Insights Team
Forbes.com
Originally posted February 11, 2019
Here is an excerpt:
In June 2018, the American Medical Association (AMA) issued its first guidelines for how to develop, use and regulate AI. (Notably, the association refers to AI as “augmented intelligence,” reflecting its belief that AI will enhance, not replace, the work of physicians.) Among its recommendations, the AMA says, AI tools should be designed to identify and address bias and avoid creating or exacerbating disparities in the treatment of vulnerable populations. Tools, it adds, should be transparent and protect patient privacy.
None of those recommendations will be easy to satisfy. Here is how medical practitioners, researchers, and medical ethicists are approaching some of the most pressing ethical challenges.
Avoiding Bias
In 2017, the data analytics team at University of Chicago Medicine (UCM) used AI to predict how long a patient might stay in the hospital. The goal was to identify patients who could be released early, freeing up hospital resources and providing relief for the patient. A case manager would then be assigned to help sort out insurance, make sure the patient had a ride home, and otherwise smooth the way for early discharge.
In testing the system, the team found that the most accurate predictor of a patient’s length of stay was his or her ZIP code. This immediately raised red flags for the team: ZIP codes, they knew, were strongly correlated with a patient’s race and socioeconomic status. Relying on them would disproportionately affect African-Americans from Chicago’s poorest neighborhoods, who tended to stay in the hospital longer. The team decided that using the algorithm to assign case managers would be biased and unethical.
The info is here.
Sunday, March 10, 2019
Saturday, March 9, 2019
Can AI Help Reduce Disparities in General Medical and Mental Health Care?
Irene Y. Chen, Peter Szolovits, and Marzyeh Ghassemi
AMA J Ethics. 2019;21(2):E167-179.
doi: 10.1001/amajethics.2019.167.
Abstract
Background: As machine learning becomes increasingly common in health care applications, concerns have been raised about bias in these systems’ data, algorithms, and recommendations. Simply put, as health care improves for some, it might not improve for all.
Methods: Two case studies are examined using a machine learning algorithm on unstructured clinical and psychiatric notes to predict intensive care unit (ICU) mortality and 30-day psychiatric readmission with respect to race, gender, and insurance payer type as a proxy for socioeconomic status.
Results: Clinical note topics and psychiatric note topics were heterogenous with respect to race, gender, and insurance payer type, which reflects known clinical findings. Differences in prediction accuracy and therefore machine bias are shown with respect to gender and insurance type for ICU mortality and with respect to insurance policy for psychiatric 30-day readmission.
Conclusions: This analysis can provide a framework for assessing and identifying disparate impacts of artificial intelligence in health care.
AMA J Ethics. 2019;21(2):E167-179.
doi: 10.1001/amajethics.2019.167.
Abstract
Background: As machine learning becomes increasingly common in health care applications, concerns have been raised about bias in these systems’ data, algorithms, and recommendations. Simply put, as health care improves for some, it might not improve for all.
Methods: Two case studies are examined using a machine learning algorithm on unstructured clinical and psychiatric notes to predict intensive care unit (ICU) mortality and 30-day psychiatric readmission with respect to race, gender, and insurance payer type as a proxy for socioeconomic status.
Results: Clinical note topics and psychiatric note topics were heterogenous with respect to race, gender, and insurance payer type, which reflects known clinical findings. Differences in prediction accuracy and therefore machine bias are shown with respect to gender and insurance type for ICU mortality and with respect to insurance policy for psychiatric 30-day readmission.
Conclusions: This analysis can provide a framework for assessing and identifying disparate impacts of artificial intelligence in health care.
Friday, March 8, 2019
Seven moral rules found all around the world
University of Oxford
phys.org
Originally released February 12, 2019
Anthropologists at the University of Oxford have discovered what they believe to be seven universal moral rules.
The rules: help your family, help your group, return favours, be brave, defer to superiors, divide resources fairly, and respect others' property. These were found in a survey of 60 cultures from all around the world.
Previous studies have looked at some of these rules in some places – but none has looked at all of them in a large representative sample of societies. The present study, published in Current Anthropology, is the largest and most comprehensive cross-cultural survey of morals ever conducted.
The team from Oxford's Institute of Cognitive & Evolutionary Anthropology (part of the School of Anthropology & Museum Ethnography) analysed ethnographic accounts of ethics from 60 societies, comprising over 600,000 words from over 600 sources.
Dr. Oliver Scott Curry, lead author and senior researcher at the Institute for Cognitive and Evolutionary Anthropology, said: "The debate between moral universalists and moral relativists has raged for centuries, but now we have some answers. People everywhere face a similar set of social problems, and use a similar set of moral rules to solve them. As predicted, these seven moral rules appear to be universal across cultures. Everyone everywhere shares a common moral code. All agree that cooperating, promoting the common good, is the right thing to do."
The study tested the theory that morality evolved to promote cooperation, and that – because there are many types of cooperation – there are many types of morality. According to this theory of 'morality as cooperation," kin selection explains why we feel a special duty of care for our families, and why we abhor incest. Mutualism explains why we form groups and coalitions (there is strength and safety in numbers), and hence why we value unity, solidarity, and loyalty. Social exchange explains why we trust others, reciprocate favours, feel guilt and gratitude, make amends, and forgive. And conflict resolution explains why we engage in costly displays of prowess such as bravery and generosity, why we defer to our superiors, why we divide disputed resources fairly, and why we recognise prior possession.
The information is here.
phys.org
Originally released February 12, 2019
Anthropologists at the University of Oxford have discovered what they believe to be seven universal moral rules.
The rules: help your family, help your group, return favours, be brave, defer to superiors, divide resources fairly, and respect others' property. These were found in a survey of 60 cultures from all around the world.
Previous studies have looked at some of these rules in some places – but none has looked at all of them in a large representative sample of societies. The present study, published in Current Anthropology, is the largest and most comprehensive cross-cultural survey of morals ever conducted.
The team from Oxford's Institute of Cognitive & Evolutionary Anthropology (part of the School of Anthropology & Museum Ethnography) analysed ethnographic accounts of ethics from 60 societies, comprising over 600,000 words from over 600 sources.
Dr. Oliver Scott Curry, lead author and senior researcher at the Institute for Cognitive and Evolutionary Anthropology, said: "The debate between moral universalists and moral relativists has raged for centuries, but now we have some answers. People everywhere face a similar set of social problems, and use a similar set of moral rules to solve them. As predicted, these seven moral rules appear to be universal across cultures. Everyone everywhere shares a common moral code. All agree that cooperating, promoting the common good, is the right thing to do."
The study tested the theory that morality evolved to promote cooperation, and that – because there are many types of cooperation – there are many types of morality. According to this theory of 'morality as cooperation," kin selection explains why we feel a special duty of care for our families, and why we abhor incest. Mutualism explains why we form groups and coalitions (there is strength and safety in numbers), and hence why we value unity, solidarity, and loyalty. Social exchange explains why we trust others, reciprocate favours, feel guilt and gratitude, make amends, and forgive. And conflict resolution explains why we engage in costly displays of prowess such as bravery and generosity, why we defer to our superiors, why we divide disputed resources fairly, and why we recognise prior possession.
The information is here.
Is It Good to Cooperate? Testing the Theory of Morality-as-Cooperation in 60 Societies
Oliver Scott Curry, Daniel Austin Mullins, and Harvey Whitehouse
Current Anthropology
The paper is here.
Abstract
What is morality? And to what extent does it vary around the world? The theory of “morality-as-cooperation” argues that morality consists of a collection of biological and cultural solutions to the problems of cooperation recurrent in human social life. Morality-as-cooperation draws on the theory of non-zero-sum games to identify distinct problems of cooperation and their solutions, and it predicts that specific forms of cooperative behavior—including helping kin, helping your group, reciprocating, being brave, deferring to superiors, dividing disputed resources, and respecting prior possession—will be considered morally good wherever they arise, in all cultures. To test these predictions, we investigate the moral valence of these seven cooperative behaviors in the ethnographic records of 60 societies. We find that the moral valence of these behaviors is uniformly positive, and the majority of these cooperative morals are observed in the majority of cultures, with equal frequency across all regions of the world. We conclude that these seven cooperative behaviors are plausible candidates for universal moral rules, and that morality-as-cooperation could provide the unified theory of morality that anthropology has hitherto lacked.
Current Anthropology
The paper is here.
Abstract
What is morality? And to what extent does it vary around the world? The theory of “morality-as-cooperation” argues that morality consists of a collection of biological and cultural solutions to the problems of cooperation recurrent in human social life. Morality-as-cooperation draws on the theory of non-zero-sum games to identify distinct problems of cooperation and their solutions, and it predicts that specific forms of cooperative behavior—including helping kin, helping your group, reciprocating, being brave, deferring to superiors, dividing disputed resources, and respecting prior possession—will be considered morally good wherever they arise, in all cultures. To test these predictions, we investigate the moral valence of these seven cooperative behaviors in the ethnographic records of 60 societies. We find that the moral valence of these behaviors is uniformly positive, and the majority of these cooperative morals are observed in the majority of cultures, with equal frequency across all regions of the world. We conclude that these seven cooperative behaviors are plausible candidates for universal moral rules, and that morality-as-cooperation could provide the unified theory of morality that anthropology has hitherto lacked.
Thursday, March 7, 2019
Prominent psychiatrist accused of sexually exploiting patients
Michael Rezendes
The Boston Globe
Originally posted February 21, 2019
A prominent North Shore psychiatrist is facing lawsuits from three female patients who say he lured them into degrading sexual relationships, including beatings, conversations about bondage, and, in one case, getting a tattoo of the doctor’s initials to show his “ownership” of her, according to court documents.
The women allege that Dr. Keith Ablow, an author who was a contributor to Fox News network until 2017, abused his position while treating them for acute depression, leaving them unable to trust authority figures and plagued with feelings of shame and self-recrimination.
“He began to hit me when we engaged in sexual activities,” wrote one plaintiff, a New York woman, in a sworn affidavit filed with her lawsuit. “He would have me on my knees and begin to beat me with his hands on my breasts,” she wrote, “occasionally saying, ‘I own you,’ or ‘You are my slave.’”
The malpractice lawsuits, two of them filed on Thursday in Essex Superior Court and a third filed last year, paint a picture of a therapist who encouraged women to trust and rely on him, then coaxed them into humiliating sexual activities, often during treatment sessions for which they were charged.
When the New York woman had trouble paying her therapy bills, she said, Ablow advised her to work as an escort or stripper because the work was lucrative.
Although the women used their real names in their lawsuits, the Globe is withholding their identities at their request. The Globe does not identify alleged victims of sexual abuse without their consent.
The info is here.
The Boston Globe
Originally posted February 21, 2019
A prominent North Shore psychiatrist is facing lawsuits from three female patients who say he lured them into degrading sexual relationships, including beatings, conversations about bondage, and, in one case, getting a tattoo of the doctor’s initials to show his “ownership” of her, according to court documents.
The women allege that Dr. Keith Ablow, an author who was a contributor to Fox News network until 2017, abused his position while treating them for acute depression, leaving them unable to trust authority figures and plagued with feelings of shame and self-recrimination.
“He began to hit me when we engaged in sexual activities,” wrote one plaintiff, a New York woman, in a sworn affidavit filed with her lawsuit. “He would have me on my knees and begin to beat me with his hands on my breasts,” she wrote, “occasionally saying, ‘I own you,’ or ‘You are my slave.’”
The malpractice lawsuits, two of them filed on Thursday in Essex Superior Court and a third filed last year, paint a picture of a therapist who encouraged women to trust and rely on him, then coaxed them into humiliating sexual activities, often during treatment sessions for which they were charged.
When the New York woman had trouble paying her therapy bills, she said, Ablow advised her to work as an escort or stripper because the work was lucrative.
Although the women used their real names in their lawsuits, the Globe is withholding their identities at their request. The Globe does not identify alleged victims of sexual abuse without their consent.
The info is here.
Supreme Court should adopt an ethics code
Robert H. Tembeckjian
Special to the Washington Post
Originally published February 23, 2019
During the contentious Supreme Court confirmation process for Brett Kavanaugh, and soon after he was confirmed on Oct. 6, dozens of ethics complaints against him were filed. All were dismissed on Dec. 18 by a federal judicial review panel, without investigation, because once Kavanaugh was elevated to the Supreme Court, he became immune to ethics oversight that applies to judges in lower courts.
Allegations that the review panel had deemed “serious” – that Kavanaugh had testified falsely during his confirmation hearings about his personal conduct and about his activities in the White House under President George W. Bush, and that he had displayed partisan bias and a lack of judicial temperament – went into ethical limbo.
The fate of the Kavanaugh complaints seems to have stirred House Democrats to action: The first bill introduced in the 116th Congress, H.R. 1, includes, along with provisions for voting rights and campaign finance reform, a measure to require the development of a judicial code of ethics that would apply to all federal judges, including those on the Supreme Court.
Chief Justice John Roberts is on the record as opposing such a move. In 2011, he addressed it at some length in his year-end report on the federal judiciary. Roberts argued that the justices already adhere informally to some ethical strictures, and that the separation-of-powers doctrine precludes Congress from imposing such a mandate on the Supreme Court.
Roberts’ statement didn’t deter Rep. Louise Slaughter, D-N.Y., from introducing legislation in 2013 and in subsequent sessions that would impose a code of ethics on the Supreme Court. Slaughter died last year. Her proposals never gained traction in Congress, and the current incarnation of the idea probably faces a steep challenge, with Republicans controlling the Senate and Democrats controlling the House.
The info is here.
Special to the Washington Post
Originally published February 23, 2019
During the contentious Supreme Court confirmation process for Brett Kavanaugh, and soon after he was confirmed on Oct. 6, dozens of ethics complaints against him were filed. All were dismissed on Dec. 18 by a federal judicial review panel, without investigation, because once Kavanaugh was elevated to the Supreme Court, he became immune to ethics oversight that applies to judges in lower courts.
Allegations that the review panel had deemed “serious” – that Kavanaugh had testified falsely during his confirmation hearings about his personal conduct and about his activities in the White House under President George W. Bush, and that he had displayed partisan bias and a lack of judicial temperament – went into ethical limbo.
The fate of the Kavanaugh complaints seems to have stirred House Democrats to action: The first bill introduced in the 116th Congress, H.R. 1, includes, along with provisions for voting rights and campaign finance reform, a measure to require the development of a judicial code of ethics that would apply to all federal judges, including those on the Supreme Court.
Chief Justice John Roberts is on the record as opposing such a move. In 2011, he addressed it at some length in his year-end report on the federal judiciary. Roberts argued that the justices already adhere informally to some ethical strictures, and that the separation-of-powers doctrine precludes Congress from imposing such a mandate on the Supreme Court.
Roberts’ statement didn’t deter Rep. Louise Slaughter, D-N.Y., from introducing legislation in 2013 and in subsequent sessions that would impose a code of ethics on the Supreme Court. Slaughter died last year. Her proposals never gained traction in Congress, and the current incarnation of the idea probably faces a steep challenge, with Republicans controlling the Senate and Democrats controlling the House.
The info is here.
Wednesday, March 6, 2019
A Pedophile Doctor Drew Suspicions for 21 Years. No One Stopped Him.
Christopher Weaver, Dan Frosch and Gabe Johnson
The Wall Street Journal
Originally posted February 8, 2019
Here is an excerpt:
An investigation by The Wall Street Journal and the PBS series Frontline found the IHS repeatedly missed or ignored warning signs, tried to silence whistleblowers and allowed Mr. Weber to continue treating children despite the suspicions of colleagues up and down the chain of command.
The investigation also found that the agency tolerated a number of problem doctors because it was desperate for medical staff, and that managers there believed they might face retaliation if they followed up on suspicions of abuse. The federal agency has long been criticized for providing inadequate care to Native Americans.
After a tribal prosecutor outside of the IHS finally investigated his crimes, Mr. Weber was indicted in 2017 and 2018 for sexually assaulting six patients in Montana and South Dakota. Court documents and interviews with former patients show that Mr. Weber plied teen boys with money, alcohol and sometimes opioids, and coerced them into oral and anal sex with him in hospital exam rooms and at his government housing unit.
“IHS, the local here, they want to just forget it happened,” said Pauletta Red Willow, a social-services worker on the Pine Ridge reservation. “You can’t ever forget how someone did our children wrong and affected us for generations to come.”
The info is here.
The Wall Street Journal
Originally posted February 8, 2019
Here is an excerpt:
An investigation by The Wall Street Journal and the PBS series Frontline found the IHS repeatedly missed or ignored warning signs, tried to silence whistleblowers and allowed Mr. Weber to continue treating children despite the suspicions of colleagues up and down the chain of command.
The investigation also found that the agency tolerated a number of problem doctors because it was desperate for medical staff, and that managers there believed they might face retaliation if they followed up on suspicions of abuse. The federal agency has long been criticized for providing inadequate care to Native Americans.
After a tribal prosecutor outside of the IHS finally investigated his crimes, Mr. Weber was indicted in 2017 and 2018 for sexually assaulting six patients in Montana and South Dakota. Court documents and interviews with former patients show that Mr. Weber plied teen boys with money, alcohol and sometimes opioids, and coerced them into oral and anal sex with him in hospital exam rooms and at his government housing unit.
“IHS, the local here, they want to just forget it happened,” said Pauletta Red Willow, a social-services worker on the Pine Ridge reservation. “You can’t ever forget how someone did our children wrong and affected us for generations to come.”
The info is here.
Stanford investigates links to scientist in baby gene-editing scandal
Guardian staff and agencies
The Guardian
Originally posted February 7, 2019
Stanford University has begun an investigation following claims some of its staff knew long ago of Chinese scientist He Jiankui’s plans to create the world’s first gene-edited babies.
A university official said a review was under way of interactions some faculty members had with He, who was educated at Stanford. Several professors including He’s former research adviser have said they knew or strongly suspected He wanted to try gene editing on embryos intended for pregnancy.
The genetic scientist sparked global outcry after he claimed in a video posted on YouTube in November 2018 that he had used the gene-editing tool Crispr-Cas9 to modify a particular gene in two embryos before they were placed in their mother’s womb. He – who works from a lab in the southern Chinese city of Shenzhen – said the twin girls, known as Lulu and Nana, were born through regular IVF but using an egg that was modified before being inserted into the womb. He focused on HIV infection prevention because the girls’ father is HIV positive.
The info is here.
The Guardian
Originally posted February 7, 2019
Stanford University has begun an investigation following claims some of its staff knew long ago of Chinese scientist He Jiankui’s plans to create the world’s first gene-edited babies.
A university official said a review was under way of interactions some faculty members had with He, who was educated at Stanford. Several professors including He’s former research adviser have said they knew or strongly suspected He wanted to try gene editing on embryos intended for pregnancy.
The genetic scientist sparked global outcry after he claimed in a video posted on YouTube in November 2018 that he had used the gene-editing tool Crispr-Cas9 to modify a particular gene in two embryos before they were placed in their mother’s womb. He – who works from a lab in the southern Chinese city of Shenzhen – said the twin girls, known as Lulu and Nana, were born through regular IVF but using an egg that was modified before being inserted into the womb. He focused on HIV infection prevention because the girls’ father is HIV positive.
The info is here.
Tuesday, March 5, 2019
Former Ethics Chief Blasts Groups for Holding Events at Trump Hotel
Charles Clark
www.govexec.com
Originally posted March 4, 2019
Here is an excerpt:
“How many members of Congress, who have a constitutional duty to conduct meaningful oversight of the executive, giddily participate in events at the Trump International Hotel, a taxpayer owned landmark where Trump is his own landlord and the emoluments flow like the $35 martinis?” Shaub wrote.
The criticism of Kuwait was prompted by a letter tweeted earlier by Rep. Ted Lieu, D-Calif. Kuwait's ambassador to Washington, Salem Abdullah Al-Jaber Al-Sabah, had invited Lieu to the February celebration of Kuwait’s 58th National Day and 28th Liberation Day.
Lieu wrote the ambassador on Feb. 11 saying that while he looked forward to a continuing productive partnership, “Regrettably, the event will take place at the Trump International Hotel, which is owned by the President of the United States. I must therefore decline your invitation, as the Emoluments Clause of the U.S. Constitution (Article 1, Section 9, Paragraph 8) stipulates that no federal officeholders shall receive gifts or payments from foreign state or rulers without the consent of Congress.”
Lieu then warned the embassy that the issue raises “serious ethical and legal questions,” and that continuing to hold events “could amount to a violation of the U.S. Constitution.”
The info is here.
www.govexec.com
Originally posted March 4, 2019
Here is an excerpt:
“How many members of Congress, who have a constitutional duty to conduct meaningful oversight of the executive, giddily participate in events at the Trump International Hotel, a taxpayer owned landmark where Trump is his own landlord and the emoluments flow like the $35 martinis?” Shaub wrote.
The criticism of Kuwait was prompted by a letter tweeted earlier by Rep. Ted Lieu, D-Calif. Kuwait's ambassador to Washington, Salem Abdullah Al-Jaber Al-Sabah, had invited Lieu to the February celebration of Kuwait’s 58th National Day and 28th Liberation Day.
Lieu wrote the ambassador on Feb. 11 saying that while he looked forward to a continuing productive partnership, “Regrettably, the event will take place at the Trump International Hotel, which is owned by the President of the United States. I must therefore decline your invitation, as the Emoluments Clause of the U.S. Constitution (Article 1, Section 9, Paragraph 8) stipulates that no federal officeholders shall receive gifts or payments from foreign state or rulers without the consent of Congress.”
Lieu then warned the embassy that the issue raises “serious ethical and legal questions,” and that continuing to hold events “could amount to a violation of the U.S. Constitution.”
The info is here.
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