Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Health-records software pushed opioids to doctors in secret deal with drugmaker

bloomberg.com

Post reply on HN
Print view View original

51–60 of 269 posts

Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#51

Post by Wowfunhappy »

GabrielBen wrote: post #37

Designing the tools that providers use to treat patients is exceedingly difficult and filled with moral hazards. What makes this instance so pernicious is that it was involved in what is now a national crisis, but it's not very different to what a flu vaccination manufacturer could do, and which would raise no eyebrows in the eyes of the public or the government. Medicine is one of those fields where the discrepancy…

> Designing the tools that providers use to treat patients is exceedingly difficult and filled with moral hazards.

I don't doubt that—but I also have a lot of trouble believing that the people who designed this tool didn't know exactly what they were incentivizing. A UI designed with the user's interests in mind simply would not have come out this way.

The degree to which we've normalized the creation of dark patterns is scary.

Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#52

Post by mehlmao »

nkrisc wrote: post #6
pimmen wrote: post #4

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 a…

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…

This "feature" was added to the software in 2016, well into the epidemic.

Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#53

Post by Nasrudith »

ptah wrote: post #28

doesn't texas still have death penalty? pity it doesn't apply to corporations. both of them deserve it

I don't think the crimes technically qualify as a capital crime despite the major and obvious ethical and moral lapses. Even with more blatant and callous examples like "miracle mineral solution" (read: bleach as medicine for internal use) fraudsters don't reach that level. Nor even "knowingly selling possibly tainted products". Not a lawyer but I think it essentially would call for say deliberately adding cyanide to your products to be outright murder.

Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#54

Post by bpaddock »

conanbatt wrote: post #46
bpaddock wrote: post #41

Earlier quoted context omitted.

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…

Incredible that this is another comment of yours that manifests the answer I gave you in this topic. Providers are under the microscope for opioids now, so why risk it, it's not their pain. Medicine is a rough field.

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.

Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#55

Post by vsareto »

CoolGuySteve wrote: post #27
vsareto wrote: post #21

Earlier quoted context omitted.

Always good to throw the line developers under the bus and let the executives get away with it. I mean, as a developer, I'm always going business to business to pitch my dark-pattern UI features to companies and by gosh I just wish someone would stop me!

Why shouldn’t you implicate the developer? If your manager asks you to implement something that can kill people you have a moral obligation to quit. Whoever implemented this is as much of a shitbag as the executive who asked for it.

So the manager has no idea it would kill people, but the developer does? All developers are now well-versed in medical ethics and would never need a lawyer?

Show me a well-known whistleblowing route that would give you protections for bringing this forward. Let’s pretend only the people pulling the trigger are the only ones who should go to jail in this case, and developers are the last and only defense that society wants for its software. You can do full stack, why not handle being a lawyer at the same time?

Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#56

Post by vsareto »

slumdev wrote: post #30
vsareto wrote: post #21

Earlier quoted context omitted.

Always good to throw the line developers under the bus and let the executives get away with it. I mean, as a developer, I'm always going business to business to pitch my dark-pattern UI features to companies and by gosh I just wish someone would stop me!

People in our line of work have a much greater ability to walk than others do. A software engineer with only a few years of experience can leave and have a $100k+ job lined up in a matter of days or weeks. $150k+ if you're in NYC and $200k+ if you're in SF or Seattle. Sticking around and implementing an evil feature is cooperation with evil.

Executives and managers make even more than line developers and have a much greater ability to walk.

Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#57

Post by vsareto »

ethanbond wrote: post #26
vsareto wrote: post #21

Earlier quoted context omitted.

Always good to throw the line developers under the bus and let the executives get away with it. I mean, as a developer, I'm always going business to business to pitch my dark-pattern UI features to companies and by gosh I just wish someone would stop me!

How about both are responsible?

Correct, but some are more responsible than others

Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#58

Post by slumdev »

vsareto wrote: post #56
slumdev wrote: post #30

Earlier quoted context omitted.

People in our line of work have a much greater ability to walk than others do. A software engineer with only a few years of experience can leave and have a $100k+ job lined up in a matter of days or weeks. $150k+ if you're in NYC and $200k+ if you're in SF or Seattle. Sticking around and implementing an evil feature is cooperation with evil.

Executives and managers make even more than line developers and have a much greater ability to walk.

They are also culpable.

It might take them longer to find similar employment elsewhere, though, so I'd suggest that their increased earning power is offset by the potential for longer periods of unemployment.

Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#59

Post by mtgx »

codeulike wrote: post #5

[when opening a patients records] a pop-up would appear, asking about a patient’s level of pain. Then, a drop-down menu would list treatments ranging from a referral to a pain specialist to a prescription for an opioid painkiller. Click a button, and the program would create a treatment plan. From 2016 to spring 2019, the alert went off about 230 million times. The tool existed thanks to a secret deal. Its maker, a s…

People are going to go to prison for this, right?

Or has all white crime been made legal in America? Because I can't tell anymore.

Re: Health-records software pushed opioids to doctors in secret deal with drugmaker

#60

Post by m_fayer »

bitwize wrote: post #47

Candy Crush adverts in Windows 10 was bad enough, but this is next-level evil. Time for the software industry to wake up and realize it's not the advertising industry.

Most software is streamlined automated bureaucracy. Not in the pejorative sense, but in the "basic infrastructure of a human enterprise" sense.

Seen that way, it's absolutely criminal for software to allow the highest bidder to inject arbitrary bias into this infrastructure. On the other hand, it's absolutely foolish for organizations, which in the paper days hand-grew their infrastructure, to not closely scrutinize the nervous system/potential-trojan-horse that they're taking off the shelf and installing right into their core.

Post reply on HN