Health care, dental care up to adulthood, parental leave protected by law and education through college is definitely not unrelated to standard of living. Neither is mandatory pension contributions from your employer, as well as a guaranteed contribution from the state (we unknowingly get contributions to our retirement for every month we go to college).
Sure, if you're single with no kids, in very good shape, employed as a data engineer and 30 years old , like me, you would gladly take the money instead of all the other stuff. But I like the fact that children who are born into working poor families in Sweden will have a much healthier upbringing than if they were born in the US.
That's like saying humans have evolved radically different behavior compared to 200 years ago because back then they couldn't travel to another celestial body.
I would argue jerking off to Internet porn and jerking off to a fantasy are both exhibiting the same behavior, just like a polar explorer from the 19th century and a lunar explorer from the 20th century are exhibiting the same behavior.
We have very little actual knowledge of pre-historic humans to speculate about their sexual behaviours (and as with all other human behavior, I'm sure there is and has been great variance in this).
In any case bonobos would not write Kama Sutra even in 20,000 years. Your timescale and argument is way off.
Users having multiple addresses is something I've cursed a lot over. I work in a team that does data analytics for a news publishing company, and our print business is still very important. Unfortunately, in our database over print customers users are basically addresses because you don't really need to know how many people are receiving your paper as a distributor, only where and how many papers. Since it's also been a safe assumption for a century that people share newspapers with each other, market research was done street by street to inform ad buyers of which markets we reached. Many people have more than one home. Some people take out another subscription for a relative.
This mapped very awkwardly to digital subscribers who we had individual data on. We were able to join databases in a way that sort of works through more or less (mostly less) comfortable assumptions. The queries are not pretty.
There's a whole subfield of information science dedicated to basically this exact problem: entity resolution.
Hilariously, it has dozens of names, because it just comes up in so many places for so many people. It appears that "record linkage" is the term that has won the top spot at Wikipedia: https://en.wikipedia.org/wiki/Record_linkage
There are also countries that thrived economically after the fall of socialism. Why yes, I'll gladly take an apartment in East Berlin if you're offering me one.
The Swedish company Klarna is a good example. It’s now so common among Swedish consumers to have a Klarna account that it’s probably the most frictionless way for customers to pay online.
I have a colleague who worked there like five years ago. She bought as much stock as she could. Once it IPO or gets acquired I suspect she’ll get a hefty contribution to her retirement.
Open plan offices became more frequent because office area is more expensive because real estate has become more expensive. That's at least my guess of how we ended up in this mess that everyone knows is bonkers.
I think this will have unforseen effects on real estate.
If the population globally is shrinking, that means the likelihood that any given town will increase in size is also shrinking. At first, this might look like the real estate prices across the board will decrease but I don’t think so. I think that when people factor in that the town they are in currently will not increase in size they look at cities that already have good markets and move there instead, driving up the prices of already established cities.
This is basically what is already happening in European countries with falling birth rates.
this could also cause a vicious cycle for the towns and smaller cities. there's a certain amount of fixed cost to maintain existing infrastructure. if a significant number of properties become vacant, the municipality will have to start hiking taxes to keep the same revenue, making the place even less desirable and causing more tax base to leave.
I've slowly been developing the opposite habit. Over the years I've become more interested in how articles are digested by people without an agenda (which the modern, salaried digital author may be increasingly pressured to succumb to). Reception is demonstrated in comment sections, and that sometimes feels like a more pure read, stripped of whatever fluff or flair a journalist may feel compelled to add (accelerated portfolio enrichment attempt? Agenda implies bonus payment).
We can assume these may also be populated by automatically generated comments to suggest support or rejection of the content. Sometimes this leads me into [rabbit-hole] investigations through a user's post history if I am significantly moved by their angle(s).
I needn't read anything more than the title, as the meat content would likely just be an assimilation of empirical evidence and/or gossip. I'm not even going to bother turning off ad blocker or using archive.is with this one - in aggregate I just see it as yet another "distrust [insert internet company] with your data" offensive (defensive?) campaign.
I think it's dangerous to consider commenters "people without an agenda". Automatically generated comments aside, I'm quite sure that plenty of real human beings have "an agenda" when they're commenting on an article.
I'm also not really sure what agenda the "modern, salaried digital author" is supposed to be succumbing to. Clickbait? If they're salaried then they aren't paid per click. Again, the journalist is a known employee of a known organisation. To think of anonymous commenters as more reliable feels a little baffling to me.
Yep, I rarely read the articles, and mostly come for the comments. I'm especially unlikely to click the link when it comes from known clickbait factories.
I think this creates an interesting discussion on the part of the designers and programmers. Did they understand that what they were building was going to increase opioid dependence? Did they ask about it?
And, the most interesting question of all: If they found out that was the case did they try to justify building it to themselves in some way?
Full disclaimer: I have built software that I had ethical reservations about myself. I am in no way a saint, I don't claim to know what I would've done in the same situation but I think it's for the benefit of software development to acknowledge that we do make ethical decisions when we build things and that the solution to something as complicated and diverse as ethics is not to just ignore it.
To be fair to the developers and designers: how exactly would they know that the inclusion of "opioid prescription" as an item in that list would help fuel a an opioid epidemic? Hindsight is 20/20, but would you expect them at the time to think, "If we include this as an option in this list, it will contribute to a nationwide epidemic of opioid abuse and countless deaths"? Honestly, I think it's a stretch, especially if they weren't aware of a deal with opioid manufacturers being the reason for it in the first place.
It would be one thing of some product manager came to them and said, "since a large opioid manufacturer has paid us a lot of money, we're going to implement this feature in order to increase unnecessary opioid prescriptions" but I would be surprised if that happened. "We're going to implement this feature to help doctors pick the right treatment for a patient's pain."
Someone here is evil and deserves what's coming, but I don't know that it necessarily would have been readily obvious to those implementing it. In fact, it would likely have been preferable to conceal the true nature of it lest any of them have any moral qualms or objections.
I'm not trying to negate your question, either. I think it's a good question to ask and consider.
> If we include this as an option in this list, it will contribute to a nationwide epidemic of opioid abuse and countless deaths?
Give. me. a. break!
At a minimum they should ask, "What are the potential downsides? How extreme are they? How can we determine how likely those potential downsides are?"
I'd expect every junior PM to ask _that_ series of questions about any product decision in any market.
There's a reason clinical trials have protocols for early termination. Not understanding that early termination is a thing when building a social app is one thing, but they're building EMR software!
Must be nice to work in a place where a developer has complete influence through the entire process. Every place I've worked has been so large that a single developer can only work on a very minute segment of the code unless they are very senior. I'm guessing the bulk of developers work at large companies and have experiences much closer to mine.
This tool was probably built by several teams of developers working somewhat isolated. Someone built a system that allows for treatments to be suggested for certain ailments, another team did the UI, another testing, then there was probably completely separate team of people in charge of determining what to suggest for as treatments. This treatment team was very likely not staffed by developers at all.
Which of these groups are responsible here? Do I need to be pushing back with every dialog option I create with data from a database? Ask my PO, "what are we going to do to ensure that nobody puts dangerous options in the db?" I'm being serious, if you're blaming the developers for this, then you should make suggestions that are appropriate for the real environment most of us work in; that is: we're often a very small cog in a very large machine with no view of the big picture.
I’ve never been a big fan of the “I don’t know what my software does—I just move JSON around” excuse. As professionals, we need to be aware of the intended use of the things we make, and that includes weighing the ethical implications.
We also need a professional ethical vow with teeth like the Hippocratic Oath that allows tech professionals to push back against demands to write unethical software, but that’s a topic for another thread.
I don't disagree. But my point was that it's not always clear what the implications are. Sometimes it's more obvious, sometime it's not. We also don't know what the "intended" use of this feature that was presented to the people who made it was. They could very well have been deceived as to it's true nature.
This could very easily have been presented and sold to a team in a way that does not make it immediately seem like something evil.
The bottom line is that developers and designers are not professionals, who would have to accept responsibility for their products. It is in the best interests of developers and designers not to be professionals and not to accept responsibility in cases like this.
A standard argument for this state of affairs is that it is in the best interest of society to allow developers and designers this freedom from responsibility, because of all the shiny new products. In which case you have to accept incidents like this---you can't make an omelette without breaking a few eggs.
I'm a doctor. During medical school and residency, I was taught in good faith that "only as much as necessary" opioid was OK to give and wouldn't create dependence - it was only an "excess" of opioid that would cause a problem. So under the banner of reducing the suffering of our patients, and a mandate to reduce patient-reported pain scores, opioids flowed relatively freely.
Now we know that was a terrible idea with devastating consequences. But we didn't know better and truly thought we were doing right by our patients. It's hard to imagine a programmer without medical training could be blamed.
The problem is things have gone to far the other way now.
Those with Chronic Pain are now committing suicide (as did my wife) when they are let to suffer.
The CDC itself stated in April of 2019:
"CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain
Some policies, practices attributed to the Guideline are inconsistent with its recommendations"
Sadly the medical community is not getting that message due to this mater now becoming political.
We posted at the same time, see my comment above yours about the documentary Pain Warriors.
Dr Mark Ibsen is one of the five stories. He lost everything for helping those with Chronic Pain. Five of his patients killed themselves when he was no longer able to prescribe. The medical board said he was over prescribing, that blood is on the boards hands. The arbitrator/judge in the case said that Mark did not do anything wrong, yet The System destroyed him.
Yes it is a rough field. I see it every single day in advocating for those that the Medical Establishment has forsaken.
There are bad doctors, there are bad people writing medical software as this thread explains. They need dealt with.
Pain Warriors documentary about Chronic Pain and medical establishment teaser is on my YouTube channel.
Read the reviews of those that have seen the full movie previews.
> Now we know that was a terrible idea with devastating consequences.
Practice Fusion knew that at the time. Internal emails released as part of the legal process make it clear that this feature was designed to get previously "opioid naive" patient (people not previously prescribed opioids) hooked on extended release opioids. This was specifically done to address the falling rates of ERO prescriptions, which the pharma company described as being due to "political reasons".
US negligence law encourages physicians to follow "the medical standard of care." This means doing what they are taught in medical school shields MDs from liability until the standard of care changes. The law discourages MDs from deviating from "standard" practice because doing so removes the "standard of care" liability shield.
The software developers are not protected by the "standard of care" shield. The software developers, like just about every other profession are held to a higher standard than MDs, namely "ordinary care" or "reasonable care".
Is a software company taking reasonable care to avoid harm when it builds a software feature that secretly encourages doctors to issue dangerous prescriptions? I don't know -- doesn't sound like it to me. Though there are probably a few plaintiff's attorneys willing to find out how a jury thinks about it.
Going through medical school and years of post-doc training makes physicians less responsible than people with no medical knowledge whatsoever? Yikes! If this is true, I hope the AMA lobbyists who bribed that turd onto the books were paid well for their evil deeds...
It's probably also not great for patients with rare diseases, that physicians are penalized for trying to solve problems no physician has solved before.
Yep, if safer or more effective innovative techniques become known, US MDs are not expected to practice them until those innovations become accepted as the standard of care. Other industries/professions don't get that break.
That would absolutely be a valid reason to build the service like that; the medical community thought that only an excess of opioids would be a problem, and it directly improves the numbers they're evaluated on.
However, once the medical community gets wise to what an awful idea that was, I hope that when the software providers hear about this they try to figure out a way to mitigate the damage they're causing. This feature was added in 2016.
Though, I think we agree that you cannot make an ethical decision on which action you should take unless you have any idea of what the consequences of your actions will be.
> It's hard to imagine a programmer without medical training could be blamed.
Sure, but I would have expected that there would have been some perplexities by the actual doctors when they were presented these popups at each patient data access.
I'm not a lawyer or legal expert, but I think that over the past century the entertainment industry has successfully gotten a myriad of laws and court rulings in their favor which complicates something like that a lot. Data is new and fluffy and there are still many areas where it's unsettled who owns the data. The EU probably sees the opportunity to write the rules in a more "blank sheet of paper" kind of way when this industry is still relatively young, and not repeat the mistakes of the entertainment industry where the governments have been sleepwalking for the better part of a century.
Sure, if you're single with no kids, in very good shape, employed as a data engineer and 30 years old , like me, you would gladly take the money instead of all the other stuff. But I like the fact that children who are born into working poor families in Sweden will have a much healthier upbringing than if they were born in the US.