧的消息。
We have heard many alarming things about AI recently.
就在我们节目开始前，几乎整个新闻简报都在讲人工智能以及相关的担忧。
The entire news bulletin almost right before we let into the show was many, many items about AI and AI concerns.
你知道，我们遇到了Medicare被黑客入侵的事件。
You know, we we had this hack into Medicare.
还有那些关于人工智能完全自主的末日情景。
We've got these doomsday scenarios about, you know, AI becoming fully autonomous.
解释一下那个AI……
Explain how that AI...
这有什么不同吗？
Is that is that different?
这和现在医生在诊疗中使用的AI技术类似吗？
Is that similar to what the AI technology being used like by doctors in appointments these days?
在诊疗中，其实有两种不同的AI在使用。
So in appointments, there's kind of two different kinds of AI that are being used.
第一种基本上就是转录你说的话。
The first is just kind of basically transcribing what you say.
就是AI听你说，然后转换成文字。
So the AI listens and it converts that to text.
这是一种AI。
That's a one kind of AI.
第二种AI呢，基本上是拿这些转录内容，然后尝试把它们总结成AI认为的医生笔记。
The second kind of AI that's used is essentially to try and take those transcriptions and to summarize them into what the AI thinks is a doctor's note.
好的。
Okay.
还有……
And in...
你自己在这个领域工作，当全科医生问你“我可以用AI记录这次问诊吗？”的时候，你会怎么回答？
For yourself, as someone who works in this field, what do you say when the GP asks you, can I use AI to record this appointment?
我觉得很不好意思，因为通常我会说可以，但说完马上就后悔了。
I feel really bad because usually I say yes and then immediately regret it.
因为我知道这背后有很多伦理和复杂的问题，我觉得医生们其实还没准备好去讨论这些。
Because I'm aware of all the ethical and kind of complex issues that go with this that I don't think doctors are really prepared to have the conversation about.
但我也明白，他们这么做是因为工作负担太重了。
But I also am aware that they're doing this because they're overstretched.
他们花时间写病历，却没有得到相应的报酬。
They're not being paid for the time they spend taking their notes.
所以我能理解他们面临的压力。
So I can understand the pressure on them.
我真的很希望他们不是这样。
I just really wish they probably weren't.
这其实是一个系统性的问题。
It's about a sis...
这其实是一个系统性的问题。
It's a systemic kind of thing.
所以说到你脑子里那个过程，我觉得我能理解，因为我觉得我也差不多。
So in terms of that process that goes through your mind, I think I can relate to that because I think I'm similar.
你知道吗？
You know?
我虽然同意了，但我心里其实有一大堆保留意见，只是没说出口。
I give my consent, but I have a whole heap of reservations that I keep back.
这可能跟很多因素有关。
And that can be a bit due to a number of factors.
你知道吗？
You know?
我们时间都很紧，医生和我都一样。
We are all time poor, the doctor and myself.
我大概花了三到四周才约上那个号。
It's probably taken me three three or four weeks to get that appointment.
在那一刻，我有很多事情在权衡要不要答应，我觉得这让同意的充分性变得有些模糊。
There's a lot of things I'm weighing up in that moment of whether to say yes that I think creates some gray areas around how fulsome that consent is.
迈克尔，你肯定知道诊所里的这种情况。
Michael, you must be aware of this dynamic in clinic.
你一般怎么处理？
How do you try to address that?
我觉得我们整个行业都认同，作为工具它是有用的，但它不是万能的。
I think we, as a profession, take on the idea that as a tool, this is useful, but it is not the be all and end all.
我很多门诊都没有用任何转录或辅助工具。
Many of my consults are without any form of transcription or support.
我就跟以前一样，自己写笔记，我觉得这样也挺好……
I just, you know, write my notes like I like I have in the past, and I I think that's...
这不仅仅是因为……
Part of that is is not just due to...
你知道，部分原因是考虑到谁可能会更自在，以及某种程度上要问对合适的病人，看他们是否感兴趣、是否舒服，而且不一定非得在那个时候问。
You know, part of it is due to thinking about who might be more comfortable and asking, you know, in some ways asking the right patient if they are, you know, interested, you know, comfortable, and doesn't always have to be at the at the time.
一个有趣的思考和实践方式是，经常在问诊的……
One of the interesting ways to think about it and do it is to often ask people at...
问诊进行到后面的时候再问，而不是在刚开始时因为时间压力而急着问。
Later on in a consult when you're not just kind of the time pressure of getting the consult to start.
你快要结束的时候，可以问那些……
You're, you know, you're you're getting towards the end, and you can ask someone who...
我们正在考虑在诊所里使用AI转录软件。
We're thinking about using AI, you know, software transcription in the practice.
你会不会，呃，会……
Would you, you know, would...
关于你的病历记录，你有什么偏好？
What would you what would you like in terms of your records?
你希望用这个来支持我们的工作吗？
Would would you like that to support what we do?
你希望我像今天这样继续做笔记吗？
Would you like me to continue taking notes like I've done today?
我在想不同的方式，让大家在咨询开始时不会感到压力，因为我也同意，那样可能会造成一种情况，就是人们觉得自己同意了，但可能并不是完全知情的。
You know, trying to think of different ways in which to make it so that people don't feel the pressure of the start of a consult, because I I can agree that that could make for a scenario where people feel that they give their consent, but it may not be fully informed.
再进一步说，如果病人说，不，我不想你用这个，我觉得从文字交流中能感觉到，而且总体上我觉得病人不想被视为难缠，所以他们犹豫着不敢说不。
Just to take this a bit further, if a patient says, no, I don't want you to use it, I think there's a sense coming through on the text line, and also I think just generally that patients don't want to be seen as difficult, you know, and so they hesitate to say no.
但作为医生，你那边是什么感觉？
But how is it for you on the on the doctor side of that?
你看到了吗？
Do you see that?
你也这么觉得吗？
Do you see it that way as well?
我完全不这么觉得。
I mean, not at all.
我们始终希望在问诊时赋予患者选择权。
We we always want to empower patient choice when it comes to consults.
你知道，其中一部分就是保持开放，让你来就诊时可以谈论任何你想聊的话题。
You know, part of that is about keeping the door open to any topic that you might like to cover when you come in and see us.
也就是说，如果你想讨论一些比较难开口的事情，可以带个人来支持你。
It's to making sure that if you've, you know, wanna discuss something that's difficult, you might bring someone to support you.
对吧？
You know?
其实，来看医生的时候，有很多方式可以积极、以患者为中心地行使你的选择权。
There are, you know, there are lots of ways in which when you come to see a doctor, you can exert your choices in a positive and, you know, patient orientated way.
比如说……
With with...
我想说的是，我们不会评判你。
I I would I would say this, there is there is no judgment.
不会有任何批评。
There is no criticality.
我们多年来，甚至几十年来，一直都在写病历。
We all have written notes for, you know, years or decades.
我们对此毫无问题。
We have no problem doing that.
事实上，我们发现，即使我们使用任何形式的AI记录软件，我们仍然会回去经常重写、添加、删减、修改病历，以更好地反映我们进行的诊疗过程。
In fact, you know, we note that even when we use any form of AI scribing software, that we still go back and often rewrite, add, subtract, change the notes to better reflect the consultation we've had.
所以这并不意味着
So it doesn't mean that
对。
Yep.
仅仅因为你看不到我们在某些时刻打字，并不意味着我们不会回去仔细审视这些病历。
Just because you don't see us type in the moments that we aren't going back and taking a very critical eye to the notes that are there.
关于这个话题有很多短信。
A lot of texts on this topic.
一位发短信的人说，如果医生使用AI，他们应该收费更低。
One texter says, if the doctor is using AI, they should charge less.
如果他们不知道这些信息，就不应该指望我们付钱。
If they don't know the information, they shouldn't expect us to pay.
另一位听众说，我不喜欢AI医疗记录员，因为技术不可靠，而且对环境有影响……
Another texter says, I don't love AI medical scribes due to both the unreliable tech and its environmental impact...
影响，但我觉得说出来不舒服，因为和医生之间存在权力不对等。
Impacts, but I felt uncomfortable saying so due to the power differential with doctors.
另一位听众说，我总是说同意，但那只是因为我去看医生时很紧张，怕惹他们烦。
Another texter says, I always say yes, but only because I'm stressed when I go to the doctor and I'm afraid of annoying them.
这里还有一位非常积极的听众。
And here's one person who's very positive.
是的。
Yes.
我喜欢我的医生用AI来总结她的笔记并写下来。
I love my doctor using AI to summarize her notes and write them up.
她会检查一遍，这对她来说非常节省时间。
She reviews it, and it's a great time saver for her.
双赢。
Win win.
这里还有一位听众提出了一个有趣的观点，我想听听你的看法，安德鲁。
There is another texter here who raises an interesting point that I'd to put to you, Andrew.
凯莉说，如果转录质量和语音转文字一样，那简直就是垃圾。
Carrie says, if the quality of transcription is as good is as good as voice to text, it's garbage.
对于任何有口音或声音差异的人来说，这根本没用。
For anyone with an accent or voice difference, it's useless.
安德鲁，你能跟我聊聊这些医疗记录助手在准确性方面的情况吗？
Can you talk to me a little bit about some of the accuracy around these scribes, Andrew?
特别是像我刚才提到的，那些有不同口音或者母语不是英语的人，这些转录工具确实很难处理他们的语音。
So especially as the kind of text I mentioned, people who've got a different accent or maybe who've got a non English as a first language background, these transcription tools really do struggle with them.
大规模研究发现，这些AI医疗记录助手生成的转录中，大约有十分之九存在某种程度的错误，大约五分之一存在严重到足以根本改变诊断的错误。如果有人再次阅读这些记录，比如你回去看医生，他们查看你的护理记录，五分之一会有如此大的错误，以至于会根本改变医生对你的治疗方式以及对你之前情况的看法。
And so large scale studies have found that about nine in 10 transcriptions that are made by these AI scribes have some level of mistake, and about one in five have a mistake so serious that it would really fundamentally change the diagnosis that if somebody was reading those notes again, like, you went back to the doctor and they're reviewing your care notes, one in five are gonna have a mistake so big that's gonna fundamentally change how the doctor treats you and how the doctor views what you did before.
迈克尔，我想听听你的意见。
Michael, I wanna come to you.
如果你在诊所里经常用AI记录员，当时可能确实省时间，但我想你之后还得回头检查那些记录。
If you're using AI scribes regularly in your GP practice, it might be saving you time in the moment, but I imagine you then have to go through the notes and check them through.
你会检查得多仔细呢？
How thoroughly do you do that?
你觉得检查转录错误的标准应该是什么样的？
What do you think the standard should be for checking the transcriptions for errors?
我觉得这个问题有好几个方面。
There are, I think, multiple dimensions to that.
首先是那些明显的错误，需要我们在工作中明确修正的地方，但另外我觉得也会出现一种自动化带来的自满。
There is the first part, which is obvious errors and things that need to be clearly you know, repaired in what we do, but then there also becomes, I think, some automation complacency.
我们一开始会仔细检查输出，但我们必须对任何工具的作用保持警惕，因为上次它是对的，不代表这次也是对的。
We start by checking output carefully, but we have to remain vigilant as to what a tool of any kind does, because just because it was right last time doesn't mean it's right this time.
我想说，我们围绕这些理念建立临床实践已经几百年了。
I would say we have built, you know, clinical practice around those ideas for, hundreds of years.
每个病人都不一样。
Each patient is different.
每次看诊都不一样。
Each consult is different.
上次听到某人这么说，不代表这次别人这么说就是一样的。
Just because you heard something said some way the last time doesn't mean it's the same when someone else says it this time.
我们得认识到，这其实不是把写病历自动化的过程。
It's actually really critical when we think about this that this is not a is not a process of automating your notes.
这绝对是一个借助辅助工具，把病历写得更好、更全面地反映实际情况的过程。
This is absolutely a process of getting assistance to take better notes that are informed by more of what goes goes on.
你明白吗？
You know?
我相信安德鲁也深有体会，人的大脑在看诊时很容易出错，有时候我们还能借助工具捕捉到一些信息，否则我们可能会忘记写进病历里。
I'm I'm sure Andrew might recognize this as well, is that the human mind is quite fallible for a consult, and sometimes what we also get is the ability to pick up information that we might otherwise have forgotten to incorporate into a note.
迈克尔，目前澳大利亚有没有统一的法规，规定全科医生应该如何审核AI记录员提供的转录内容？
Are there, Michael, are there currently uniform regulations as to how GPs should review the transcriptions provided by AI scribes across the medical field in Australia?
澳大利亚医学会和全科医学院都给出了相关建议，特别强调，当你批准病历的时候，责任就在你身上，所以里面任何内容，你都必须检查过。
So there's advice given by both the AMA and the general practice colleges around this, specifically, to recognize the importance that when you approve the note, it's your responsibility, and so anything that goes into that, you need to have checked.
你要小心那些更容易带来风险的事情。
You need to be wary of things that are more likely to have risks associated with them.
就像安德鲁刚才说的，有些口音可能比较难识别，还有药物名称，以及你可能会指出的身体部位，比如发现病变的地方。
So as Andrew was describing, accents that are, you know, sometimes more difficult, but also then drug names, you know, the sides of the body in which you might have, you know, you you might have identified, you know, a lesion or something like that.
在整个过程中，最关键的是，笔记是由AI工具辅助完成的，而不是完全由它来写，我觉得这一点非常重要，我们一定要明确。
It is absolutely critical in all of this that the note is assisted by an AI tool, it is not written solely by it, and I think that's really important that we come through this.
在咨询后索取那些笔记的转录文本？
Seek transcriptions of those notes after their consults?
如果我让医生把转录文本发给我，这样允许吗？
Would that be allowed if I ask my doctor to send me the transcription?
出于合理的目的，咨询笔记是患者和记录者之间共享的文件。
So for a reasonable purpose, the consult note is, you know, it's a shared document between the patient and the the person writing it.
在大多数情况下，这些笔记通常存放在患者管理软件里，也就是另一种支持临床护理的软件。
For the most part, in most of practice, that generally lives in a patient management software, so another piece of software that, you know, helps and supports clinical care.
抱歉。
Sorry.
但确实是可以申请的。
But it is but it is something that you can request.
好的。
Okay.
那就是可以了。
That's a yes.
安德鲁，我想听听你的看法。
Andrew, I wanna come to you.
迈克尔提到了防护措施。
Michael's mentioned guardrails.
你也听到了大家的担忧。
You've heard the concerns.
你觉得在使用AI记录员和其他技术进行这类会诊时，哪些方面应该加强防护措施？
I mean, where do you think there should be more of these guardrails when it comes to the use of AI scribes and other technology in appointments like this?
我觉得我们真的需要了解这对全科医生到底有多大影响。
I think we really need to understand how much of an impact it really does have on GPs.
比如说，如果全科医生得花时间检查这些记录，我们知道人类其实很不擅长校对自己的工作，或者当……
Like, if GPs are having to spend time reviewing these notes, one thing that we know about humans is we're actually really bad at copy editing our own work or when...
比如，我们看到一些内容，就会觉得，哦，对。
Like, we see something and it's like, oh, yeah.
这……
This is...
看起来跟我读到的差不多。
Looks like what I read.
但可能不是写‘建议某人戒烟’，而是写‘建议他们避免房屋火灾’，听起来很离谱，但这确实出现在……
But it might instead of saying somebody was counseled to stop smoking, it might actually say that they were counseled to avoid house fires, which sounds crazy, but that was actually in a...
我之前审阅的一个AI记录员生成的记录里，确实这么写了。
An AI scribes that I was reviewing at one stage that actually said that.
所以，我们真的需要思考，这是否真的为医生提高了效率。
So there's a real need to kind of think about if this is actually driving efficiencies for doctors.
同时，也需要有防护措施，以便我们更好地理解真正的伦理考量，以及我们的数据去向何方。
There's also a need for guardrails so that we understand better what the actual ethical considerations are and kind of where our data is going.
因为目前，我们真的不知道这些转录记录被保存后，数据最终去了哪里，谁在访问，如何使用，是否被用来训练AI模型。
Because at the moment, we don't really know when this transcription is recorded, where that data ends up, who is accessing it, how it's used, if it's being used as training for AI models.
这些都是关于技术发展和个人数据去向的根本性问题，我们完全不清楚，监管机构需要介入并在这方面加强管理。
There's all these really big fundamental questions about what's happening with the tech and what's happening with our personal data that we just don't know, and there's a need for the regulators to kinda come in and step up on that front.
需要明确的是，这就是TGA对AI抄写员的说法。
And to be clear, this is what the TGA says on AI scribes.
它说，仅用于转录和翻译临床对话为书面记录，而不进行分析或解释的数字抄写员，不被视为医疗设备。
It says that digital scribes only intended to transcribe and translate clinical conversations into written records without performing analysis or interpretation are not considered medical devices.
然而，如果数字抄写员分析或解释临床对话，例如生成诊断、鉴别诊断或治疗建议……
However, if a digital scribe analyzes or interprets clinical conversations, for example, by generating a diagnosis, differential diagnosis, or treatment rec...
……那么它就被视为医疗设备。
Recommendations, it is considered a medical device.
迈克尔，你认为这些规定应该更进一步吗？
Michael, do you think these regulations should go further?
这正是澳大利亚医学会自2023年这些产品首次上市以来一直呼吁的，即应该制定更明确、更严格的软件作为医疗设备的规则，并解决市场上许多产品中出现的范围蔓延问题，这样既能确保患者更安全，也能保护医疗环境，让人们感到安心。
That's something the AMA has been calling for since 2023 when some of these products first became available, is that there should be both clearer but stronger rules around software as a medical device, and the scope creep that we can agree has been seen through many of the products that exist on the market, and in doing so, making sure that it's both safer for patients, but also that we are protecting the health environment so people feel safe going there.
最后还有一个听众的问题。
Got a final question from a listener.
伊薇特说，她预约一位专治多动症的全科医生时，被要求必须同意使用AI记录工具，否则就不给看。
Yvette says that she was refused an appointment with a GP who specializes in ADHD unless she agreed to her using an AI scribe.
她拒绝了，结果医生就不见她。
I refused, so she wouldn't see me.
这是……
Is that...
你怎么看伊薇特遇到的这种情况？
What do you think of that situation that was described by Yvette?
确实。
Absolutely.
贝弗利，我觉得这里确实有一些我们不得不面对的挑战。
So, Beverly, so I think there's there's some real challenges that we have to face here.
如果医生想说这是他们临床实践的一部分，那他们必须提前明确告知，这样如果患者觉得不舒服，就不会考虑预约了。
If, as a doctor, someone wanted to say, this is a inherent part of my clinical practice, then they need to be very upfront about that so that someone wouldn't even consider booking an appointment if that was something that they didn't feel comfortable with.
在这个过程中，我们需要非常清楚地考虑患者的数字权利，以及他们有权事先了解信息，这样他们就不会陷入那样的境地。
In doing so, we need to think really clearly about, like, the digital rights of our patients and their right to have, you know, information upfront so that they don't end up in a situation like that.
如果你和患者已经建立了治疗关系，那么他们拒绝你使用AI记录员，我认为是完全合理的。
If you have an established therapeutic relationship with a patient, then them saying no to your using an AI scribes, I think, is perfectly justified.
你有……
You have...
这种治疗关系是我们与患者关系的核心。
That therapeutic relationship is the core of what we have with the patient.
我们周围的其他工具都是次要的。
All of the other tools around us are kind of secondary.
所以，对于已经建立的临床关系，我认为你不能改变规则……
So an established clinical relationship, I I don't think you can move the guardrails...
或者，抱歉。
Or sorry.
你不能改变规则，然后说，没有记录员我就不见你。
You can't move the goalposts and, you know, just say, I can't see you without a scribe.
但如果你想这样运营你的诊所，那你就需要……
But if you want to set up your practice to operate like that, then you need...
而且从一开始，你就需要非常明确地告诉你的病人。
And from the, you know, from the starting point, then you need to be really upfront about that with your patients.
谢谢两位今天来参加我们的对话。
Thank you both for joining me for this conversation today.
安德鲁·卡伦博士是墨尔本大学计算与信息系统学院的高级研究员，迈克尔·邦宁博士是全科医生，也是澳大利亚医学会的候任主席。
Doctor Andrew Cullen is a senior research fellow at the School of Computing and Information Systems at the University of Melbourne, And doctor Michael Bonning is a GP and president-elect of the Australian Medical Association.
你们收到了好多短信。
So many of your texts coming in.
贝拉说，她让一位新全科医生用AI记录我们的预约，但她没有让心理学家记录我们的会谈。
Bella says, I allowed a new GP to use AI to record our appointment, but I did not allow a psychologist to record our session.
所以这就是贝拉设定的界限。
So those are the boundaries for Bella.
另一位发短信的人说，据我理解，AI会旁听我的预约，然后为记录生成摘要。
Another texter says, as I understand it, AI will listen in on my appointment and then make a summary for the records.
我觉得这样能让医生有更好的时间质量，真正看着我、专注听我说话。
I think it will allow the doctor to have a better quality time by actually looking, focusing, and listening to me.
只要作为病人，我也能读到那份摘要，我就很乐意接受这个做法。
I'm happy for this to happen as long as I too, as the patient, can also be able to read the summary.
我确实问过迈克尔·邦宁这个问题，他绕来绕去，答案算是肯定的，但听起来后面可能还有一些别的麻烦。
And I did ask that question of Michael Bonning, and in a roundabout way, the answer was yes, but it sounds like there might have been some other complications down the track.
不过没错，你完全可以提出这个要求。
But yes, you absolutely can request that.
露丝说，AI在医生那里很棒，因为现在医生能和你眼神交流，不用一直盯着电脑，可以完全专注于当前的问题。
And Ruth says AI is great at the doctors because you now have eye contact and the doctor isn't spending all their time looking at the computer and can focus completely on the issues at hand.
所以大家对AI在医疗方面的看法真是五花八门……
So a big mix of your views on AI in the medical...
在医生的诊室里。
In the doctor's office.
请继续分享你们的想法。
Please keep them coming.
0418226576。
0418226576.
接下来，我们来聊聊孤独这个话题，因为澳大利亚人正变得越来越孤独，社交也越来越孤立，而最让我们担心的其实是年轻一代。
Next up, let's talk about loneliness because Australians are becoming increasingly lonely and socially isolated, and it's the younger generations we need to be most worried about.
接下来，澳大利亚顶尖的孤独问题专家会跟我们聊聊解决办法。
Up next, Australia's leading loneliness expert is gonna talk us through the solutions.
从青春期过渡到成年期，这个过程可能非常艰难。
The transition from adolescence to adulthood can be brutal.
有一天，你的朋友还在你身边。
One day, your friends are just there.
你的日常生活也很熟悉。
Your routines are familiar.
你知道自己属于哪里。
You know where you fit.
然后突然间，你离开学校，友谊也变了。
Then suddenly, you leave school and friendships change.
而且你不仅要弄清楚你想做什么，还要弄清楚在没有那些让你感到安全的人和地方之后，你是谁。
And you're not just figuring out what you want to do with your life, you're figuring out who you are without the people and places that made you feel safe.
这个人生阶段一直都不容易，但有些东西已经变了。
This phase of life has always been hard, but something has changed.
最近的研究显示，过去二十年里，社交隔离的比例几乎翻了一番，而年轻一代的孤独感增幅最大。
Recent research shows rates of social isolation have nearly doubled over the past two decades, with younger generations experiencing some of the biggest increases in loneliness.
他们比之前任何一代人都更紧密地连接在数字世界里，但很多人却长期感到孤独。
They're more digitally connected than any generation before them, and yet many are persistently lonely.
你知道，我们大多数人都经历过孤独。
You know, most of us have experienced loneliness at some stage.
如果你也有这样的经历，我很想听听你是怎么走出来的。
If that's you, I'd love to hear how you work through it.
或者，如果你担心你身边的年轻人正在经历孤独，你是怎么鼓励他们保持社交联系的呢？
Or if you're worried that young people in your life are experiencing loneliness, how are you encouraging them to maintain social connections?
为了帮助我们理解为什么会这样以及该怎么办，欢迎我们的嘉宾医生。
To help us understand how we got here and what to do about it, welcome to Doctor.
林博士。
Lim.
她是“共同终结孤独”组织的首席执行官兼科学主席，这是澳大利亚应对孤独和社会隔离的最高机构。
She's the CEO and scientific chair of Ending Loneliness Together, which is Australia's peak body addressing loneliness and social isolation.
她还写了一本新书，叫《孤独的一代：为什么我们的孩子陷入危机，以及我们如何解决》。
She's also the author of a new book called The Lonely Generation, Why Our Kids Are in Crisis and How We Fix It.
欢迎来到《生活要事》，米歇尔。
Welcome to Life Matters, Michelle.
你知道吗，我在回想我年轻的时候，我成长的那个年代还没有智能手机。
You know, I was thinking about my younger days, and I came of age at a time when we didn't have smartphones.
所以我是从被高中同学包围，到被成千上万的大学同学包围，真的是成千上万。
So I went from being surrounded by high school classmates to being surrounded by university classmates in the thousands, literally.
所以每当我想到那段时光，我想到的词就是“拥挤”。
So when I think of that time, I think of the word crowded.
但这并不代表我那时不感到孤独。
That doesn't necessarily exclude the fact that I was lonely from time to time.
但请告诉我，最近这种情况有什么变化？
But tell me, you know, how has that changed recently?
另外，我也想听听你关于自己过渡到成年期的经历。
And also, I'd love to hear from you about your own transition to adulthood.
这个问题问得真好。
That's a really good question.
我觉得年轻人告诉我们的是，孤独感实际上是在人群中、在他人之间体验到的。
I think this is what young people tell us, that loneliness is actually experienced...
嗯，他们在人群中也会感到孤独。
Well, they experience loneliness in a crowd and amongst people.
从定义上讲，年轻人并不与社会隔离，但他们感到孤独的经历很大程度上与有质量的连接有关。
By definition, young people are not socially isolated, but their experience of feeling alone is very much around quality connections.
他们确实拥有数量。
They do yield quantity.
我觉得如果你想想随着年龄增长，你对友谊的看法，它们确实会改变。
I think if you kind of think about the way you see friendships as you age, they do change.
我们的优先考虑会有点不一样。
We prioritize a little bit differently.
年轻人更看重数量而不是质量。
Young people prioritize quantity over quality.
随着年龄增长，我们开始真正关注高质量的关系。
And as we age, we really start focusing high quality relationships.
但我认为现在，不仅在澳大利亚，全球范围内孤独感的普遍性都很高。
But I think right now, we see high prevalence of loneliness across not just in Australia, but across the globe.
年轻人基本上在抱怨他们感受到的主观体验。
Young people are basically complaining about the subjective feeling that they're getting.
这让人很痛苦。
It's distressing.
就是他们的关系没有完全满足他们的社交需求。
It's that their relationships are not quite meeting their social needs.
那么，从很多年前我年轻的时候到现在，有什么变化呢？
And what's changed then in, say, the time many years ago when I was a young person to now?
我觉得我们现在生活的世界很不一样。
I think the world that we're living in is very different.
可能跟你很像，我上大学的时候还没有数字化的选择。
Probably, very similar to you, went to university at an age where there was no digital options.
你知道，那时候没有在线课程。
You know, there was no classes online.
我们必须亲自到场。
We had to be there.
必须去校园。
Had to be on campus.
如果没课，就只能等着。
And if you didn't have a class, you just waited.
就等着下一节课，对吧？
You just waited for your next class, right?
所以你在大学里花了很多时间。
So you're spending immense amount of time at university.
但现在，大学生们告诉我们的是，他们的日程安排其实不太能对上，因为很多课程都是线上的，所以他们缺少那种自然的面对面交流。
But right now, what university students are telling us is that their schedules don't really meet because a lot of it is online, so they don't have that organic interactions.
另外，我觉得大学里对社团活动和参与度的投入也不够。
There's also, I guess, a lack of investment into community clubs and participation at universities.
所以这些因素加起来，就造成了大学环境变得非常不一样。
So all these things add up to, you know, a very different environment at the university level.
年轻人经常说，比如有些大三的学生会说，哎呀，我终于交到一个新朋友了。
And young people often say, well, you know, some of them in their third year of university and say, Oh, I've just finally made a new friend.
因为这种自然的互动太难得了，他们必须主动去建立联系。
Because this organic interaction is so much harder to come by and they have to make the intention to connect.
而且线上交朋友也挺别扭的。
And online is kind of an awkward way of making new friends.
那你怎么衡量孤独感和社交隔离呢？
And so how do you measure loneliness and social isolation?
因为，你看，说到孤独，我确实理解很多人都会经历，但我也觉得有时候我们得稍微体验一下孤独。
Because, look, when I think about loneliness, I do understand that many people experience it, but I also think sometimes we have to experience it a little bit.
你懂吗？
You know?
我们不可能完全把自己和孤独隔离开来。
We can't necessarily quarantine ourselves from loneliness.
那么，什么是健康的……
So what is a healthy...
我能这么说吗？
Can I say that?
可以。
Yes.
健康的孤独感和不健康的孤独感，界限在哪里？
What's a healthy amount of loneliness versus an unhealthy one?
我很喜欢你问这个问题，因为实际上，孤独本身并不是病态的，它不是心理健康问题，也不是身体健康问题。
I love that you asked that because actually, loneliness itself isn't pathological, isn't a mental health problem or physical health problem.
它只是一个天生的信号，提醒我们要对现有的关系做出一些不同的回应。
It is just an innate signal for us to respond a bit differently to the relationships that we currently hold.
所以如果你感到孤独，那只是说明你没有真正得到身体或心灵所需要的东西。
So if you're feeling lonely, it just means that you're not really getting quite what your body needs or what your mind needs.
我觉得社交隔离，是关于人数的。
And I think that social isolation, it's around the number of people.
但认识人并不代表你会觉得不那么孤独。
But just because you know people doesn't mean that you feel less lonely.
有时候你认识很多人，但你们之间有很多冲突。
Sometimes you know a lot of people, but you have a lot of conflict.
那你怎么衡量这个呢？
So how do you measure that?
这主要是靠自我报告，让那个人反思自己对关系的感受。
It's really by self report and around getting the person to reflect how they feel about the relationships.
你有可以求助、倾诉的人吗？如果你有问题的话。
Do you have people that you can go to or turn to and talk to if you have a problem?
你觉得别人理解你吗？
Do you feel like people understand you?
展开剩余字幕（还有 358 条）
你觉得你身边有没有那种对你有意义的陪伴？
Do you feel like you have companionship that means something to you?
所以你会问一系列不同的问题。
So you ask a range of different questions.
通常我们会尽量避免直接问这个问题，因为现在孤独感仍然被视为一个比较丢脸的问题。
Usually, we try to avoid asking the direct question because right now, loneliness is still seen as quite a stigmatized issue.
比如，会觉得这是我的问题。
Like, oh, it's because of me.
是我的性格问题。
It's my personality.
我孤独是因为我自己。
I'm lonely because of me.
是因为没人愿意跟我做朋友。
It's because nobody wants to be a friend to me.
但现在我们知道，孤独感和那种信号其实是我们人类系统的一部分。
But now we know that that loneliness and that signal is actually really part and parcel of our human systems.
那不同的人对孤独的承受力是不是不一样？
And do different people have different tolerances for loneliness?
是的，我觉得是这样。
Yes, I would say so.
而且我们成长的环境会影响我们如何应对社交环境。
And the environment in which we develop and we grow in can change the way we navigate our social environment.
有些人不需要太多，有些人则需要更多。
Some people don't need a lot and some people need much more.
没有对错之分。
There's no right or wrong.
关键在于我们要思考自己有哪些资源，真正需要什么，以及能否在环境中找到这些社交资源。
It's about us trying to think about what our resources are and what we actually need and whether we can find and, you know, find those social resources within our environment.
那在你的书里，哪里……
So in your book, where...
《孤独的一代：为什么我们的孩子陷入危机以及如何解决》这本书里，你有一些案例研究，年轻人跟你分享他们孤独的经历。
The lonely generation, why our kids are in crisis and how we fix it, you have some case studies, young people telling you about their experiences with loneliness.
有一个……
One in...
有一个叫凯西的人的情况让我印象特别深刻。
One situation of someone named Kathy really stood out to me.
你能给我讲讲那个案例吗？
Can you tell me about that case study?
她就是那个摔倒后把头伸进浴缸里的人。
She's the one who fell down and put her head in the bathtub.
这其实是一个真实的……
This is actually a real...
一个真实的故事。
A real story.
真实的故事。
Real stories.
凯利其实曾经为我工作过。
Kelly actually worked for me.
她其实是个年轻的研究员。
She was actually a young researcher.
其实还在上大学，正在接受心理学家的培训。
Actually, was still in university and training to be a psychologist.
她经历过不少心理问题，因为她来自维多利亚州的农村，后来去城里读书。
She's gone through quite a lot of mental ill health as she came from rural Victoria, went into the city to study.
她最后上了大学，但后来搬进了一个大房子，里面住了八个人，我记得好像是八个室友之类的。
And she ended up in college, but then she moved out to a big household full of eight, I think it was eight housemates or something like that.
那真是挺多的。
It's quite quite a lot.
就是那种大房子……
It's one of those big house...
那种有很多房间的合租房。
Big share houses with lots of rooms.
然后她基本上……
And she she basically...
她在浴缸里摔倒了。
She she fell in the bathtub.
她撞到了头。
She hid ahead.
而且没有人来看她。
And no one came no one came to check on her.
我是说，她被发现的时候，大概已经过了二十四小时，甚至四十八小时。
I mean, she was found, what, twenty four hours, forty eight hours later.
她最后在医院住了一个月。
She ended up in the hospital for a month.
她之所以被发现，是因为她姐姐一直在联系她。
And the only reason why she was found is her sister was trying to get a hold of her.
她姐姐不住在城里，花了一段时间才赶到她那里。
And her sister wasn't living in the city, and it took a while to get to her.
他们发现她的时候，她正躺在浴缸里。
They they found her actually lying in a bathtub.
她后来得了低体温症，之后还有各种其他问题。
And she had hypothermia, and she had all these other issues after that.
那个故事把我吓坏了，你知道，因为这就是那种情况——你和别人住在一起，但那些人可能并不关心你。
That story terrified me, you know, because it is case of you're living with other people, but those people may not care about you.
你和他们没有那种有意义的关系。
You don't have those meaningful relationships with them.
他们都进进出出那栋房子。
They were all going in and out of the house.
没有人真正和她有那种会去关心她的友谊，你懂吗？
No one really had a friendship where they would check on her, you know?
这就是我们的问题——我们可以和很多人住在一起。
And that's the problem that we have is that we can live with many people.
我们可以……
We can...
但可能会和他们有冲突。
But we may have conflict with them.
我们可能没法开口寻求帮助。
We may not be able to ask for support.
而且，光是感到孤独，现在真的可能导致早逝，死亡率更高。
And just feeling lonely can now actually lead to earlier death, more mortality.
我们现在知道，我们处理信息、感知环境的方式，对健康有巨大的影响。
We know now that there's massive health impacts in the way we process information, process our environment.
这种状态压力很大，所以长期下来，各种健康问题都会随之而来。
It's a much more stressful state to be in, and therefore you have all these health implications down the line.
哇。
Wow.
这确实让人担忧。
That's quite concerning.
这里是ABC国家广播电台的《生活要事》节目。
This is Life Matters on ABC Radio National.
我是贝弗莉·王，今天和米歇尔·林医生一起，聊聊孤独这种流行病，特别是它对年轻一代的影响。
I'm Beverly Wang here with doctor Michelle Lim talking about the loneliness epidemic, particularly how it's affecting younger generations.
我很想听听大家的分享，无论是你自己的经历，还是你身边的年轻人，你是怎么应对孤独的，又是怎么走出来的。
And I'd love to hear from you, either in your own experience or young people in your life, how you have coped with loneliness, how you got through it.
我收到一条短信，有人说：因为行动不便，我有点孤独。
I got a text here from someone who says, I got a bit lonely from mobility issues.
我儿子加入了一个田径俱乐部，我也跟着加入了那个社区。
I joined the little athletics community through my son joining a club.
现在我自愿当一名年龄组管理员。
I now volunteer as an age manager.
米歇尔，我有个问题想问你。
And a question for you, Michelle.
把伴侣当作主要朋友，这样不好吗？
Is it bad to have a partner as your main friend?
这总被视为一件负面的事情。
It's always seen as a negative.
我不会说这不好，但心理学家通常会建议——我戴上我的心理学家帽子来说——你需要一点多样性。
I wouldn't say it's bad, but what psychologists tend to recommend and just put my psychologist hat on is that you want a little bit of complexity.
而且除了家人和非常亲密的朋友之外，你还需要一个可以去找的人，比如聊聊工作上的支持，或者聊聊其他事情，或者你的爱好。
And also beyond family and very close friends, you want someone that you can go to you know, to talk about support at work or someone you, you know, can go to to talk about something else or your hobbies.
所以我们总是鼓励人们拥有一定的多样性，因为这基本上能给你一个更稳定的基础。
So we always encourage people to have a bit of complexity because it is basically giving you a more stable base.
有一个非常亲密的伴侣并不是坏事，但关键是要扩展，要更灵活、更敏捷一些。
It's not a bad thing to have a partner that you're very close to, but it's also about extending and being a little bit more flexible and more nimble.
因为当你在某个方面需要支持的时候，你的伴侣不应该觉得必须满足你所有的需求。
Because at times where you might need support in one area, your partner shouldn't feel the need to have to cater to all of those needs as well.
我们正在讨论孤独如何影响年轻人。
We are talking about how loneliness affects young people.
正如你提到的，根据Hilda调查数据，在经历孤独的年轻人群体中，人数有所增加。
As you have mentioned, according to Hilda survey data, there is an increase in the number of...
在经历孤独的年轻人群体中，人数有所增加。
In the cohort of young people who are experiencing loneliness.
那么米歇尔，我很好奇，为什么这种观念仍然存在，认为孤独主要发生在老年人群体中。
I'm curious then, Michelle, why it is that this notion persists that loneliness exists predominantly in older cohorts.
所以这就是……
So this is...
而且需要明确的是，老年人确实也会感到孤独。
And just to be clear, older people do experience loneliness as well.
所以他们是极其脆弱的群体。
So they are an incredibly vulnerable group.
但作为旁观者，我们也看到客观的社会隔离现象。
But what we also see on the kind of as a third person is that, you know, we also see the objective social isolation.
长期以来，人们一直误解这两个概念。
And people have long misunderstood the two concepts.
一个是客观的，就是作为旁观者我能看到你每天和多少人交谈，或者你是否独居。
One is very objective, which is I can see as a third person how many people you talk to or if you're living by yourself.
人们会假设，如果你身边没有人，那你一定很孤独。
And the assumption is if you don't have anybody around you, then you must be lonely.
而我认为，老一辈人对人际关系有更健康的理解，也许他们自己也有点代际间的偏见。
Whereas I think in the older generation, they also have a healthier understanding of how relationships work and maybe they might and also perhaps a little bit of intergenerational stigma themselves.
他们即使感到孤独也不会说出来，因为他们觉得自己应该承受这些。
They would not say they're lonely even if they are because they're expected to cope with it.
所以有几个因素会影响这一点。
So there are couple of things that do play into that.
但确实，我们现在意识到，不仅身体上独处对健康不利，感觉孤独同样对我们有害。
But yeah, I think now we realize it's not just being physically alone that's actually not healthy for us, but also feeling like you're alone is equally bad for us.
所以我们现在才开始更好地理解这两个概念。
So now we're just starting to understand those two concepts a little bit better.
为了进一步了解这些影响，凯西，你提到了你书中那个因为独处而经历急性健康危机的案例。
And just to take the understanding of the impacts a little bit further, you mentioned, Kathy, the case on your book who experienced an acute health crisis because of being alone.
但我觉得越来越多的人把孤独视为一个公共健康问题。
But I think more and more is loneliness being seen as a public health issue?
告诉我为什么。
Tell me why that is.
世界卫生组织大概在2023年启动了他们的社会联系委员会。
So the World Health Organization commenced their commission to social connection probably about 2023.
我们实际上会在2026年结束这个委员会。
We're actually ending this commission in 2026.
他们之所以成立这个委员会，是因为再也无法忽视孤独对健康的影响，尤其是因为这个问题被忽视了很久很久。
And the reason why they didn't start the commission is because they can no longer really ignore the health effects of loneliness, particularly because that's been that's been far neglected for a very long time.
我们早就知道社交隔离对健康的影响。
We've known about the health effects of social isolation for a long time.
这两者对我们都不好。
They're both they're both bad for us.
它们都是社交脱节的表现。
They're both forms of social disconnection.
目前估计，孤独每年在全球导致约87万人死亡。
Now loneliness is estimated to cost about 870,000 deaths per year globally.
这些死亡是可以预防的，而且孤独会增加患心血管代谢疾病的风险，加速中风，削弱免疫反应，并导致认知能力下降。
These are preventable deaths and increases your risk to cardiometabolic disease, increases your acceleration to stroke, poor immunity responses and cognitive decline.
所以数据已经摆在那里了。
So the data is there.
我觉得我们真正不知道的是该怎么去应对这个问题。
I think what we don't know is how to actually deal with it.
他们呼吁的首先就是，这已经是一个全球性的公共卫生危机了。
And what they've called for is basically first of all, this is a global public health crisis.
不能只靠个人或者社区层面的应对。
It can't just rely on an individual's response or just a community response.
我们需要更宏观层面的应对措施，他们真的在呼吁所有成员国制定某种国家战略，来应对孤独感、社会隔离或者说是社交脱节。
We need a much more macro level response, and they're really calling for all member states to develop some sort of national strategy to address loneliness and social isolation or or social disconnection.
我们知道在澳大利亚也存在这个问题，所以我们希望澳大利亚政府能够采取行动，毕竟有强有力的证据支持这样的战略。
And we know we have a problem here in Australia, so this is something that we hope the Australian government would would take action given the the strong evidence for the strategy.
我很好奇，米歇尔，不同文化对孤独感的看法或者谈论方式有什么不同。
I'm curious, Michelle, how loneliness is perceived or spoken about differently across different cultures.
你知道吗，有些文化里其实没有“孤独”这个词。
You know, there are some cultures that actually don't have the word loneliness.
所以，因为没有人会感到孤独。
So Because nobody's lonely.
那么，具体是哪些文化呢？
Well, so so Which cultures are those?
很多集体主义文化是这样的……
So a lot of the collective cultures are...
我的欧洲同事们基本上说……
My my European colleagues basically say...
他们实际上做的是，他们测量了整个欧盟范围内的孤独感。
So what they they have done is they actually measured loneliness across the EU.
那可是很多国家啊。
That's a lot of countries.
但欧盟里有些国家非常集体主义，有些则非常个人主义。
But some of the EU countries are very collective based and some individual based.
他们实际上不得不改变测量的项目。
And they actually have to change the item to measure.
就像你说的……
You know, as you said...
你之前问我，到底是怎么测量的？
Asking me before, how do you actually measure?
嗯，其实就是直接问那个人。
Well, you do ask that person.
但他们确实得用“非自愿的孤独”这个词才能真正捕捉到那种感觉。
But they actually had to use the word unwanted solitude to actually capture that.
也就是说，是孤独、一个人待着，但不是自己想要的。
So it's solitude and being alone, but it's not wanted.
是让人痛苦的。
It's distressing.
而且，尽管我自己的专业知识和他们的假设都认为集体主义文化的人会更少感到孤独。
And against my own expertise and their hypothesis as well, we thought that the collective cultures would be less lonely.
但结果恰恰相反。
What they found was the opposite, actually.
他们发现，个人主义文化的人，比如北欧人，得分反而比南欧人好一些，我觉得这有点不寻常。
They found that individual cultures, the ones on the North, Northern Europeans, they were scoring a little bit better than the ones in the South, which I thought was a little bit unusual.
我们在世界卫生组织的数据里也看到了一些类似的趋势。
And we kinda see some of the trends as well in the WHO.
我们发现中低收入国家，特别是很多集体主义文化的社会，报告的孤独感水平更高。
So we find that low middle income countries as well, specifically a lot of collective cultures, were reporting higher levels of loneliness.
我在想，澳大利亚这里有没有什么特别的孤独特质？
I'm wondering if there's any Australian qualities in particular to loneliness here.
这个问题问得好。
That's a good question.
因为，怎么说呢……
Because what what...
我的问题是，什么是澳大利亚式的？
My my my question is what is Australian?
因为澳大利亚太多元文化了。
Because Australia is so multicultural.
这还真把我问住了。
So got me there.
我收回这个问题。
I retract the question.
这里有个来自短信平台的问题。
There's a question here from the text line.
你对用AI伴侣来缓解孤独有什么看法？
What are your thoughts on AI companions for loneliness?
这个问题问得好。
That's a great question.
我觉得我在这里有一整章关于技术的内容。
I I think I have a whole chapter on technology here.
坦白说，我确实支持一些技术的使用，但技能方面，你知道，我们在教年轻人如何交朋友和维持友谊的技能。
And to be open, I do advocate for some technology use, but skills, you know, we're teaching young people skills on how to make friends and how to maintain friendships.
AI伴侣的发展正在加速。
AI companionship is accelerated.
现在在澳大利亚，它真的也开始被广泛采用了。
It's really being now taken up as well in Australia.
我觉得现在不够的是，开发这项技术的人是谁，透明度不够。
What I don't see enough of is, I guess, a bit of transparency of who's developing the technology.
我敢肯定不是健康专业人士，因为我在想的是，如果一个人很孤独，可能非常容易受到心理健康问题的影响，或者有自杀念头，你知道，那些我们谈论和关注的更严重的事情，那种互动会变成什么样？
I'm pretty sure it's not health professionals because what I'm thinking about is if someone is lonely and maybe incredibly vulnerable to mental ill health or, you know, suicidal ideation, you know, kind of the more serious things that we talk about and we pay attention to, what happens to that interaction?
而现在AI或者AI模型的方式，至少目前，大部分都是系统在附和你的观点。
And the way AIs or the models of AI right now, at least right now, most of it is very much just the system agreeing with you.
所以如果你心情不好，我无法想象，它们会一直跟你唱反调吗？
So if you're not in a good headspace, I can't imagine, will they keep on disagreeing with you?
所以我……
So I...
我的观点是，我们对这个以及它是如何构建的，了解得还不够。
My my thing is that we don't know enough about this and how it's being built.
而且我们不知道……
And we don't know...
安全是我最大的担忧，还有监管和透明度。
Safety is the the biggest issue I have and regulation and transparency.
这些措施目前还没有真正落实到位。
Those sorts of things are not really put in place at this stage.
所以，对于AI伴侣给年轻人提供那种支持，我其实非常谨慎。
So it's something that I'm very hesitant about in terms of an AI companion offering that sort of support to young people.
非常感谢您，米歇尔·林医生。
Thank you so much, doctor Michelle Lim.
她是“共同终结孤独”组织的首席执行官兼科学主席，这是澳大利亚应对孤独和社会隔离的最高机构。
She's the CEO and scientific chair of Ending Loneliness Together, which is Australia's peak body addressing loneliness and social isolation.
她也是新书《孤独的一代：为什么我们的孩子陷入危机以及如何解决》的作者。
She's also the author of a new book called The Lonely Generation, Why Our Kids Are in Crisis and How We Fix It.
在本次对话中，还有最后一条短信。
Just one final text in this conversation.
发短信的人说，作为一个年轻人，我觉得社交媒体扮演着巨大的角色。
The texter says, as a young person, I feel as though social media has a huge role to play.
当过度使用时，我常常觉得自己错过了很多活动，而且我的关系也不像屏幕上展示的那样令人满意。
When used excessively, I often feel as though I'm missing out on the action and that my relationships are not adequate in the ways they are portrayed to be on screen.
是的。
Yes.
我们在屏幕上看到的很多东西都是精心策划的，我们必须意识到这一点。
A lot of what we see on screen is very curated, and we have to be aware of that.
接下来，不久前媒体上还有大规模的反盗版宣传活动。
Next up, it wasn't too long ago that there were huge anti piracy campaigns in the media.
但流媒体服务是如何说服人们付费观看内容比替代方案更好的呢？
But how did streaming services convince people that paying for content was better than the alternative?
我们来看看。
We're going to find out.
你还记得那些广告吧。
You remember the ads.
我喜欢那个。
I love that.
我可以让它播一整天。
I could let that run all day.
你不会去偷一辆车，对吧？
You wouldn't steal a car, would you?
不会。
No.
多年来，这样的信息无处不在，警告我们非法下载和分享电影、音乐和电视节目会有什么后果。
For years, messages like that were everywhere, warning us about the consequences of illegally downloading and sharing movies, music, and TV.
后来流媒体兴起了，突然之间，我们不再想方设法绕过付费娱乐，而是有一堆服务每个月让我们付费。
Then streaming took off, and suddenly, instead of finding ways around paying for entertainment, we had a stack of services asking us to pay every month.
而且我们确实付了，澳大利亚人平均每月在视频流媒体平台上花费大约42美元。
And pay we have, Australians pay roughly $42 a month on video streaming platforms.
那么，是什么改变了呢？
So what has changed?
是什么让我们乖乖听话了？
What made us fall in line?
我们现在真的很少听到关于盗版的事了。
We don't really hear about piracy anymore.
流媒体赢下这场仗了吗？
Has streaming won the battle?
稍后，你会听到一位消费者行为专家的观点。
Shortly, you'll hear from a consumer behavior expert.
但我想听听你的想法。
But I wanna hear from you.
你现在在付几个流媒体账号的费用？
How many streaming accounts are you paying for?
是不是已经数不清了？
Have you lost count?
哪些是你长期保留的？
Which do you keep for the long term?
哪些是你开了又关、关了又开的？
Which do you switch on and off from?
我得坦白说。
I'm gonna confess.
我九月份给自己开了几个新的流媒体服务，结果加起来差不多一百美元。
I treated myself to a couple new streaming services just for the month of September, and the total came across the streamers to close to a $100.
不用说，我很快就要取消这些订阅了。
Suffice to say, I'm canceling things very, very soon.
不过这只是为了透明起见。
But that's just for the sake of transparency.
请跟我分享你的流媒体订阅情况吧。
Please do share your streaming confessions with me.
有人能超过一百美元吗？
Can anybody top a $100?
我希望没有。
I hope not.
保罗·哈里森博士是迪肯大学消费者行为学的负责人。
Doctor Paul Harrison is head of consumer behavior at Deakin University.
他加入了Life Matters Fort Lee节目...
He joins Life Matters Fort Lee...
每两周一次，在我们的《买家当心》栏目中。
Fortnightly for our segment Buyer Beware.
保罗，我亮出了我的金额。
Paul, I showed mine, my amount.
你订阅了多少个流媒体服务？
How many streaming services have you signed up for?
你愿意跟全国观众分享一个具体的数字吗？
And do you have a dollar figure that you care to share with the nation?
说实话，贝芙，我可能比你订得还多。
I think it's probably more than you, Bev, to be honest.
而且，前几天我才发现，我居然订阅了一个自己都不知道的服务。
And actually, the other day, I realized subscription to one that I hadn't even known that I had a subscription to.
所以，是的，我也一样是受害者。
So, yeah, I'm just as much of a victim.
我也是受害者。
I'm I'm a victim.
好的。
Okay.
稍后我想吐槽一下那些既要你付费还要给你看广告的流媒体服务。
A little later on, I wanna complain about streaming services that make you pay and then also show you ads.
不过我们先回到更早之前，在流媒体出现之前。
Take us back though to a little time ago before streaming.
那时候媒体消费者的市场是什么样的？
What was the market like for media consumers?
嗯，我觉得关键在于，你想想那些系统……
Well, I I mean, I think that's the thing is that you think about systems...
像Napster那样的服务，那些是非法的系统。
Services like Napster and those kinds of things, which were illegal systems.
我觉得音乐和任何形式的艺术本身一直在以某种方式演变，你可以想想，一百五十年前，人们得去音乐厅或者音乐厅才能听音乐。
I think music and any form of art itself has always kind of evolved in a particular way, and you can kind of think about the fact that a hundred and fifty years ago, people used to have to go to a music hall or a concert hall to listen to music.
随着时间推移，人们想要更方便。
As time kind of moved on, people wanted more convenience.
我们开始能买唱片，然后是CD，接着我们开始……
We started being able to buy things on records and then CDs, and then we started...
我不知道大家还记不记得，早期那种服务就是CD直接寄到你家。
I don't know if people remember that the early days of the kind of services was that you'd get CDs sent to your house.
我……
I...
你可以租……
You would rent...
描述一下那个服务。
Describe to that service.
对。
Exactly.
就是
It was
一个DVD租赁服务。
a DVD learning service.
DVD和
DVDs and
还有CD。
and CDs.
对。
Exactly.
没错。
Exactly.
然后……
And so...
而且，你知道，所有这些演变最终导致了一大堆不同技术的融合，这意味着我们可以流媒体播放音乐了。
And that was, you know, again, all of these types of evolutions led to basically a a conflagration of a whole bunch of different technologies coming together, which meant that we could stream music.
所以很多时候，技术和创新并不是突然爆发的。
So often technology and innovation doesn't happen in some kind of big burst.
而是很多因素在合适的时候汇聚在一起。
It's a whole series of things come together at the right time.
现在，流媒体就是我们目前所处的阶段。
Right now, streaming is where we are right now.
谁知道未来会是什么样子呢？
Who knows what it looks like in the future?
那么从我们的行为来看，为什么我们变得不那么厌恶风险，更愿意掏钱付费了呢？
So in terms of our behavior, why have we become less risk averse and happier to open our wallet to pay?
我觉得归根结底，核心原则就是便利性。
I I think ultimately, the underlying principle is the convenience.
我的意思是，即使我们当初尝试使用那些点对点服务时，那也是……
And so what I mean by that is that even when we were trying to use those peer to peer type services, it was it was...
替代方案要么是买CD，要么是去图书馆借CD。
The alternative was either buying CDs or going to the library and renting CDs.
所以那比直接买音乐本身要方便得多。
So that was a more convenient option than actually buying the music itself.
我觉得很多发行公司没有理解的是，人们的行为很好地反映了他们想要怎么行事。
What I think a lot of the distribution companies didn't understand was that people people's behavior is a good indicator of how people want to behave.
所以人们当时在做的事情就是流媒体，或者他们用的是某种形式的流媒体，也就是点对点。
And so what people were doing was streaming or that they were using a form of streaming, the peer to boot peer.
他们用了法律手段，包括那个……
They used the legal mechanism, which is including the...
你刚才展示的那个广告，试图阻止人们做某些事，但实际上大多数人都想遵纪守法。
That ad that you just showed to try and prevent people from doing something when in fact, most people want to be law abiding.
大多数人都不想当盗版者。
Most people do not wanna be pirates.
所以大多数时候，他们……
And so most of the time, they...
最终，他们只需要想出另一种方式，把那个特定的服务提供给人们。
Ultimately, all they had to do was come up with a different way of getting that particular service to people.
然后我们都乖乖听话了。
And we all fell in line.
现在，有一个特定的流媒体服务，我就不点名了，但不管付多少钱都无所谓。
Now, there's a particular streaming service I'm not gonna name here, but it doesn't matter how much you pay for it.
他们还是会给你插广告。
They're still going to charge you ads.
对。
Yes.
而且有时候，它是我最贵的流媒体服务。
And sometimes, it's it's my most expensive streaming service.
为什么我们作为消费者，还乐意接受这种事？
Why, as consumers, are we happy to do that?
我能理解那些便宜的套餐，你付得少，看广告，这没问题。
I understand the budget ones where you're paying just a little bit and you get ads, fine.
但到了高端套餐这个级别，为什么我们还接受这种行为？
But when you get to that premium space, why do we accept that behavior?
那我想问问你，Bev。
Well, I'd ask you, Bev.
你为什么愿意接受
Why are you willing to accept
我不是
I'm not
想要那个特定服务的人，但确实是的。
the one who wants that particular service, but yes.
那不就得了。
Well, there you go.
那不就得了。
Well, there you go.
这其实很有意思，有时候我们想要的东西，并不一定是我们真正花钱买的东西。
And that's a really interesting thing is that sometimes the things that we want aren't necessarily influenced by the things that we actually pay for.
所以你可能住在一个家里，有人想要某个特定服务，比如你有孩子或者伴侣什么的，他们想要那个。
And so you might live in a household where people want a particular service, where where you have kids or you have a partner or something like that who wants that.
所以人类行为真的很复杂。
So human behavior is really quite complex.
归根结底，就是各种不同的成本，以及我拿什么来交换。
What it comes down to is all sorts of different forms of cost, and what am I trading off in return.
某种程度上，你是在权衡，我愿意为广告买单，因为这是我喜欢的服务。
In a way, you know, you're trading off here, I'll pay for the ads because it's a service that I I like.
很多时候，我们以为消费者行为中唯一的开销或成本就是金钱。
And a lot of the time, we think that the only expense or the only cost involved in consumer behavior is the financial cost.
还有时间。
It's time.
还有精力。
It's effort.
还有身边有人不停说“拜托，我们能要这个吗”的那种烦人劲儿。
It's just the annoyingness of having people around saying, please, can we have this?
我们为了得到想要的东西，会权衡很多因素。
We trade off a whole bunch of things to get the things that we want.
我们一直在付出代价。
We're paying all the time.
这里是ABC国家广播电台的《生活要事》节目。
This is Life Matters right here on ABC Radio National.
我是贝弗莉·王，你正在收听的是保罗·哈里森，我们《买家当心》节目的消费行为专家。
I'm Beverly Wang, and you're hearing from Paul Harrison, our consumer behavior expert here for Buyer Beware.
这里很安全，所以你就实话实说吧。
It's a safe space, so be honest.
如果你以前在内容、音乐、电影方面有点像个海盗，告诉我你是不是……
If you were a bit of a pirate back in the day on content, music, movies, tell me if you were...
在短信平台上举手示意一下。
Put your hand up on the text line.
有个海盗浮出水面了。
And a pirate has surfaced.
啊嘿。
Arr.
啊嘿。
Arr.
马蒂斯在短信平台上，这位海盗说：我今天打算盗播一个电视节目，因为我虽然付了两三个服务的钱，但我想看的那个节目不在这些服务里。
Matisse on the text line, and the pirate says, I'm planning today to pirate a TV show because while I pay two or three services, the show I wanna watch is not on those.
如果他们一年赚几十亿，那我心里也过得去。
And if they make billions a year, I can feel okay about that.
而且我也开始更多地回归购买实体媒体了。
Also started to lean back more into owning physical media.
对于这种心理算账，觉得没关系，他们赚几十亿呢，你怎么看？
What's your response to that kind of mental arithmetic that it's okay, they're making billions?
这真是那种合理化思维的绝佳例子，就是他们并没有亏钱。
That's such a perfect perfect example of this of this rationalization, which is they're not losing money.
我只是一个人而已。
I'm just one person.
反正我本来也不会买。
I wouldn't have bought it anyway.
我也不想要那个服务。
I don't want that service.
你知道，这家公司现在赚得够多了。
You know, this company makes enough money now.
这些都是我们为了某种程度上的违法而给自己找的合理化借口。
These are these are these rationalizations that we twist ourselves into to some degree to break the law.
我觉得归根结底就是，从某种意义上说，我们都有点像罪犯，因为我们时不时都会犯点法。
And I think that's what it comes down to is that in a way, we're all kind of criminals because we all tend to break the law here and there from time to time.
比如，大多数人都会超速，大多数人有时候不小心开车经过某个地方，本来该减速或者该让行什么的。
Like, most people speed, most people kind of, you know, sometimes accidentally, you know, drive through somewhere and they were meant to slow down or they were meant to give way or whatever.
所以问题就在于，我们总是为自己的行为找合理化解释。
So this is the thing is that we make rationalizations about behavior.
这个例子是……
This one here is...
有意思的是，尤其是数字音乐，它被视为……
It's interesting because particularly with digital music, it's seen...
或者数字音频、视频，感觉好像没有受害者。
Or digital audio or video, it feels victimless as well.
就像，下载这个东西和它长期造成的影响之间，存在一种心理上的脱节。
Like, there is a psychological gap between the reality of I'm downloading this and the effect that it has in the long term.
但这种情况在很多方面都会再次发生。
But it happens again in all sorts of ways.
再说，人们往往只有在规则的效果是立竿见影的时候才会去遵守。
Again, people tend to only respond to rules if to some degree they're...
也就是说，要么你能立刻感受到规则带来的影响，要么罚款或者其他后果马上就来了。
The the actual effect of the rule is immediate, so you actually experience it happen, or the the fine or the whatever happens happens immediately.
一般来说，我们并不知道……
Generally speaking, you know, we we don't know if...
当我们犯罪的时候，我们是否真的会惹上麻烦，我觉得这也是其中的一部分原因。
When we're committing a crime, whether actually we're going to get in trouble, and I think that's part of it.
那些广告宣传活动就是想把这个点突出出来，但这类道德宣传活动通常没什么效果。
That's what they were trying to do with those ad campaigns is to try and bring it to the front, but these types of moral campaigns rarely work.
嗯，有意思的是，目前澳大利亚正在讨论烟草价格的问题。
Well, it's interesting because at the moment in Australia, we're having a conversation about the price of tobacco.
合法烟草和非法烟草的价格对比。
The legal cost of tobacco versus the illegal tobacco.
你觉得你刚才跟我说的这些想法，怎么应用到那个情况里？
How do you see these ideas you've just described to me translating into that scenario?
我觉得有几个想法挺适用的。
Well, I think there are a couple that are a good translation.
其中一个就是，某种程度上……
One of the thing is that to some...
对很多抽烟的人来说，烟草很贵，因为监管和相关的成本。
For a lot of people who smoke, tobacco is expensive or or because of regulation and because of the costs that are involved with that.
所以人们就会想，对，确实贵。
So people will go, yeah.
你知道，就是，太贵了。
You know, like, it's expensive.
有别的选择。
There's an alternative.
这里的复杂之处在于，这不像搞个道德宣传那么简单。
The complexity here is that it's not as simple as kind of running a moral campaign or whatever.
我觉得大家首先需要明白的一点是，我可以通过省钱来获得买这个东西的好处。
I think the the immediate issue that people need to kind of process is I can get the benefit of buying this by saving money.
他们没考虑到的是那些更长期的影响。
What they're not thinking about is the the kind of longer term effects.
执法也很复杂，就像音乐盗版之类的。
Enforcement is complex as well, similar to music piracy or whatever.
执行起来很复杂。
The enforcement of it is complex.
所以，是的，这……
So, yeah, it...
不过，我们看到的非法烟草问题也反映出……
It's also though what we're seeing with illicit tobacco is kind of...
我想这正好说明了，光告诉人们不要做是有限度的。
I guess it highlights the the limits of, you know, just tell people not to do it.
因为我觉得我们常常会这么想。
Because I think that's what we often think.
我们觉得，给人们提供信息，告诉他们为什么不好，说，你知道的，这就是你不该这么做的原因。
We think we'll give people information, we'll say why it's bad, we'll say, you know, this is why you shouldn't be doing this.
但实际上……
It's actually...
这挺抽象的，人们不一定对抽象的信息有很好的反应。
That's quite abstract, and people don't necessarily respond that well to abstract messaging.
必须要有某种即时的回应。
There has to be some kind of immediate response.
大多数人，他们更关注眼前的东西，而不是长期的后果。
Most most people, they respond to something that's immediately in front of them rather than necessarily the longer term consequences.
这里有个问题，我想听听你对这段文字的看法。
Here's a question or I'd like to get your thoughts on this text.
发短信的人说，当流媒体服务让用户额外付费购买内容，但之后又交易掉那些内容的权利，导致内容不再在该平台上可用时，那个专门为此付费的人会毫无愧疚地去盗版，甚至盗版更多。
The texter says, when streaming services have users buy content at an additional fee, but then trade off the rights for that content and is no longer available on that platform, the person that paid specifically for it is going to pirate it and more without remorse.
你怎么看？
What do think?
这就是商业世界，我觉得关键就在这里。再说，我认为那位发消息进来的听众说得完全正确。
And that's the business world, and I think that's the thing is, again, I think, yes, the the the person who messaged that in, texted that in, is exactly right.
但我觉得我们现在生活的这个世界，有太多所谓的中间层级的代理商，也就是不同的公司。
But I think we live in this world now where there are so many, what you would call the kind of mid mid kind of tier agents, the different companies.
所以那些流媒体服务，大多数其实并不真正制作很多内容，但它们却拿这些内容去和其他消费者的决策做交易。
So any of those streaming services, most of them don't really actually make a lot of the content, and yet they are trading that off against other consumers' decisions.
最后三十秒，保罗·哈里森。
Final thirty seconds for you, Paul Harrison.
我们看到流媒体服务开始收紧账户共享并提高价格。
We've seen streaming services start to tighten up on sharing accounts and raising prices.
那你觉得我们未来的情况会怎样？
So what do you think the future holds for us there?
我不知道，而且我从来不预测未来，因为你……
I have no idea, and I choose not to predict the future always because you...
比如，我一直在ABC上看《黑天鹅》之类的节目。
Like, I've been watching Black Swans on the ABC and everything like that.
我觉得预测未来总是很难的。
I think it's always hard to predict the future.
好的。
Alright.
好吧，我尽力了。
Well, I tried.
有道理。
Fair enough.
保罗·哈里森博士是迪肯大学消费者行为学的负责人。
Doctor Paul Harrison is head of consumer behavior at Deakin University.
他每两周来参加我们的《买家当心》栏目。
He joins Life Matters fortnightly for our segment Buyer Beware.
还有几条你们的留言要进来。
And just a couple more of your techs coming in.
克里斯说，我的原则是同时只订阅一个流媒体服务。
Chris says, I live by rule never to have more than one streaming service at a time.
我能看多少？
How much can I watch?
还有很多人自豪地说，你们看流媒体一分钱都不花。
And so many of you proudly proclaiming that you pay zero for streaming services.
你们比我强多了。
You are a much better person than I am.
恭喜你们。
Congratulations.
关于我们之前聊到的，在医疗和心理咨询中使用人工智能的话题。
About that conversation we had earlier about the use of AI in medical appointments and psychologists appointments.
这里有一些听众的反馈。
Here are a few of them.
有位听众发短信说，我已经要求医生和专家不要用AI做笔记，因为报告回来后信息有误，需要更正。
One texter says, I've asked medical doctors and specialists to not use AI for notes after reports return with incorrect information which required correction.
凯伦说，我的家庭医生也要求这样做。
Karen says, my GP has asked to do this.
只要它是作为诊断和治疗的辅助检查手段，我完全没问题。
I have no problems as long as it's used as a secondary check to the diagnosis and treatment.
也就是说，最终决定还是由我的医生来做。
That is my that is my doctor makes the final decision.
最重要的是，AI捕捉到的对话中，我的身份不能被识别出来。
And most importantly, that I am not identifiable in the conversation captured by AI.
我不确定实际情况是不是这样。
I'm not sure this is the case.
我很想知道这一点。
I'd be interested to know this.
还有一位发短信的人说，我的心理医生可以应用特定的模型来做笔记，所以AI不仅能逐字记录，还能理解对话内容。
One more texter says, my psychologist has a capacity to have a particular model applied to the note taking, so AI has the capacity to interpret the conversation, not just take notes verbatim.
我确实同意了，但当我听到带有这种附加解读的会话回放时，感觉很奇怪，而且这显然有风险。
I did give my consent, but it was weird having a session read back to me with this overlay, and this clearly has its risks.
最后一条短信。
One final text.
应该承诺与患者再次确认，记录或总结的内容确实是他们实际说过的。
There should be a commitment to double check with a patient that what has been recorded and or summarized is what has actually been said.
我们不能假设录音或总结是准确的，医疗专业人员应该对患者的隐私负责，我觉得这有问题。
We can't assume that the recording or the summary is correct, and the health professional should take responsibility for the privacy of the patient, which I think is problematic.
非常感谢你总是让我们知道你的想法。
Thank you so much for always letting us know what you think.
明天在《生活要事》节目中，职场生活栏目的丽莎·梁将和我一起主持她的常规环节，我们将讨论如何在倦怠季节照顾好自己。
Tomorrow on Life Matters, This Working Life's Lisa Leung joins me for her regular segment, and we're going to be talking about how to take care of yourself during burnout season.
这显然是一个周期性现象。
This is apparently a regular cycle.
那你如何应对呢？
So how do you cope with it?
丽莎·梁会给我们指引方向。
Lisa Leong will guide the way.
随着AFLW职业联赛迎来十周年，它也在澳大利亚各地激发了一些艺术创作。
And as AFLW celebrates its tenth year as a professional league, it's inspired a few works of art across Australia.
我们来仔细看看体育和艺术这种跨界结合。
We're going to take a closer look at this crossover of sport and art.
明天《生活要事》节目见。
That's tomorrow on Life Matters.
我是贝弗莉·王。
I'm Beverly Wang.
到时候见。
I'll catch you then.
你收听的是澳大利亚广播公司的播客。
You've been listening to an ABC podcast.
你可以在ABC Listen应用上发现更多ABC播客、直播电台和独家内容。
You can discover more ABC podcasts, live radio, and exclusives on the ABC Listen app.
关于 Bayt 播客
Bayt 提供中文+原文双语音频和字幕，帮助你打破语言障碍，轻松听懂全球优质播客。