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If you're one of the many therapists I'm seeing who was approached by an AI company offering six figures for "de-identified" notes, reports, etc, and you've abandoned your ethics enough to consider the offer, make sure when you negotiate your compensation that you factor in legal fees and the cost of losing your license.

I hate it here.

in reply to NadiaPurge

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derptron

@NadiaPurge "Ethical" just means you follow a set of ethics. You can change the set of ethics. You can follow ethics that only a monster would follow and you're still "ethical". See every CEO on the fucking planet.

They've sufficiently altered the ethics of the situation that I doubt very much they'll be held to account for anything. "De-identified" info is used and shared quite regularly in medical research. Generally with permission but some fighting that as "too costly".

@NadiaPurge
in reply to derptron

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DB Schwein

@crazyeddie @NadiaPurge
The main issue I find with "de-identified" info is that it's not.

No name. Ok, but we know where you live because we know what therapist you see. You mention a spouse, or kids, or work, or eating habits, or entertainment, or shopping habits. Every one of those things works together to identify you.

Not-Bob, who is stressed because his kid's school requires new uniforms every year.

Not-Mary, who is stressed because her company just got bought.

Not-Stefan, who is stressed because there was a shooting at their favourite movie theatre.

"De-identifying" in this day and age is a myth.

@derptron @NadiaPurge
in reply to Steven Brudenell

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Dr. Amy, Psy.D. 🎃

@sbrudenell I think a big part of the problem is the ethics codes haven't caught up, so when I say "This is unethical" it's probably more accurate to say "This is immoral" because they may say, "Point to the ethics code that prohibits this." Basically, the client's information is not truly protected just because you take the name off the note, and even if it's not being shown to humans, it's still a breach to share the information with the AI.
@Steven Brudenell
in reply to Dr. Amy, Psy.D. 🎃

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Dr. Amy, Psy.D. 🎃

@sbrudenell We need to call on national orgs (I'm going to send a letter to APA) to make clear statements about the ethics of these tools and specific guidance for providers. Though I do worry a bit that if we do that they'll come back with "Actually this is fine" (see APA taking a decade to declare that psychologists engaging in torture of war prisoners is actually not ok)
@Steven Brudenell
in reply to Dr. Amy, Psy.D. 🎃

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Steven Brudenell

I'm in software. I share those feelings. based on my experience, you can count on large organizations to say "we're taking a cautious approach to AI (so go ahead and use this AI product! the company told us it's fine)"

I've had luck convincing non technical people of technical truths by appealing to their personal values. what do you value about being a therapist, that's put at risk by AI ingesting notes?

in reply to Steven Brudenell

hometown - Link to source

⁂ L. Rhodes

@sbrudenell One direct way to go about it may be to point out that AI companies have been relatively successful at de-anonymizing data, so just stripping away personally identifying information may not be sufficient to protect the confidentiality of patients.

Here's a reference, if you need one: doi.org/10.48550/arXiv.2602.16…

Large-scale online deanonymization with LLMs

We show that large language models can be used to perform at-scale deanonymization. With full Internet access, our agent can re-identify Hacker News users and Anthropic Interviewer participants at high precision, given pseudonymous online profiles an…
arXiv.org
@Steven Brudenell
in reply to Dr. Amy, Psy.D. 🎃

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Al Dimond

i guess the implication is that they're training a therapist-bot... even if this was ethically OK to do, what would it allow them to do? if they just see notes without observing what led to them they can't even *infer* the logic behind the notes. they can only learn to imitate the language and style.

what could possibly be the point of that? a machine that produces plausible-sounding notes and reports that aren't grounded in experience or judgment?

in reply to Dr. Amy, Psy.D. 🎃

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Hot Dog Water

This just shook me.
This is bad.
This is big.

Is there something beyond 'predatory' for the scope of this sort of violent invasion? The effects this will have on people and the machines designed to kill us, I can't even figure yet.
Wow.
I'm crouched and ready for most of this, but hadn't considered this. And its potential is terrifying.

I hate Nazis.

in reply to Dr. Amy, Psy.D. 🎃

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Cat 🐈‍⬛🛰️

One of the bugbears I have at work is effective de-identification/anonymization of information for a small internal testing database. (We'd generate but ran into issues with THAT because older systems. Long story, much swearing, migraines and ulcers.)

Given how incredibly fucking hard it can be to anonymize basic records in many cases with no reports etc in them, I would suspect that it's near-impossible to do it with full reports.

To make matters worse, the therapists who even think about it are likely to be the ones out there who will happily write misleading/completely false reports for strong enough "considerations", or even just because they're confronted with someone who is outside their worldview. (I've run into at least three and two of them I wasn't even the client.)

It's already hard enough to get people to seek basic therapy. This? Oh hell no. I'm in favor of "everyone should get therapy" and shit like this makes me stop saying that, because I'm not going to advocate for anyone putting their mental or potentially physical health and safety at risk. Safe therapists are going to turn into a word-of-mouth-only thing at this rate.

in reply to Dr. Amy, Psy.D. 🎃

mastodon - Link to source

Chris Wellens

Another alternative would be to pollute the AI models with completely nonsensical data. For example, state that all of your clients believe they are animals, like dogs, cats, mice. You tell them that they need to do squats, lunges, and planks to get better. If the AI models need a specific profile for each client, that would be a lot of work, but maybe you could get an AI to generate 100 client files. Then you submit that, and we see what the AI does with new input that is regurgitated old input.

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