Curious Bioethics: Sept 4-10, 2023
🤖 ACCEPT-AI, prison abuses children, removing racism from medicine, Mr. Yuk, Dr. Glaucomenflecken
In today’s curated collection, you’ll find:
🗞️Bioethics News: Kids must be moved from Angola prison; Removing racism from medicine; Mifepristone access
📚Recommended Reading: History of Mr. Yuk and Poison Protection
🦉Educational Opportunities: Dr. Glaucomenflecken’s 30 Days of US Healthcare
Hey there, Curious Human!
I’m continuing to recover from Covid! I’ve had some pesky neurologic symptoms (new insomnia, wordfinding difficulty) that I hope will resolve completely soon.
I’m excited to share that I have a new paper out this week in Nature Digital Medicine with ethics guidance for including kids in artificial intelligence data sets. Data sets trained with adult data don’t perform well in pediatric cases, so mixing up data from kids and adults willy-nilly can have disastrous consequences. We argue protocols shouldn’t accept kids’ data unless collection meets basic ethical standards.
You can read it for free here: “ACCEPT-AI: Recommendations for the Use of Pediatric Data in Artificial Intelligence and Machine Learning.” ACCEPT-AI stands for considerations based on age, communication, consent/assent, equity, protection of data, and technological considerations.
My friend Vijaytha and I spoke with Adam Hadhazy at Stanford Human-Centered AI group about why we need more guidance for AI researchers hoping to include data about kids.
Over my career, I've watched AI go from something we see in science fiction movies to now exploding in the public spheres that impact our health. At this point, we need to figure out how do we do good work, how do we do ethical work, and how do we get ahead of these new technologies rather than waiting for there to be disasters.
~Me talking to Stanford’s HAI
🗞️ Bioethics in the News
Federal Judge Orders Louisiana to Move Kids Out of Angola Prison
Children in the former death row unit at Angola, one of the nation’s most infamous prisons, have been locked in solitary confinement, shackled while they eat and play, and attacked by guards.
Just reading this ruling made me cry.
These kids have been denied adequate food, and education, and locked up alone for hours and hours - worsening existing mental health conditions and no doubt, creating lasting trauma. The deck was already stacked against these kids and Louisiana’s prison is making it worse.
Dick’s ruling found that authorities at the facility had locked children up in cells for days at a time as a form of punishment, punished detained youth with the use of handcuffs, mace, and denial of family visits, and failed to provide appropriate educational and social services and mental health treatment, according to a press release from the ACLU, which was part of the legal team that filed suit against the placements.
We live in an unbelievably cruel society. Unfortunately, through our “justice” system, we condone violence and abuse against adults and extend the pain to children. The trauma of incarceration is not helping any of these kids but compounding the harm that will follow them the rest of their lives.
The Louisiana Office of Juvenile Justice plans to challenge the ruling.
Pushing to Remove Racism From Medicine
As a medical student, I learned about race-adjusted renal function. Despite asking for more information, it never quite made sense why race would make any difference in these measurements.
As anesthesiology residents, we knew our pulse oximeters could read falsely high on people with darker skin colors. I assumed since we knew about it, that companies like Phillips (who made our monitors and the proprietary algorithms that spit out pulse ox readings) would be updated with more inclusive data. It wasn’t until Covid hit and the problem of pulse oximeters became more widely known that I realized no change ever happened. We still rely on pulse oximetry data collected primarily on white folks.
Health systems and insurers are finally pushing to remove racism from medicine systematically. Race is a social construct, so anytime we use race to deliver care, race is simply a proxy for racism. Despite this being obvious to us now, there are still plenty of race-based algorithms used across medical specialties.
Supreme Court is asked to reject limits on a drug used in the most common method of abortion
In appeals filed Friday, the Biden administration and New York-based Danco Laboratories, the manufacturer of mifepristone, argued that federal judges should not second-guess the Food and Drug Administration’s approval of the drug or the conditions under which it is dispensed.
Mifepristone is unbelievably safe - safer than many over-the-counter medications. Yet, anti-abortion advocates have succeeded in getting case after case through the courts to peel back access to the medication. Recent rulings removed the ability to send the medication to patients by mail and diminished access from 10 to 7 weeks of pregnancy. Mail access is critical since rural patients suffer immense barriers to accessing medical care, especially abortion.
📚 Recommended Reading
Mr. Yuk: The History of Poison’s Most Iconic Symbol
by Erin McCarthy (2014)
Dr. Richard Moriarty, pediatrician and creator of the poison warning Mr. Yuk, passed away this week at 83 years old. In his memory, I’m pleased to share this 2014 essay from Mental Floss on the iconic symbol designed to help kids recognize dangerous poisons at home.
"The skull and crossbones was designed by adults for adults," Moriarty told the Post-Gazette. "Mr. Yuk is actually the first symbol specifically designed for kids." And by kids, too: The final logo was created by fourth grader Wendy Brown from West Virginia as part of a contest sponsored by the Pittsburgh Poison Center. With the addition of the local poison center's phone number in the black band surrounding his face, Mr. Yuk was finished.
🦉Educational Opportunities
No registration is required! Just go straight to YouTube for this on-demand bioethics education.
Dr. Glaucomenflecken’s 30 Days of US Healthcare
Ophthalmologist and comedian William Flanery, AKA Dr. Glaucomenflecken, uses his signature tongue-in-cheek style to teach about the cruelty of American health insurance. Every day in September, Glauc releases a new video skit explaining how health insurance in the US is expensive, low value, and absurd.
Here is a link to his Youtube channel playlist with every skit.
That’s it!
As always, thanks for being curious!
Hit reply and let me know what ethics issues you are most curious about this week—I’d love to hear from you!
See you next week!
Be Well & Be Curious,
Alyssa