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Illinois limits the use of AI in therapy and psychotherapy

washingtonpost.com

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Re: Illinois limits the use of AI in therapy and psychotherapy

#251

Post by fc417fc802 »

heyjamesknight wrote: post #122
lokar wrote: post #102

Earlier quoted context omitted.

At least in the us I think HIPPA would cover this, and IME medical providers are very careful to select products and services that comply.

Yes, but HIPAA is notoriously vague with regards to what actual security measures have to be in place. Its more of an agreement between parties as to who is liable in case of a breach than it is a specific set of guidelines like SOC 2. If your medical files are locked in the trunk of a car, that’s “HIPAA-compliant” until someone steals the car.

I think that's a good thing. I don't want a specific but largely useless checklist that absolves the party that ought to be held responsible. A hard guarantee of liability is much more effective at getting results.

It would be nice to extend the approximate equivalent of HIPAA to all personal data processing in all cases with absolutely zero exceptions. No more "oops we had a breach, pinky promise we're sorry, don't forget to reset all your passwords".

Re: Illinois limits the use of AI in therapy and psychotherapy

#252

Post by fc417fc802 »

romanows wrote: post #27
PeterCorless wrote: post #20

Earlier quoted context omitted.

Correct. It is more provider-oriented proscription ("You can't say your chatbot is a therapist.") It is not a limitation on usage. You can still, for now, slavishly fall in love with your AI and treat it as your best friend and therapist. There is a specific section that relates to how a licensed professional can use AI: Section 15. Permitted use of artificial intelligence. (a) As used in this Section, "permitted use…

Yes, but also "An... entity may not provide... therapy... to the public unless the therapy... services are conducted by... a licensed professional". It's not obvious to me as a non-lawyer whether a chat history could be decided to be "therapy" in a courtroom. If so, this could count as a violation. Probably lots of law around this stuff for lawyers and doctors cornered into giving advice at parties already that might…

These things usually (not a lawyer tho) come down to the claims being actively made. For example "engineer" is often (typically?) a protected title but that doesn't mean you'll get in trouble for drafting up your own blueprints. Even for other people, for money. Just that you need to make it abundantly clear that you aren't a licensed engineer.

I imagine "Pay us to talk to our friendly chat bot about your problems. (This is not licensed therapy. Seek therapy instead if you feel you need it.)" would suffice.

Re: Illinois limits the use of AI in therapy and psychotherapy

#253

Post by fc417fc802 »

taneq wrote: post #200
amanaplanacanal wrote: post #133

Earlier quoted context omitted.

Usually when it comes to medical stuff, things don't get approved unless they are better than existing therapies. With the shortage of mental health care in the US, maybe an exception should be made. This is a tough one. We like to think that nobody should have to get second rate medical care, even though that's the reality.

I think a good analogy would be a cheap, non-medically-approved (but medical style) ultrasound. Maybe it’s marketed as a “novelty”, maybe you have to sign a waiver saying it won’t be used for diagnostic purposes, whatever. You know that it’s going to get used as a diagnostic tool, and you know that people are going to die because of this. Under our current medical ethics, you can’t do this. Maybe we should re-evaluat…

Moral hazard? Versus not getting even a diagnostic, let alone care, because someone couldn't afford it? Versus self determination? A clear upfront statement of what the product is not ought to suffice.

What we have isn't motivated by protection from moral hazard (at least IMO). It's a guild system that restricts even vaguely related access and practices in (I'd argue) an overly broad manner.

To be clear I don't object to the guild in this case. Only to the overly broad fence surrounding it.

Re: Illinois limits the use of AI in therapy and psychotherapy

#254

Post by BurningFrog »

amanaplanacanal wrote: post #136
BurningFrog wrote: post #87

Earlier quoted context omitted.

Last I heard, most therapy doesn't work that well.

If you have some statistics you should probably post a link. I've heard all kinds of things, and a lot of them were nothing like factual.

I don't, but what I remember from when I looked into this is that usually, people have the same problems after the therapy as they had before. Some get better, some get worse, and it's hard to tell what's a real effect.

One exception was certain kinds of CBD therapies, for certain kinds of people.

Re: Illinois limits the use of AI in therapy and psychotherapy

#255

Post by mrbungie »

hyghjiyhu wrote: post #242
mrbungie wrote: post #227

Earlier quoted context omitted.

I thought we were talking about outcomes, not opinions. Are those other humans doctors? Is there the clinical research or guidelines to backup giving meth to a person in withdrawal syndrome?

Tapering is the keyword you are looking for. Gradually reducing the dose is a well known method for minimizing withdrawal issues. It has both pros and cons compared to quitting cold turkey . I think a real doctor would probably first get the patient on a less addictive stimulant and then taper that one.

Yeah, sure, but we were talking about giving the person meth, not amphetamines or lisdexamphetamine.

Re: Illinois limits the use of AI in therapy and psychotherapy

#256

Post by pmarreck »

terminalshort wrote: post #171
zdragnar wrote: post #121

Earlier quoted context omitted.

It would still need to be regulated and licensed. There was this [0] I saw today about a guy who tried to replace sodium chloride in his diet with sodium bromide because ChatGPT said he could, and poisoned himself. With a regulated license, there is someone to hold accountable for wantonly dangerous advice, much like there is with humans. [0] https://x.com/AnnalsofIMCC/status/1953531705802797070

You cite one case for LLMs, but I can cite 250,000 a year for licensed doctors doing the same https://pubmed.ncbi.nlm.nih.gov/28186008/ . Bureaucracy doesn't work for anyone but the bureaucrats.

Wow. I had never heard this before.

Re: Illinois limits the use of AI in therapy and psychotherapy

#257

Post by pmarreck »

laserlight wrote: post #182
terminalshort wrote: post #171

Earlier quoted context omitted.

You cite one case for LLMs, but I can cite 250,000 a year for licensed doctors doing the same https://pubmed.ncbi.nlm.nih.gov/28186008/ . Bureaucracy doesn't work for anyone but the bureaucrats.

Please show me one doctor who recommended taking a rock each day. LLMs have a different failure mode than professionals. People are aware that doctors or therapists may err, but I've already seen countless instances of people asking relationship advice from sycophant LLMs and thinking that the advice is “unbiased”.

> LLMs have a different failure mode than professionals

That actually supports the use-case of collaboration, since the weaknesses of both humans and LLMs would potentially cancel each other out.

Re: Illinois limits the use of AI in therapy and psychotherapy

#258

Post by pmarreck »

ivell wrote: post #233
fl0id wrote: post #223

Earlier quoted context omitted.

That’s actually a example of sth different. And as it’s basically a placebo it only harms people’s wallets (mostly). That cannot be said for random llm failure modes. And whether it can be prescribed by doctors depends very much on the country

I don't think it is that harmless. Believe in homeopathy often delays patients from taking timely intervention.

Yes. See: Steve Jobs, maybe.

Re: Illinois limits the use of AI in therapy and psychotherapy

#259

Post by pmarreck »

quantummagic wrote: post #140
jakelazaroff wrote: post #119

Earlier quoted context omitted.

Why is that a foregone conclusion?

Because meat isn't magic. Anything that can be computed inside your physical body, can be calculated in an "artificially" constructed replica. Given enough time, we'll create that replica, there's no reason to think otherwise.

> Anything that can be computed inside your physical body, can be calculated in an "artificially" constructed replica.

What's hilarious about this argument (besides the fact that it smacks of the map-territory relation fallacy https://en.wikipedia.org/wiki/Map%E2%80%93territory_relation) is that for most of my life (53 years), we've been trying not just to simulate a nematode or Drosophila (two of the most-studied creatures of all time- note that we COMPLETELY understand their nervous systems) and failed to create anything remotely convincing of "life" (note that WE are the SOLE judgers of what is "alive", there is no 100% foolproof mechanistic algorithm to detect "life" (look up the cryptobiosis of tardigrades or wood frogs for an extra challenge)... therein lies part of the problem), but we cannot even convincingly simulate a single cell's behavior in any generous span of time (so for example, using a month to compute 10 seconds of a cell's "life"). And yes, there have been projects attempting to do those things this entire time. You should look them up. Tons of promise, zero delivery.

> Given enough time, we'll create that replica, there's no reason to think otherwise.

Note how structurally similar this is to a "God of the gaps" argument (just substitute "materialism-given-unlimited-time" for "God").

And yet... I agree that we should continue to try. I just think we will discover something interesting in... never succeeding, ever... while you will continue to refer to the "materialism-given-unlimited-time of the gaps" argument, assuming (key word there) that it must be successful. Because there can't possibly be anything else going on. LOL. Naive.

(Side note, but related: I couldn't help noticing that most of the AI doomers are materialist atheists.)

Re: Illinois limits the use of AI in therapy and psychotherapy

#260

Post by heyjamesknight »

fc417fc802 wrote: post #251
heyjamesknight wrote: post #122

Earlier quoted context omitted.

Yes, but HIPAA is notoriously vague with regards to what actual security measures have to be in place. Its more of an agreement between parties as to who is liable in case of a breach than it is a specific set of guidelines like SOC 2. If your medical files are locked in the trunk of a car, that’s “HIPAA-compliant” until someone steals the car.

I think that's a good thing. I don't want a specific but largely useless checklist that absolves the party that ought to be held responsible. A hard guarantee of liability is much more effective at getting results. It would be nice to extend the approximate equivalent of HIPAA to all personal data processing in all cases with absolutely zero exceptions. No more "oops we had a breach, pinky promise we're sorry, don't…

No disagreement. Its just something I point out when people are concerned about "HIPAA compliance."

My experience is that people tend to think its some objective level of security. But its really just the willingness to sign a BAA and then take responsibility for any breaches.

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