6 ms·

This qualifies for /r/assholedesign

by eddywebs 7y ago

aqme28 7y ago
More than that. This is unethical design. It's a design that probably killed people.
- brianwawok 7y ago
  I think it's safe to remove probably. This went down a chain of people. CEO. VP. PM. Tech Lead. Developer. All of them made a choice to kill people for profit.
  - ohithereyou 7y ago
    I've said this before on HN and I'll say it again. Every C-level exec that was aware this happened and let it happen should be charged with a single count of involuntary manslaughter for every patient who had an opioid overdose that was prescribed pain medication by this system. This is not acceptable, and people's heads should roll.
    - sneak 7y ago
      Nobody forced anyone to put those drugs into their body.
      - sonotathrowaway 7y ago
        Nope, they just lied about their addiction potential. Intentionally getting someone addicted to a drug can’t in any way be seen as forcing them to take it.
  - SkyBelow 7y ago
    Would this same logic apply to other jobs? For example, do people who brew beer make the choice to kill others? If the drunk drivers add a level of indirection that prevent blame, then why doesn't the same happen with the doctors in this case? Gun manufacturers? People who build cars that have a known higher fatality rate? People who build swimming pools (look up how many kids die to swimming pools a year)? People who sell unhealthy food? People who make tech/video games that result in less physical activity?
    - danharaj 7y ago
      We all choose every day to continue reproducing business as usual.
    - deleted 7y ago
      [deleted]
    - asdfgionio1234 7y ago
      If I brew beer, odds are I also drink beer. If I manufacture guns, odds are I also own guns. If I make sports cars, odds are I also like to drive sports cars. People who build swimming pools swim. People who sell junk food buy junk food. People who make video games play video games. The people in your examples are all selling things they probably want to be able to buy. Perhaps you disagree with their decisions, but they are acting out of a good-faith belief that the things they make are good. No one wants to have someone try to get them hooked on opioids. Follow the Golden Rule. (Maybe the junk food and video games examples are different, since some foods and games are deliberately addictive.)
      - TeMPOraL 7y ago
        > (Maybe the junk food and video games examples are different, since some foods and games are deliberately addictive.) Yes and no. I'm not sure who and where sells true junk food; the usual culprit - McD, KFC - sell food that's unhealthy in the long run, but it's also cheap, tasty and quick to get, making it desirable in many different situation. (Also, frankly, I think McDonald's may be better for you than equivalents from a "normal" restaurant. Large fast food chains are ridiculously optimized, but they have standards to meet and an individual location doesn't have the freedom to screw with it. Meanwhile in a random restaurant, I always have to worry how cheap they get with the ingredients and their process, and whether e.g. the meat I'm getting was actually grilled, or was just microwaved and then decorated with grill marks. I don't know anyone currently working on the "back end" of a typical restaurant, but from second-hand reports I keep hearing, I'm not reassured about quality.) And "videogames" as a product category is too broad for this consideration. On one end of the spectrum you have beautiful, engaging videogames designed by passionate creators who absolutely build what they'd like to play. On the other end, you have the bottom-feeding Zynga-like garbage that's essentially gambling in disguise, designed from grounds-up to screw players over.
  - sneak 7y ago
    I don’t think that’s an accurate statement, and is a misattribution of responsibility. The responsibility ultimately rests with the person who puts the drug in their own body. You can make an argument that their physician is in a position of trust, and that some responsibility lies with their prescribing it. Extending it out to the workers of the vendor is as silly as extending it out to the workers of the keyboard vendor.
    - mlazos 7y ago
      It’s definitely not like extending it to the keyboard manufacturer, that’s the reddest of red herrings. They intentionally signed off on a feature that encourages a physician (in a position of trust) to prescribe opioids. The keyboard or tools to build the software had absolutely nothing to do with this unethical decision. It was a ux design decision which they all certainly knew what its intention was (or they were incompetent af).
      - sneak 7y ago
        The software can’t write prescriptions. The software can not force people to ingest pills.
        mlazos 7y ago
        Your argument rationalizes literally every dark pattern in ux that has ever existed. No of course there isn't a gun to anyone's head here. That's not the point that anyone is arguing. The point is that it encourages someone in a position of trust to act against a patient's interest. They at least share blame with the physician. I'd say most of the blame, because if this feature didn't exist, the physician wouldn't act against the patient's self interest. The world isn't black and white, it's why manslaughter exists as a crime and why we don't just have murder.
        sneak 7y ago
        Nobody is forced to write such software, either. Assigning responsibility for actions with clear boundaries does not “rationalize” anything. It is important to remember that humans, regardless of their level of ignorance, are responsible for themselves and their own actions. Encouraging people to make bad decisions isn’t the issue at all, even if the final result would not have happened without such encouragement.
- horsawlarway 7y ago
  I'd argue it's actually MUCH worse than simply killing people (which is already pretty staggeringly bad). The constant push to privatize and let market forces drive medical interactions is CRUSHING trust in the system. Let's take an example patient, Sally. Sally goes to see her doctor, she's got some minor knee pain, but nothing serious. As a result of this profit motivated system, her doctor is likely to try to prescribe her expensive pain killers. She doesn't really think she needs them, but she gets the prescription anyways since she trusted her doctor. Now Sally is actually lucky - no addiction issues, no real problems with the meds. She just decides to stop paying for them after a while since she didn't really think she needed them. AND SHE WAS RIGHT. Now she's got a nagging thought in the back of her head - Why did my doctor ask me to buy this thing? I didn't need it. Next time Sally hits the doctors office she's got her kids in tow and the doctor recommends several vaccines. Not super expensive, but not cheap. Normally she'd just trust the doc and say sure. But last time she was burned and paid for something she didn't need. So this time she decides to do some googling and hits a whole host of anti-vax propaganda. Things that say kids don't need them, they're expensive and risky. So she opts out. ---- We see this happen everywhere in medicine right now. Things like: - The dentist that "finds" a cavity at the last minute to fill even though everything has been fine, and the patient doesn't normally have cavities. - The physician that runs a whole slew of expensive tests for a simple issue - The dermatologist who wants to do a biopsy on the mole that's been fine for years and doesn't look any different. Each interaction like this - Where the patient feels more like a walking wallet than a person - they erode trust. Rightfully so, in my opinion. The end result is whole swathes of disillusioned people who no longer trust the medical system. The consequences become staggering for society as a whole when this trust is gone. --- I don't think it's any accident AT ALL that the most common group to believe the anti-vax rhetoric is the upper middle class. They're the patients most likely to have disposable income that can be targeted with schemes like this. And while those people are horribly wrong, their gut instinct is SPOT ON. They're being targeted financially and it's bullshit.
  - deleted 7y ago
    [deleted]
  - m_fayer 7y ago
    My partner is a new doctor in an underserved lower class area. The hospital is barely getting by from lack of resources, and on top of all that, the patients are often mistrustful and hostile. You work frantic 12 hour days for a lower middle class salary, and have patients accusing you of profiteering. Of course my partner understand how her patients got that way and doesn't blame them. Exactly as you said. It's terrible.
stevula 7y ago
/r/dangerousdesign

This qualifies for /r/assholedesign

aqme28 7y ago

More than that. This is unethical design. It's a design that probably killed people.

brianwawok 7y ago
I think it's safe to remove probably. This went down a chain of people. CEO. VP. PM. Tech Lead. Developer. All of them made a choice to kill people for profit.
- ohithereyou 7y ago
  I've said this before on HN and I'll say it again. Every C-level exec that was aware this happened and let it happen should be charged with a single count of involuntary manslaughter for every patient who had an opioid overdose that was prescribed pain medication by this system. This is not acceptable, and people's heads should roll.
  - sneak 7y ago
    Nobody forced anyone to put those drugs into their body.
    - sonotathrowaway 7y ago
      Nope, they just lied about their addiction potential. Intentionally getting someone addicted to a drug can’t in any way be seen as forcing them to take it.
- SkyBelow 7y ago
  Would this same logic apply to other jobs? For example, do people who brew beer make the choice to kill others? If the drunk drivers add a level of indirection that prevent blame, then why doesn't the same happen with the doctors in this case? Gun manufacturers? People who build cars that have a known higher fatality rate? People who build swimming pools (look up how many kids die to swimming pools a year)? People who sell unhealthy food? People who make tech/video games that result in less physical activity?
  - danharaj 7y ago
    We all choose every day to continue reproducing business as usual.
  - deleted 7y ago
    [deleted]
  - asdfgionio1234 7y ago
    If I brew beer, odds are I also drink beer. If I manufacture guns, odds are I also own guns. If I make sports cars, odds are I also like to drive sports cars. People who build swimming pools swim. People who sell junk food buy junk food. People who make video games play video games. The people in your examples are all selling things they probably want to be able to buy. Perhaps you disagree with their decisions, but they are acting out of a good-faith belief that the things they make are good. No one wants to have someone try to get them hooked on opioids. Follow the Golden Rule. (Maybe the junk food and video games examples are different, since some foods and games are deliberately addictive.)
    - TeMPOraL 7y ago
      > (Maybe the junk food and video games examples are different, since some foods and games are deliberately addictive.) Yes and no. I'm not sure who and where sells true junk food; the usual culprit - McD, KFC - sell food that's unhealthy in the long run, but it's also cheap, tasty and quick to get, making it desirable in many different situation. (Also, frankly, I think McDonald's may be better for you than equivalents from a "normal" restaurant. Large fast food chains are ridiculously optimized, but they have standards to meet and an individual location doesn't have the freedom to screw with it. Meanwhile in a random restaurant, I always have to worry how cheap they get with the ingredients and their process, and whether e.g. the meat I'm getting was actually grilled, or was just microwaved and then decorated with grill marks. I don't know anyone currently working on the "back end" of a typical restaurant, but from second-hand reports I keep hearing, I'm not reassured about quality.) And "videogames" as a product category is too broad for this consideration. On one end of the spectrum you have beautiful, engaging videogames designed by passionate creators who absolutely build what they'd like to play. On the other end, you have the bottom-feeding Zynga-like garbage that's essentially gambling in disguise, designed from grounds-up to screw players over.
- sneak 7y ago
  I don’t think that’s an accurate statement, and is a misattribution of responsibility. The responsibility ultimately rests with the person who puts the drug in their own body. You can make an argument that their physician is in a position of trust, and that some responsibility lies with their prescribing it. Extending it out to the workers of the vendor is as silly as extending it out to the workers of the keyboard vendor.
  - mlazos 7y ago
    It’s definitely not like extending it to the keyboard manufacturer, that’s the reddest of red herrings. They intentionally signed off on a feature that encourages a physician (in a position of trust) to prescribe opioids. The keyboard or tools to build the software had absolutely nothing to do with this unethical decision. It was a ux design decision which they all certainly knew what its intention was (or they were incompetent af).
    - sneak 7y ago
      The software can’t write prescriptions. The software can not force people to ingest pills.
      - mlazos 7y ago
        Your argument rationalizes literally every dark pattern in ux that has ever existed. No of course there isn't a gun to anyone's head here. That's not the point that anyone is arguing. The point is that it encourages someone in a position of trust to act against a patient's interest. They at least share blame with the physician. I'd say most of the blame, because if this feature didn't exist, the physician wouldn't act against the patient's self interest. The world isn't black and white, it's why manslaughter exists as a crime and why we don't just have murder.
        sneak 7y ago
        Nobody is forced to write such software, either. Assigning responsibility for actions with clear boundaries does not “rationalize” anything. It is important to remember that humans, regardless of their level of ignorance, are responsible for themselves and their own actions. Encouraging people to make bad decisions isn’t the issue at all, even if the final result would not have happened without such encouragement.
horsawlarway 7y ago
I'd argue it's actually MUCH worse than simply killing people (which is already pretty staggeringly bad). The constant push to privatize and let market forces drive medical interactions is CRUSHING trust in the system. Let's take an example patient, Sally. Sally goes to see her doctor, she's got some minor knee pain, but nothing serious. As a result of this profit motivated system, her doctor is likely to try to prescribe her expensive pain killers. She doesn't really think she needs them, but she gets the prescription anyways since she trusted her doctor. Now Sally is actually lucky - no addiction issues, no real problems with the meds. She just decides to stop paying for them after a while since she didn't really think she needed them. AND SHE WAS RIGHT. Now she's got a nagging thought in the back of her head - Why did my doctor ask me to buy this thing? I didn't need it. Next time Sally hits the doctors office she's got her kids in tow and the doctor recommends several vaccines. Not super expensive, but not cheap. Normally she'd just trust the doc and say sure. But last time she was burned and paid for something she didn't need. So this time she decides to do some googling and hits a whole host of anti-vax propaganda. Things that say kids don't need them, they're expensive and risky. So she opts out. ---- We see this happen everywhere in medicine right now. Things like: - The dentist that "finds" a cavity at the last minute to fill even though everything has been fine, and the patient doesn't normally have cavities. - The physician that runs a whole slew of expensive tests for a simple issue - The dermatologist who wants to do a biopsy on the mole that's been fine for years and doesn't look any different. Each interaction like this - Where the patient feels more like a walking wallet than a person - they erode trust. Rightfully so, in my opinion. The end result is whole swathes of disillusioned people who no longer trust the medical system. The consequences become staggering for society as a whole when this trust is gone. --- I don't think it's any accident AT ALL that the most common group to believe the anti-vax rhetoric is the upper middle class. They're the patients most likely to have disposable income that can be targeted with schemes like this. And while those people are horribly wrong, their gut instinct is SPOT ON. They're being targeted financially and it's bullshit.
- deleted 7y ago
  [deleted]
- m_fayer 7y ago
  My partner is a new doctor in an underserved lower class area. The hospital is barely getting by from lack of resources, and on top of all that, the patients are often mistrustful and hostile. You work frantic 12 hour days for a lower middle class salary, and have patients accusing you of profiteering. Of course my partner understand how her patients got that way and doesn't blame them. Exactly as you said. It's terrible.

stevula 7y ago

/r/dangerousdesign