Archive for the ‘Medical’ Category
Interesting article by Tristan Harris at Medium:
I’m an expert on how technology hijacks our psychological vulnerabilities. That’s why I spent the last three years as a Design Ethicist at Google caring about how to design things in a way that defends a billion people’s minds from getting hijacked.
When using technology, we often focus optimistically on all the things it does for us. But I want to show you where it might do the opposite.
Where does technology exploit our minds’ weaknesses?
I learned to think this way when I was a magician. Magicians start by looking for blind spots, edges, vulnerabilities and limits of people’s perception, so they can influence what people do without them even realizing it. Once you know how to push people’s buttons, you can play them like a piano
And this is exactly what product designers do to your mind. They play your psychological vulnerabilities (consciously and unconsciously) against you in the race to grab your attention.
I want to show you how they do it.
Hijack #1: If You Control the Menu, You Control the Choices
Western Culture is built around ideals of individual choice and freedom. Millions of us fiercely defend our right to make “free” choices, while we ignore how those choices are manipulated upstream by menus we didn’t choose in the first place.
This is exactly what magicians do. They give people the illusion of free choice while architecting the menu so that they win, no matter what you choose. I can’t emphasize enough how deep this insight is.
When people are given a menu of choices, they rarely ask:
- “what’s not on the menu?”
- “why am I being given these options and not others?”
- “do I know the menu provider’s goals?”
- “is this menu empowering for my original need, or are the choices actually a distraction?” (e.g. an overwhelmingly array of toothpastes)
For example, imagine you’re out with friends on a Tuesday night and want to keep the conversation going. You open Yelp to find nearby recommendations and see a list of bars. The group turns into a huddle of faces staring down at their phones comparing bars. They scrutinize the photos of each, comparing cocktail drinks. Is this menu still relevant to the original desire of the group?
It’s not that bars aren’t a good choice, it’s that Yelp substituted the group’s original question (“where can we go to keep talking?”) with a different question (“what’s a bar with good photos of cocktails?”) all by shaping the menu.
Moreover, the group falls for the illusion that Yelp’s menu represents acomplete set of choices for where to go. While looking down at their phones, they don’t see the park across the street with a band playing live music. They miss the pop-up gallery on the other side of the street serving crepes and coffee. Neither of those show up on Yelp’s menu.
The more choices technology gives us in nearly every domain of our lives (information, events, places to go, friends, dating, jobs) — the more we assume that our phone is always the most empowering and useful menu to pick from. Is it?
The “most empowering” menu is different than the menu that has the most choices. But when we blindly surrender to the menus we’re given, it’s easy to lose track of the difference:
- “Who’s free tonight to hang out?” becomes a menu of most recent people who texted us (who we could ping).
- “What’s happening in the world?” becomes a menu of news feed stories.
- “Who’s single to go on a date?” becomes a menu of faces to swipe on Tinder (instead of local events with friends, or urban adventures nearby).
- “I have to respond to this email.” becomes a menu of keys to type a response (instead of empowering ways to communicate with a person).
There are more ingenious hacks—e.g., Hack #2: “Put a slot machine in a billion pockets.”
Canada is not only talking about legalizing marijuana (much as alcohol was long ago legalize), but also now will stifle the illegal trade in heroin by making it legal via a prescription. When will the US wake up? Philip Smith reports in Drug War Chronicles:
Health Canada announced Friday that it is proposing new regulations to allow access to prescription heroin under its Special Access Program (SAP). That program allows for emergency access to drugs for serious or life-threatening conditions when conventional treatments have failed or are unsuitable.
“A significant body of scientific evidence supports the medical use of diacetylmorphine, also known as pharmaceutical-grade heroin, for the treatment of chronic, relapsing opioid dependence. Diacetylmorphine is permitted in a number of other jurisdictions, such as Germany, the Netherlands, Denmark, and Switzerland, to support a small percentage of patients who have not responded to other treatment options, such as methadone and buprenorphine,” the statement said.
The move is yet another reversal of hardline Conservative drug policies by the Liberal government headed by Prime Minister Justin Trudeau, which was elected last fall. The Trudeau government has pivoted sharply away from Conservative positions in favor of mandatory minimum drug sentences and against marijuana legalization, and now is moving to undo Conservative efforts to block the limited use of prescription heroin.
Canadian scientists had laid the groundwork for prescription with the North American Opiate Medication Initiative (NAOMI), which first tested “heroin-assisted maintenance” in Vancouver a dozen years ago, and which was followed by the Study to Assess Long-Term Opioid Maintenance Effectiveness (SALOME) between 2005 and 2008. SALOME examined whether giving hard-core heroin users heroin was more effective than giving them methadone.
SALOME showed that the users in the study were more likely to stay in treatment, reduce other illegal drug use, engage in fewer other illegal activities and have better physical and mental health outcomes if given heroin than if given methadone. But when that study ended in 2008, researchers were faced with the ethical dilemma of cutting off the patients whose lives were being improved by prescription heroin.
The doctors began applying for, and receiving, permission under the Special Access Program, and Health Canada approved those applications in 2013. But that infuriated the Conservatives, and then-Health Minister Rona Ambrose introduced new regulations to bar doctors from prescribing “dangerous drugs” such as heroin, cocaine, and LSD.
Former SALOME participants launched a constitutional challenge to the ban and in 2014 won a temporary injunction giving them the right to continue to receive prescription heroin while the case was being decided. Now, with Health Canada’s move, the federal government will no longer attempt to block prescription heroin. . .
Drug usage is a medical issue, not a criminal issue.
Here’s the comment, to an earlier post (for 2014, but comment is pertinent now).
Zaid Jilani reports in The Intercept on how an aide to Sen. Orrin Hatch (R-UT) tried to prevent an inexpensive generic form of a drug used to treat cancer. I guess I assumed that Sen. Hatch opposed cancer, but it did not occur to me that he opposed cancer patients:
Leaked diplomatic letters sent from Colombia’s Embassy in Washington describe how a staffer with the Senate Finance Committee, which is led by Sen. Orrin Hatch, R-Utah, warned of repercussions if Colombia moves forward on approving the cheaper, generic form of a cancer drug.
The drug is called imatinib. Its manufacturer, Novartis, markets the drug in Colombia as Glivec. The World Health Organization’s List of Essential Medicines last year suggested it as treatment not only for chronic myeloid leukemia, but also gastrointestinal tumors. Currently, the cost of an annual supply is over $15,000, or about two times average Colombian’s income.
On April 26, Colombian Minister of Health Alejandro Gaviria announced plans to take the first step in a multi-step process that could eventually result in allowing the generic production of the drug. A generic version of the drug that recently began production in India is expected to cost 30 percent less than the brand name version.
Andrés Flórez, deputy chief of mission at the Colombian Embassy in Washington, D.C., wrote letters on April 27 and April 28 to Maria Angela Holguin of Colombia’s Ministry of Foreign Affairs, detailing concerns he had about possible congressional retaliation for such a move. The letters were obtained by the nonprofit group Knowledge Ecology International (KEI), which works on drug patent issues. They were also leaked to Colombian media outlets El Espectador and NoticiasUno.
In the second letter, after a meeting with Senate Finance Committee International Trade Counsel Everett Eissenstat, Flórez wrote that Eissenstat said that authorizing the generic version would “violate the intellectual property rights” of Novartis. Eissenstat also said that if “the Ministry of Health did not correct this situation, the pharmaceutical industry in the United States and related interest groups could become very vocal and interfere with other interests that Colombia could have in the United States,” according to the letter.
In particular, Flórez expressed a worry that “this case could jeopardize the approval of the financing of the new initiative ‘Peace Colombia.’”
The Obama administration has pledged $450 million for Peace Colombia, which seeks to bring together rebels and the government to end decades of fighting that has resulted in hundreds of thousands of deaths and a shattered civil society. These funds will be used for, among other things, removing landmines. The country has the second-highest number of landmine fatalities in the world, behind only Afghanistan.
Hatch has close ties to the pharmaceutical industry. Pharmaceutical and health product manufacturers form the second-largest pool of donors to his campaigns. The industry’s main trade association, the Pharmaceutical Research and Manufacturers of America (PhRMA) spent $750,000 funding an outside nonprofit that backed Hatch’s re-election in 2012. The lobbying group also employed Scott Hatch, one of the senator’s sons, as a lobbyist, while donating to his family charity, the Utah Families Foundation.
For his part, Eissenstat has won . . .
In Quanta Emily Singer writes about a theory proposed by John Cacioppo, the director of the Center for Cognitive and Social Neuroscience at the University of Chicago, on why loneliness is important:
social animals, we depend on others for survival. Our communities provide mutual aid and protection, helping humanity to endure and thrive. “We have survived as a species not because we’re fast or strong or have natural weapons in our fingertips, but because of social protection,” saidJohn Cacioppo, the director of the Center for Cognitive and Social Neuroscience at the University of Chicago. Early humans, for example, could take down large mammals only by hunting in groups. “Our strength is our ability to communicate and work together,” he said.
But how did these powerful communities come to exist in the first place? Cacioppo proposes that the root of social ties lies in their opposite — loneliness. According to his theory, the pain of being alone motivates us to seek the safety of companionship, which in turn benefits the species by encouraging group cooperation and protection. Loneliness persists because it provides an essential evolutionary benefit for social animals. Like thirst, hunger or pain, loneliness is an aversive state that animals seek to resolve, improving their long-term survival.
If Cacioppo’s theory is correct, then there must be an intrinsic biological mechanism that compels isolated animals to seek out companionship. Something in our brains must make it feel bad to be alone and bring relief when we’re with others. Researchers at the Massachusetts Institute of Technology think they’ve found the source of that motivation in a group of little-studied neurons in part of the brain called the dorsal raphe nucleus. Stimulating these neurons drives isolated mice to find friends, according to research published earlier this year in the journal Cell. The finding provides critical support to Cacioppo’s theory and illuminates a deep connection that links specific structures in the brain to social behavior.
The new study — the first to link specific neurons to loneliness — is part of a growing effort to map out the genetics of social behavior and its underpinnings in the brain. “Over the last roughly 15 years, there has been a tremendous increase in the desire to understand the basis of social behavior, including caring for others, social rejection, bullying, deceit and so forth,” said Patricia Churchland, a philosopher at the University of California, San Diego, who studies the brain and social behavior. “I think we have a good idea for the evolutionary basis for caring and sharing and mutual defense, but the brain mechanisms are bound to be very complex.”
Together, Cacioppo’s work and the new findings from MIT are helping to move loneliness from the realm of psychology and literature to biology. “I think the bigger picture is not to understand why loneliness is painful but rather how our brain is set up to move us out of that lonely state,” said Steve Cole, a genomics researcher at the University of California, Los Angeles. “Instead of thinking about loneliness, we could think about social affinity.”
Gillian Matthews stumbled across the loneliness neurons by accident. In 2012 she was a graduate student at Imperial College London who had been studying how cocaine changes the brain in mice. She would give the animals a dose of the drug, place each one alone in a cage, and then examine a specific set of its neurons the next day. She did the same for a control group of mice, injecting them with saline instead of cocaine.
When Matthews returned to her mice 24 hours after dosing them, she expected to see changes in their brain cells, a strengthening of neuronal connections that might help explain why cocaine is so addictive. To her surprise, both the drug-treated mice and the control mice showed the same changes in neuronal wiring. Overnight, the neural connections onto a certain set of cells had grown stronger, regardless of whether the animals were given drugs or not. “We first thought there was something wrong, that we had mixed up our procedure,” said Matthews, who is now a postdoctoral researcher at MIT.
The brain cells she was interested in produce dopamine, a brain chemical typically associated with pleasurable things. Dopamine surges when we eat, have sex or use drugs. But it does more than simply signal pleasure. The brain’s dopamine systems may be set up to drive the search for what we desire. “It’s not what happens after you get what you want, it’s what keeps you searching for something,” Cole said.
The researchers focused on dopamine neurons in a brain region called the dorsal raphe nucleus, best known for its link to depression. (This may not be a coincidence — loneliness is a strong risk factor for depression.) Most of the neurons that reside there produce serotonin, the chemical messenger that drugs such as Prozac act on. Dopamine-producing cells make up roughly 25 percent of the region and have historically been difficult to study on their own, so scientists know little about what they do.
Matthews speculated that other environmental factors during the experiment might have triggered the changes. She tested to see if simply moving mice to new cages altered the dopamine neurons, but that couldn’t explain the effect. Ultimately, Matthews and her colleague Kay Tye realized that these brain cells were responding not to the drug but to the 24 hours of isolation. “Maybe these neurons are relaying the experience of loneliness,” Matthews said.
Mice, like humans, are social creatures that generally prefer to live in groups. Isolate a mouse from its cage mates, and once confinement ends it will spend more time interacting with other mice, to a much greater extent than if it had been with its mates all along.
To better understand the role the dorsal raphe neurons play in loneliness, the researchers genetically engineered the dopamine cells to respond to certain wavelengths of light, a technique known as optogenetics. They could then artificially stimulate or silence the cells by exposing them to light.
Stimulating the dopamine neurons seemed to make the mice feel bad. Mice actively avoided stimulation if given the choice, just as they might avoid physical pain. Moreover, the animals appeared to enter a state of loneliness — they acted like they had been alone, spending more time with other mice.
“I think this reveals something about how our brains may be wired to make us innately social creatures and protect us from the detrimental effects of loneliness,” Matthews said.
Spectrum of Loneliness
Cacioppo first formally proposed his evolutionary theory of loneliness a decade ago. Strong support comes from the fact that . . .
An interesting sidebar to the article:
The Danger of Solitude
Loneliness not only feels bad, it can have profound health consequences. Animals raised in isolation, from flies to mice to chimps, have shorter life-spans. Solitary confinement — considered one of our harshest criminal punishments — boosts stress in humans and other animals, weakening the immune system and increasing the risk of death. Indeed, some estimates suggest that loneliness raises risk of mortality by nearly 30 percent — as much as obesity — even when controlling for confounding factors like age and depression.
Scientists hope that better understanding the neural circuits underlying loneliness will not only help explain why it exists but also ultimately point to new treatments. “Is there a way,” Hawkley asked, “of moderating activity in the brain like we do for depression?”
Wow. This gets it out in the open.
Perhaps not in so many words, but pretty damn loudly.
Maybe we should consider whose ideas are popular. But that, of course, lets in Trump.
At any rate, interesting news development when you think on it. From the article:
Although Mr. Sanders viewed Mrs. Clinton’s latest health care proposal as progress, he said on Tuesday that it was not sufficient.
”Secretary Clinton’s proposal to let the American people buy into Medicare is a step in the right direction, but just like her support for a $12 minimum wage, it is not good enough,” Mr. Sanders said in a statement that described her idea as “Medicare for some.”