What is "Medicine"? A scoping review as baseline for the Generative AI era

The meaning of “medicine” has received very little systematic attention. This scoping review summarizes published English-language efforts to define or conceptualize “medicine” and serves as a baseline for an era in which generative artificial intelligence (GenAI) and other computational systems increasingly participate in medical activities, reshaping the notion of expertise, and blurring the limits of authority, accountability and governance. We searched PubMed, Embase and the Cochrane Database of Systematic Reviews; Google Scholar (to March 2020); the top 11 English dictionaries; and the websites of the world’s top 10 ranked medical schools, all 113 members of the World Medical Association, and other major institutions. We included any text-based definition or conceptualization and extracted data in duplicate, copying eligible statements verbatim. The searches yielded 5,341 citations; 17 sources contained eligible statements. Of these, 12 mentioned health, 10 considered medicine as a science, and 9 focused on the prevention, treatment or cure of diseases. All dictionaries provided at least one eligible statement, most emphasizing disease/illness and some mentioning health. None of the screened medical schools, associations or institutions offered an explicit definition or conceptualization, and no source described a systematic, replicable process to capture the meaning of “medicine.” Bold, systematic and replicable initiatives are needed to fill this gap, to separate medicine from other professions, and to clarify its role in the creation and preservation of health beyond the chemical-mechanical view of patients and their diseases. Without systematic definition or conceptualization, medicine risks being shaped by operational forces, such as billing structures, automation capabilities, and platform incentives, rather than by principled commitments about its purpose and boundaries.