Posted by: bkivey | 19 October 2014

Goal – Oriented Myopia

“The goal in health care is not to protect privacy,  the goal is to save lives.”

David Castro

Director, Center for Data Innovation

I once took an ethics course that dealt with the question of why good people do bad things. The focus of  the course was on scientists through history who had conducted horrific experiments on human beings. Most of the subjects had conducted clinical trials of deadly diseases on live subjects. The scientists themselves were mostly family men, well-respected in their communities. So how is it that they could subject their fellow humans to unspeakable pain, suffering, and often gruesome death?

The lesson of the course was that as people become more focused on goals, they less other considerations enter their decision-making. As results take ever greater precedence, consideration of whether a course of action is moral is diminished; in the worst cases, such considerations are eliminated.

The quote above is from an article by Matt McFarland of  the Washington Post on how technology can make it possible for healthcare providers to reap huge amounts of information on patients, then use advanced AI techniques to evaluate the data. The purpose of this process is to provide more individualized treatment, and improve chances of spotting incipient problems.

The article mentions the significant legal and privacy concerns, and I’m not sure that most people would want their lives continuously monitored. The various industry experts interviewed generally poo-poo these concerns, pointing out the potential benefits gained. But are these benefits really worth the increased monitoring and control of people’s lives, and more to the point, are the really necessary?

The current procedures used to arrive at a differential diagnosis actually work pretty well. Hundreds of years of systemized medicine has created an enormous database from which medical professionals draw. The odds are good a person will receive appropriate treatment for their condition. If the primary physician is unsure of the diagnosis, there is an army of specialists available for referral. The delivery of effective healthcare treatment is maybe not as difficult as some would believe.

Of course the system breaks down, as any human construct will do. People are mis-diagnosed, inappropriate treatments are prescribed, some conditions defy timely diagnosis. Sometimes people die from preventable mistakes. But the fact that these incidents are news points out how well the medical process generally works.

My experience with medicine is likely typical of most peoples. Most of my contact with the medical profession has resulted in correct diagnosis and appropriate treatment. Admittedly, most of the time I was seeking treatment for traumatic injury, such that even a layman could make the diagnosis. I’ve had one case of severe abdominal pain that was never diagnosed, and I’ve had experience with mis-diagnosis for which I’ve had to see a specialist to get effective treatment.

I’m not convinced that my healthcare experience would have been vastly improved if my body was continuously monitored. One of the few cases to make for this privacy invasion is providing physicians with notice of developing conditions. Diseases like diabetes and hypertension take a long time to develop, and most people won’t seek treatment until they are symptomatic. I didn’t seek treatment for hypertension until I developed impossible to ignore symptoms, and even then, stayed away from the doctor longer than I should have.

So there is a case to be made for gathering huge amounts of individual health data, but my problem is the attitudes of the people likely to be developing this technology. They don’t really care about anything except their desired results. And this is why zealots are good in development roles, but should never be put in charge.

Ad of the Week

My favorite position-wanted ad on the Portland Craigslist:

Hello everyone,

I am very adaptable at learning new things. I would be honored to be offered a position where I can do labor intensive work for good pay.
I would like to be paid in the range of $20-$30 an hour. I am also willing if an employer is able to offer for me to live at the place of work so that this way travel is never an issue.

Thanks for reading my post. =)

Translation: I have no skills but would like for someone to pay me $40 – $60,ooo annually while providing me with a place to live. My grasp of reality is tenuous at best.

 

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