Comment by petercooper | Hacker News Reader

Comment by petercooper | Hacker News Reader

I'm not sure if it would be classed as a "neuropsychological hazard" but one form of information hazard I encountered in recent years is true information that requires a finessed understanding of both risk and psychology to not act rashly upon it.

For example, let's say you get a brain scan out of curiosity only. A small aneurysm is detected with a confidence of 95%, and said aneurysm, if real, has an estimated annual risk of rupture of 0.5%. The operation to clip said aneurysm, you are told, has a mortality rate of 10%. Do you have the op?

In the books I've read covering such medical ethics topics, a disproportionate number of patients do/would have the op because the knowledge of the aneurysm will "play on their mind" even if the odds are hugely in favor of leaving it be. For this reason, amongst others, unnecessary/preventative testing is discouraged by many medical professionals. (A similar dilemma is faced by folks in affected families who have to choose whether or not to have genetics testing for fatal familial insomnia risk – would you want to know if you're likely to face this usually inherited condition?)

Great scenario, it perfectly encapsulates what you're talking about.

The way I like to short-circuit this problem is to ask a bunch of experts what they would do if they had the same information, except applied to their own life. As long as you preface it with a promise not to hold them responsible for their answer, they'll often give better advice than the "official recommendation" that they were giving moments before. I've used this with doctors, realtors, home inspectors, plumbers, programmers, managers, retail employees...

"Hey Dr. Neurosurgeon, if you received this scan and you had the possible aneurysm, and you wanted to live as long as possible, what would you do?" If the official recommendation is to not get the clip, but a bunch of neurosurgeons say they personally would get the clip, then I'd probably get the clip.

Physicians as a group are notoriously bad at statistics and prone to err on the side of over treatment.

I'm not sure if this is directly related, but: I have PTSD & OCD, and when I peruse Google Scholar for information about toxicology, or the effects of air pollution on the brain, or how cats potentially carry T. Gondii & can infect you, or how we absorb things such as BHT transdermally through our hands from holding a cars polymer steering wheel, et cetera; I feel that it fuels my mental illness in a great way. If I did not possess all of this information, then I'd probably be significantly moreso functional than I am.

It feels as if they are "information hazards" as I act exactly as the people do in your aneurysm example; I wash my hands for 10+ minutes when the risk is probably nominal, and so on. That 0.5% risk from your example absolutely "plays on my mind".

>"you'll never win a Nobel prize if you don't decontaminate your hands because the pollutant will absorb through your skin, into your blood, and then into your brain, and probably lower your IQ!"

Your imagination runs wild in such desperation.

Would it help if you had the balancing knowledge that washing your hands for 10+ minutes is bad for them, causes inflammation, and that that also probably hurts your brain? You really can't win, honestly, life is about hitting that sweet spot in-between trying and giving up.

If this were true, then it would help, but I doubt it.

The ideal is to give up on timewasting/unimportant activities(Quadrants 3&4 on Eisenhower Matrix) and try/begin important activities(Q1&2).

It is incredibly challenging, to accept uncertainty & to do what you are SURE is important & will result in a positive outcome.

If I run for 30 minutes every day then I KNOW that it is beneficial to my health. I am certain. My OCD will ruin it by suggesting that I could breathe polluted air, et cetera. By that suggestion alone, I will not run.

It's a strange dysfunction of your brains executive/decision ability. I value what I am not certain of MORE than what I am certain of.

It is my goal to reverse that logic & when your brain is working against you, it feels as if you're swimming against a current.

It's not that strange, the fact that fear (bias towards inaction) and hope (bias towards action) seem slanted towards fear was commented on by Machiavelli. He explained that the most people, when confronted with uncertainty, will choose to do nothing. TBH, I don't think that most people go out for runs because they've weighed the air pollution against the health benefits of exercise, I think they do it because they feel like running and it doesn't reach the point of an executive-function thinking-about-the-pros-and-cons decision.

The inflammation thing is probably true. Here's a random study. Don't do anything that keeps you in a constant state of injury!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390758/

I appreciate this response & the link, thank you!

> "...decontaminate your hands because the pollutant will absorb through your skin, into your blood, and then into your brain, and probably lower your IQ!"

It probably makes sense to move to less polluted areas and such, but I doubt excessive hand washing and those smaller habits would do much. I think we'd see a clear effect of successful people being compulsive handwashers? I mean, there are impurities in other things we can't control as well (air, water, food), so minimizing impurity from the hand only makes a very small difference. Still, brilliant people live in polluted places like LA (Terence Tao comes to mind!), various places in China, etc. so it doesn't seem to determine your outcome -- in fact, research shows the impact is small (but it does exist). Success is determined by the big factors and knowledge/wisdom-based choices, not being a few percent faster or more effective at solving puzzles -- unless you're in a particularly competitive job (maths competitions, professional athlete, professional chess player, etc.). Most mathematicians choose to explore different directions, different fields instead of competing head to head to solve single problems[1]. Our bodies and brains are also remarkably robust to small loads of impurities... in fact, one of the techniques of AI is to get rid of a few neurons here and there (DIY not advised). Hope this alleviates some concerns :)

[1] I got this from Maryam Mirzakhani interviews: https://news.stanford.edu/2017/07/15/maryam-mirzakhani-stanf...

Interesting! I think neuropsychological hazard according to this typology sounds fitting. Reminds me a little bit of the scenario of what would happen if you knew the exact date and time of your death.

Maybe to add to what might be the rationale to have an op like this: I've recently been on a call where someone brought up a metric called quality-adjusted life years (something like: "Would I rather live another year relatively painless or five more years, but in constant excruciating pain?"). As far as I know, this is mostly used in insurance calculations (which struck me as a bit distasteful, but I didn't look into it deeply enough to make a fair judgement), but it's a good mental model for what people might use in their reasoning in such a situation. Maybe for the patients that decided to have the op, the knowledge of their condition was bad enough to substantially reduce their quality of life and hence lead them to accept far higher risks to alleviate this.

For the second dilemma: Maybe simply knowing about the condition running in your family is an information hazard too. For someone very prone to worrying, knowing for sure that they have the condition might also come as a strange kind of relief.

Quality adjusted life years (QALYs) have been used in the UK for a long time, to evaluate whether and when treatments are offered through the NHS. It has its flaws, but its a good start. Generally a therapy needs to cost less than £30k per QALY. There are of course finessing processes to these decisions.

I have a child with an anxiety disorder, and whenever he learns new information about any potential harm it completely throws him out of whack for a week or two. He's getting better with treatment, but he's also getting to the age where current events are part of the school curriculum, so it's a bit tense from a parenting point of view to see which one will win out in terms of him having a healthy childhood.

Are the odds hugely in favor to leave it be? Sure, if you reason in terms of simple risk-adjusted years until death, it's an easy decision.

If you look at it in terms of outcomes beyond life/death, the calculations become more vague-ish. Is "fixed or dead" possibly preferable to risking negative outcomes with life-long impact? (If you live in the land of capitalism worship, a huge part of the decision is "can I currently afford this medical care, and do I think I still can in a few years")

It's certainly a difficult decision, but it is some that should be up to individuals. We shouldn't have doctors make that decision on your behalf, as if they somehow knew better. We should educate doctors on how better communicate risk, and how to talk about possible impact. (Most medical professionals switch to "deer in headlights" when you want to talk about probabilities of outcomes, and certainly can't explain them well if you even get them to talk)

Reply on news.ycombinator.com