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Comment by asdgkknio | Hacker News Reader

This may or may not be a useful technology, but the fact that Facebook thinks they have the ability and the right to diagnose their users with mental illnesses is disturbing. They have more information about their users than psychologists have about their patients. They can (and do) build a psychological profile and diagnose mental illness. Yet rather than keeping this information in the closest confidence, they sell it to the highest bidder. They can (and do) run experiments without getting informed consent (or any consent).

They're playing psychologist and should be subject to a similar code of ethics.

Another interesting article:

http://www.slate.com/articles/health_and_science/science/201...

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> Facebook thinks they have the ability and the right to diagnose their users with mental illnesses

Was this ever stated in the article? There's a big difference between diagnosing someone with mental illness and recognizing when someone is in a suicidal crisis. If someone is publicly saying things like "I wish I was dead" and "I'm going to kill myself" on Facebook, it seems highly ethical to automatically escalate to a moderator ASAP rather than waiting for someone to report it.

If someone has a heart attack in the street, would you say "I'm not a doctor, so I don't have the ability or the right to diagnose what just happened"? No, you'd recognize that it's a serious emergency and find people who are able to help. This really isn't much different.

Even more, we've seen articles which pointed out how using Facebook makes people more depressed and doesn't help with isolation, and loneliness. So in a terribly ironic way, Facebook is making them depressed, but then it doesn't want to them to die because there's nobody left to lick the "Like" button, so it deploys AI doctors to diagnose and prevent suicide from happening.

This is really accurate. Keeping people depressed and addicted works for Facebook, in the alcohol industry, food, gambling and so on.

And now a company with extremely powerful AI capabilities want to fine-tune the addiction algorithm to maximize profits.

Sounds like the old 'break their windows by night, fix em by day' trick

I get sick of screen touchers on a shared machine I use. This comment made me cringe.

I'm sure advertisers of pharmaceutical companies can't wait to take advantage of this in their ad placement strategies.

> Facebook thinks they have the ability and the right to diagnose their users with mental illnesses

Maybe it's more that Facebook thinks it's horrible when people kill themselves, and that if Facebook's tech could help prevent suicide, inaction would be immoral.

Most of us accept some level of State interference in our lives for our own good. Maybe we are going to have to have that discussion about involuntary interventions by corporations, too.

I think the core idea here is that if FB decides to work in this space, they should follow similar codes of ethics as, say, your local psychologist.

Its' _absolutely not_ OK for any of this information to get anywhere near the "targetted ads" part of their service. Imagine if you could advertise your alcohol products directly to alcoholics!

It's not OK for people to run explicit "psychological manipulation" experiments without the user's consent and without very specific rules with regards to the danger to the users. There's a reason why you don't replicate the prison experiment.

Maybe FB is already doing this in context of their algorithmic feed improvements. In that case they should already be asking for user consent when running these experiments.

It's not even that hard! "We're trying new changes to feeds to help show you content that is more relevant to you/more positive/etc. Click here if you want to opt-in. See here for details"

They can do right here, and I bet enough people within FB would like to do things "right", but might simply not be informed enough.

>Maybe it's more that Facebook thinks it's horrible when people kill themselves, and that if Facebook's tech could help prevent suicide, inaction would be immoral.

That doesn't entirely contradict what I said. We generally assume psychologists and therapists are benevolent, but they aren't allowed to disclose private information even if it's in the best interests of the patient. Even if we assume Facebook is perfectly benevolent, this kind of vigilante psychology with no oversight is scary. They've thrown out all established codes of ethics in favor of just doing whatever the hell they want.

And I'm certain Facebook isn't benevolent. They deliberately make their website as addictive as possible. They have run experiments that tried to make people unhappy. If this really is a selfless attempt to help their users, it's inconsistent with what Facebook has done before.

> They've thrown out all established codes of ethics

They may have nudged on one particular code of ethics.

Alarmism does not help your credibility.

> Most of us accept some level of State interference in our lives for our own good.

The state is elected by the people and is - at least nominally - meant to serve them.

> Maybe we are going to have to have that discussion about involuntary interventions by corporations, too.

This is textbook Corporatocracy. I have neither the power to vote corporations in or out nor any recourse if they decide I need an "intervention". How is this not high-tech serfdom?

> Maybe it's more that Facebook thinks it's horrible when people kill themselves

Of course! You can’t show ads to dead people...

I'm worried there's a taboo developing where only professionals or mentally ill people themselves are allowed to express any kind of opinion about mental illness or the mentally ill.

I'm worried that the field of psychology is gaining a monopoly on expression of feelings. We can no longer express happiness and sadness, anxiety and frustration, without being "diagnosed" in a horoscopic manner which has little or nothing to do with science and bears a great deal of stigma.

The psychological disorders of today are the occult of yesterday. We believe that one can become possessed by depression or anxiety. Possessed by psychosis, possessed by a personality disorder, possessed by PTSD, possessed by a history of child abuse. And we have to call upon the psychologists to preform an exorcism.

You are free to reject diagnosis and medication unless you are determined a danger to yourself or others. HIPAA also gives you control over where your diagnoses travel.

Not with facebook, of course, which doesn’t qualify for hipaa protections yet.

Of course you are free to do so, but back in the days of daemon possession, most people were just as free to reject the claim that they were possessed. What mattered back then, was not the claim though, what mattered back then was that ordinary people would look at someone and think "oh he's acting weird, he must be possessed". And that "possessed person" would then be feared. It interfered with the process of empathy.

Well, HIPAA also protects you from your doctor telling your social circle. So i’m not quite clear on what the parallel to “being afraid of a possessed person” would be.

Interesting.. I wonder if these profiles fall under HIPAA.

Absolutely not. HIPAA regulates the medical and insurance industries, which Facebook is certainly not. If you broadcast medical data to the public or put it in a newspaper HIPAA does not apply, much like this case.

Best case scenario, and this is still a stretch, is that Facebook could be guilty of slander if they describe you has suicidal and that description becomes known to a third party without your consent.

>known to a third party without your consent.

Sneaky suspicion: consent is given upon account registration.

Maybe, but I think health information disclosure has a lot of rules to it (at least based on my experience) where authorizations expire after 1 year etc... So I don't think a blanket exception applies. And although Facebook is a public forum not all communications are public per se so it's not clear what a disclosure is... maybe it is sufficient for Facebook to say that the information was "disclosed to us" and we are free to do what we want with it, including using an AI bot to alert emergency services. It seems like a big gray area.

> Facebook is a public forum not all communications are public per se so it's not clear what a disclosure is...

It doesn't matter. Once you surrender data to Facebook it is theirs to do whatever they want with. That is the disclosure. There is no gray area. If you don't want Facebook having that information then don't give it to them.

Facebook is known to collect key presses. If I express a desire to commit suicide in a status update, but don't actually post it, thus not showing it to anybody except Facebook, would that (should it?) be covered by HIPAA? What if I keep paper diary? What if it's in Google docs instead?

No, because you have no obligation to disclose anything to Facebook. If you choose to disclose this to Facebook that is your mistake. You absolutely must disclose medical information with a medical provider and with your insurance company.

> What if it's in Google docs instead?

If you didn't put it there than somebody has violated your privacy or violated HIPAA.

I think it is unclear. For example Apple has HealthKit which collects health related data.. That data is probably HIPAA protected. If it's not (and if Facebook is not) then I would imagine we will see legislation and/or lawsuits to clarify things.

Apple is not a covered entity under HIPAA[0], and thus has no liability for the data it collects.

"If an entity does not meet the definition of a covered entity or business associate, it does not have to comply with the HIPAA Rules."

[0] - https://www.hhs.gov/hipaa/for-professionals/covered-entities...

Apple is most likely a business associate by definition.

Doea medical data not talked about in a medical setting trigger HIPAA?

(Like me talking that I'm type 2 diabetic?)

If you talk about it outside a privileged context, you're implicitly waiving the privacy protections.

For example, if you run into your physician in public, and say, "Hi Doc. Have you gotten my test results back yet?" you're the one pointing out that she's your doctor, not her. If she, unprompted, said something about your test results to you, she'd have violated HIPAA.

It's your privacy to waive as you please.

The P in HIPAA doesn't stand for Privacy.

No, it stands for "Portability."

HIPAA does, however, have a section explicitly governing the privacy of patient medical information, under Title II, generally known as "The Privacy Rule".

EDIT: Tone and specificity.

Probably.. any disclosure could potentially be regulated. This is a company creating a health care profile of you (possibly without your consent) and potentially sharing that information of you (without your consent or release) to other entities.. so maybe? I bet there will be several lawsuits to clarify things.

Unequivocally not. Posting to Facebook is a public disclosure Health data: no one, including your own physician, is obligated to protect that which you opt to publicly disclose.

We are talking about a Facebook AI program reading your posts and deciding if you are suicidal or not. I'm not even sure how you would clinically validate that and if it would require FDA clearance, but if you are forming a mental health opinion on a stream of data and contacting the government about it that is probably something that may need to be protected.

Whether or not one thinks it ought to be protected, there is no contortion of existing law that does so.

Well take a look at this: https://nakedsecurity.sophos.com/2013/07/05/can-facebook-upd...

The medical school structured itnas a clinical trial with people volunteering to participate. Medical studies have different regulations than just reviewing public postings.

This is a reflection of the way they’ve chosen to go about things - no doubt in response to past kerfuffles - rather than an actual legal obligation on fb’s analysis of public materials.

HIPAA regs aren’t hidden from the public. Peruse at your leisure.

I can't speak to HIPAA, but medical data is covered by the EU's new GDPR framework.

> Yet rather than keeping this information in the closest confidence, they sell it to the highest bidder.

https://arstechnica.com/information-technology/2017/05/faceb...

When I read this and realize that I am not on Facebook. This IS really disturbing and should be a huge red flag for all users.

And does it not seem likely that the output of this model would be used as a signal to influence the newsfeed algorithm? It's like a feedback machine showing already depressed people pictures of happy families, making them even more depressed, yet more hooked, eventually leading to you-know-what.

What would be cool is if someone could build a GAN based on the Facebook AI training set to spit out comments that would be indicative of certain moods. This capability would be great for autistic people trying to react appropriately in social situations... or an AI chatbot trying to act human.

By the way they elevate moderation priority for posts and FB Live, I pessimisticly assume their primary concern is to prevent people from committing suicide ON Facebook Live, which is much worse for Facebook than simply loosing users

I'd be curious if they were entertaining adverse hypotheses on mental health!

Great points, I wonder if FB actually employees psychologists and if so how many and what are their accreditations and level of professional experience.

Not sure about full-time employees, but according to the video in https://www.facebook.com/safety/wellbeing/suicideprevention, they work with suicide prevention groups and researchers.

Yes they do. Main mission: to make Facebook as sticky as possible.

Is there proof though? Id assume so, Im not sure psychologists follow a Hippocratic oath if they did this seems like it would cross a bit of a line, no?

> Is there proof though?

Just one google search away. Keywords such as Facebook, psychology, experiments, ethics will generate lots of interesting reading, some of it with good sourcing and links for further reading.

It does for me, but there is always some excuse. Usually the mortgage or something to that effect.

Well if they don't have enough information to reach a diagnosis they can always head to the Zuckerberg San Francisco General Hospital.

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