The twilight of phronesis and the rise of the algorithmic leviathan:a critical exegesis on the replacement of clinical judgment by computational reason in the age of technoscience

Abstract

The present study constitutes a critical investigation into the ontological mutation of contemporary medical practice, precipitated by the large-scale integration of Generative Artificial Intelligence and Large Language Models (LLMs). Drawing on the philosophy of technology (Heidegger, Stiegler), psychoanalysis (Lacan), and digital sociology (Rouvroy, Morozov), the analysis examines the progressive substitution of phronesis (practical wisdom) by automated techne, and the consequent foreclosure of the subject within the clinical encounter. The article dissects “algorithmic governmentality” as a vector of productivist pressure in saturated healthcare systems, the precarization of medical training in contexts marked by the absence of diploma revalidation mechanisms (Revalida), and the systemic risks emerging from Shadow IT practices and low-code platforms operated by so-called “citizen developers.” It concludes that the apparent efficiency of technical systems conceals the erosion of subjective responsibility, the production of simulacra of truth (bullshit), and the radical dehumanization of care.