My Answers to HW4case, Q3

Q3. Write up your case on your blog with the following subheadings:

• “The facts of the case.” Here is where you describe the case in your own words.
• “Analysis.” Examine the case in terms of the questions.
• “My conclusions.” Your conclusions and opinions about the case. Be sure to explain and justify what you write. 3 sentences of average length or more.
  
• “Future environment.” Describe your vision of a future in which technology is more advanced than today, or society has changed in some significant way, such that the ethical issues of the case would be even more important than they are in today’s world. 3 sentences of average length or more.
• “Future scenario.” Describe how this ethical case (or an analogous one) would or should play out in the environment of the future, and give your opinions about it. 3 sentences of average length or more.

Answer:


Facts of the case:

I looked at the Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry. This code of ethics applies to anyone in the Psychiatric profession and is maintained by the American Psychiatric Association. The ethical code primarily deals with professionalism, patient welfare, and safeguarding the psychiatric profession.

Analysis:

 1.)      Many people don’t take codes of ethics very seriously, do you think most psychiatrists take this code very seriously?

 Answer:

I think most psychiatrists probably do take this seriously. Ethical abuses in this area seem rare and the difficulty of becoming a psychiatrist seems to make people take the profession much more seriously. I guess it also helps that ethical violations usually lead to psychiatrists losing their license which should further discourage unethical behavior.

2.)     What ways can psychiatrists support access to medical care for everyone?

Answer:

I think the most straightforward way would be to endorse some sort of universal health insurance legislation. In practice this is a little difficult though because historically physician groups are the largest opponents of this kind of legislation. Aside from that they could promote the spread of community healthcare centers, easing scope of practice laws, and promoting Medicaid expansion for those states that have not done it. They could also encourage people to not feel ashamed if they have mental health issues and to seek treatment.

3.)     Sometimes psychiatrists can obtain a position of great psychological influence over a patient because of the nature of their relationship. How can they avoid influencing them in an unethical manner?

Answer:

Normally I would say transparency would be helpful but that’s difficult when it comes to psychiatry. Psychiatry has to be confidential by its very nature. I think psychiatrists really just have to reiterate to their patients that they are not there to tell them what to do and that theirs is only a professional relationship.

4.)     Do you think psychiatrists do a good job protecting patient privacy from cyberattacks? What kind of threats might exist for the medical systems they use to store patient information?

Answer:

Unfortunately, no I don’t think so. There doesn’t seem to be any standardized way to process and transmit medical data so the quality of security likely varies quite a bit across clinics. Much of the time information is just faxed from one clinic to another which doesn’t seem like a very secure way to deal with it at all.

 

My conclusions:

Ultimately, I think psychiatrists, like all physicians, are largely ethical and this code of ethics is a good set of guidelines. There is an equal emphasis on patient safety, professionalism, and promoting public health. It is probably difficult to prevent unethical influence due to the confidential nature of therapy. I do think that medical information systems probably don’t do as good a job of protecting patient data as they probably could. Providing standardized ways of communicating between clinics would probably help.

Future environment:

Generative AI systems like Chat GPT have recently been released to the public. These AI, based on large language models handle language better than anything ever developed, and the conversations are indistinguishable from what a human would produce. In addition, multimodal models have been developed which incorporate different kinds of data in order to further augment an Ais capabilities. It seems possible that these breakthroughs will eventually lead to AI that could do everything a human can do.

Future scenario:

If Chat GPT continues to develop it should eventually be possible to develop an AI psychiatrist. It would be able to interact with the patient and recommend appropriate treatment based on what it learned. If that happens, there needs to be some way to ensure the AI is following the same kinds of ethics a human would. Encoding ethics in a form an AI can reason with is an ongoing effort with a lot of unanswered questions but it seems like we will need this figured out sooner rather than later. Failure to do so could result in the AI behaving in an unpredictable and damaging way.