The Inevitable Evolution of Bad Science

Ed Yong
The Atlantic
Originally published September 21, 2016

Here is an excerpt:

In the model, as in real academia, positive results are easier to publish than negative one, and labs that publish more get more prestige, funding, and students. They also pass their practices on. With every generation, one of the oldest labs dies off, while one of the most productive one reproduces, creating an offspring that mimics the research style of the parent. That’s the equivalent of a student from a successful team starting a lab of their own.

Over time, and across many simulations, the virtual labs inexorably slid towards less effort, poorer methods, and almost entirely unreliable results. And here’s the important thing: Unlike the hypothetical researcher I conjured up earlier, none of these simulated scientists are actively trying to cheat. They used no strategy, and they behaved with integrity. And yet, the community naturally slid towards poorer methods. What the model shows is that a world that rewards scientists for publications above all else—a world not unlike this one—naturally selects for weak science.

“The model may even be optimistic,” says Brian Nosek from the Center of Open Science, because it doesn’t account for our unfortunate tendency to justify and defend the status quo. He notes, for example, that studies in the social and biological sciences are, on average, woefully underpowered—they are too small to find reliable results.

The article is here.

Scientists “Switch Off” Self-Control Using Brain Stimulation

By Catherine Caruso
Scientific American
Originally published on October 19, 2016

Imagine you are faced with the classic thought experiment dilemma: You can take a pile of money now or wait and get an even bigger stash of cash later on. Which option do you choose? Your level of self-control, researchers have found, may have to do with a region of the brain that lets us take the perspective of others—including that of our future self.

A study, published today in Science Advances, found that when scientists used noninvasive brain stimulation to disrupt a brain region called the temporoparietal junction (TPJ), people appeared less able to see things from the point of view of their future selves or of another person, and consequently were less likely to share money with others and more inclined to opt for immediate cash instead of waiting for a larger bounty at a later date.

The TPJ, which is located where the temporal and parietal lobes meet, plays an important role in social functioning, particularly in our ability to understand situations from the perspectives of other people. However, according to Alexander Soutschek, an economist at the University of Zurich and lead author on the study, previous research on self-control and delayed gratification has focused instead on the prefrontal brain regions involved in impulse control.

The article is here.

Walter Sinnott-Armstrong discusses artificial intelligence and morality

By Joyce Er
Duke Chronicle
Originally published October 25, 2016

How do we create artificial intelligence that serves mankind’s purposes? Walter Sinnott-Armstrong, Chauncey Stillman professor of practical ethics, led a discussion Monday on the subject.

Through an open discussion funded by the Future of Life Institute, Sinnott-Armstrong raised issues at the intersection of computer science and ethical philosophy. Among the tricky questions Sinnott-Armstrong tackled were programming artificial intelligence so that it would not eliminate the human race as well as the legal and moral issues involving self-driving cars.

Sinnott-Armstrong noted that artificial intelligence and morality are not as irreconcilable as some might believe, despite one being regarded as highly structured and the other seen as highly subjective. He highlighted various uses for artificial intelligence in resolving moral conflicts, such as improving criminal justice and locating terrorists.

The article is here.

A Bright Robot Future Awaits, Once This Downer Election Is Over

By Andrew Mayeda
Bloomberg
Originally published October 24, 2016

Here is an excerpt:

‘Singularity Is Near’

An hour’s drive away, in San Francisco, the influx of tech workers has helped push the median single-family home price to $1.26 million. Private buses carry them to jobs at Apple Inc., Alphabet Inc.’s Google, or Facebook. Meanwhile, one former mayor has proposed using a decommissioned aircraft carrier to house the city’s homeless, who throng the sidewalks along Market Street, home to Uber and Twitter Inc.

How much will the “second machine age” deepen such divisions? Last month, a trio of International Monetary Fund economists came up with some chilling answers. Even if humans retain their creative edge over robots, they found, it will likely take two decades before productivity gains outweigh the downward pressure on wages from automation; meanwhile, “inequality will be worse, possibly dramatically so.”

And if the robots become perfect substitutes, the paper envisages an extreme scenario in which labor becomes wholly redundant as “capital takes over the entire economy.” The IMF economists even invoke futurist Ray Kurzweil’s 2006 bestseller, “The Singularity Is Near.”

Silicon Valley executives say alarm bells have been ringing for decades about job-killing technology, and they’re usually false alarms.

The article is here.

The VSED Exit: A Way to Speed Up Dying, Without Asking Permission

by Paula Span
The New York Times
Originally published October 21, 2016

Here is an excerpt:

In end-of-life circles, this option is called VSED (usually pronounced VEEsed), for voluntarily stopping eating and drinking. It causes death by dehydration, usually within seven to 14 days. To people with serious illnesses who want to hasten their deaths, a small but determined group, VSED can sound like a reasonable exit strategy.

Unlike aid with dying, now legal in five states, it doesn't require governmental action or physicians' authorization. Patients don't need a terminal diagnosis, and they don't have to prove mental capacity. They do need resolve.

"It's for strong-willed, independent people with very supportive families," said Dr. Timothy Quill, a veteran palliative care physician at the University of Rochester Medical Center.

He was speaking at a conference on VSED, billed as the nation's first, at Seattle University School of Law this month. It drew about 220 participants -- physicians and nurses, lawyers, bioethicists, academics of various stripes, theologians, hospice staff. (Disclosure: I was also a speaker, and received an honorarium and some travel costs.)

What the gathering made clear was that much about VSED remains unclear.

Is it legal?

For a mentally competent patient, able to grasp and communicate decisions, probably so, said Thaddeus Pope, director of the Health Law Institute at Mitchell Hamline School of Law in St. Paul, Minn. His research has found no laws expressly prohibiting competent people from VSED, and the right to refuse medical and health care intervention is well established.

The article is here.

Why Suicide Keeps Rising for Middle-Aged Men

By Lisa Esposito
US News and World Report
Originally published Oct. 19, 2016

Suicide rates in the U.S. continue to rise, and working-age adults – particularly men – make up the largest increase, according to the Centers for Disease Control and Prevention. Middle-aged men in the 45 to 60 range experienced a 43 percent increase in suicide deaths from 1997 to 2014, and the rise has been even sharper since 2005. Untreated mental illness, the Great Recession, work-related issues and men's reluctance to reach out for help converge to put them at greater risk for taking their own lives. And because men are more likely than women to use a gun, their suicide attempts are more often fatal.

Historically, suicide rates have always been higher for men, says Dr. Alex Crosby, surveillance branch chief in the CDC's Division of Violence Prevention. "But what we've seen in these past few years is rates have been going up among males and females," he told journalists attending a National Press Foundation conference in September. "Still, rates are higher among males – about four times higher." For suicide attempts that don't prove fatal, the balance changes, with two to three times more females than males trying to take their own lives.

"In about half of the suicides in the United States, the mechanism or the method was a firearm," Crosby says. Males are more likely to use firearms, while poison is more common for females. However, he notes, "When you look at suicide in the military, females choose firearms almost as much as men."

The article is here.

Moral Dilemmas and Guilt

Patricia S. Greenspan
Philosophical Studies: An International Journal for Philosophy in the Analytic Tradition
Vol. 43, No. 1 (Jan., 1983), pp. 117-125

In 'Moral dilemmas and ethical consistency', Ruth Marcus argues that moral dilemmas are 'real': there are cases where an agent ought to perform each of two incompatible actions.  Thus, a doctor with two patients equally in need of his attention ought to save each, even though he cannot save both. By
claiming that his dilemma is real, I take Marcus to be denying (rightly) that it is merely epistemic - a matter of uncertainty as to which patient to save.  Rather, she wants to say, the moral code yields two opposing recommendations, both telling him what he ought to do. The code is not inconsistent,
however, as long as its rules are all obeyable in some possible world; and it is not deficient as a guide to action, as long as it contains a second order principle, directing an agent to avoid situations of conflict. Where a dilemma does arise, though, the agent is guilty no matter what he does.

This last point seems implausible for the doctor's case; but here I shall consider a case which does fit Marcus's comments on guilt - if not all her views on the nature of moral dilemma.  I think that she errs, first of all, in counting as a dilemma any case where there are some considerations favoring each of two incompatible actions, even if it is clear that one of them is right. For instance, in the case of withholding weapons from someone who has gone mad, it would be unreasonable for the agent to feel guilty about breaking his promise, since he has done exactly as he should. But secondly, even in
Marcus's 'strong' cases, I do not think that dilemmas must be taken as yielding opposing all-things-considered ought-judgments, viewed as recommendations for action, rather than stopping with judgments of obligation, or reports of commitments. The latter do not imply 'can' (in the sense of physical possibility); and where they are jointly unsatisfiable, and supported by reasons of equal weight, I think we should say that the moral code yields no particular recommendations, rather than two which conflict.

The article is here.

The map is not the territory: medical records and 21st century practice

Stephen A Martin & Christine A Sinsky
The Lancet
Published: 25 April 2016

Summary

Documentation of care is at risk of overtaking the delivery of care in terms of time, clinician focus, and perceived importance. The medical record as currently used for documentation contributes to increased cognitive workload, strained clinician–patient relationships, and burnout. We posit that a near verbatim transcript of the clinical encounter is neither feasible nor desirable, and that attempts to produce this exact recording are harmful to patients, clinicians, and the health system. In this Viewpoint, we focus on the alternative constructions of the medical record to bring them back to their primary purpose—to aid cognition, communicate, create a succinct account of care, and support longitudinal comprehensive care—thereby to support the building of relationships and medical decision making while decreasing workload.

Here are two excerpts:

While our vantage point is American, documentation guidelines are part of a global tapestry of what has been termed technogovernance, a bureaucratic model in which professionals' behaviour is shaped and manipulated by tight regulatory policies.

(cut)

In 1931, the scientist Alfred Korzybski introduced the phrase "the map is not the territory", to suggest that the representation of reality is not reality itself. In health care, creating the map (ie, the clinical record) can take on more importance and consume more resources than providing care itself. Indeed, more time may be spent documenting care than delivering care. In addition, fee-for-service payment arrangements pay for the map (the medical note), not the territory (the actual care). Readers of contemporary electronic notes, composed generously of auto-text output, copy forward text, and boiler plate statements for compliance, billing, and performance measurement understand all too well the gap between the map and the territory, and more profoundly, between what is done to patients in service of creating the map and what patients actually need.

Contemporary medical records are used for purposes that extend beyond supporting patient and caregiver. Records are used in quality evaluations, practitioner monitoring, practice certifications, billing justification, audit defence, disability determinations, health insurance risk assessments, legal actions, and research.

The article is here.

Psychiatric patients wait the longest in emergency rooms

By Amy Ellis Nutt
The Washington Post
Originally published October 18, 2016

Here is an excerpt:

Many studies over the past decade have shown that ER overcrowding results in higher mortality rates of ER patients, higher costs and higher stress levels for medical professionals.

That overcrowding won’t end anytime soon, Parker said, unless access to outpatient treatment centers expands. But in the latest survey, more than half of the ER physicians said mental health resources in their communities had declined in the past year.

The paradox at the heart of the problem is almost beyond comprehension, in Lippert’s view.

“Nowhere else in medicine,” she said, “do we have our most severely ill patients staying the longest.”

The article is here.