Thursday, October 08, 2015

Death with Dignity

There has been a lot of attention lately on Death with Dignity laws, most recently because the biggest state in the Union passed a End of Life Option Act this week as well as the anniversary of Brittany Maynard's assisted death in Oregon. 

There was a great panel on this subject on the Diane Rehm this week.  The panel had strong opinions on both sides, but they were able to stay in control and debate the issues.  The debate didn’t devolve into yelling back and forth. Rare these days, but more common on this show - kudos to Diane.

The arguments against were pretty weak:
  • They were based on someone’s religious beliefs. It is evil.  It is a sin. It is “wrong.” If you feel this way, I strongly believe in your right to abide by it. But I also strongly believe in another person’s right to have his/her own beliefs. 
  • They were based on false choices. It would be better to invest in better palliative care. I agree that investment in palliative care is also very important.  But why does it have to be either/or?
  • They were based on what-ifs.  Yes, there could be someone suffering from depression who wants the procedure.  Or perhaps some external pressure on a poor person to save the family the burdensome medical costs of treatment by using this option instead. But the laws can be (and are) designed to prevent these situations.
I agree that this is a very delicate issue and needs very careful consideration.  I am still waiting for an argument against it that convinces the libertarian in me that death with dignity shouldn’t be an option.  The one that resonates with me the most is that it could psychologically devastate your relatives.  But so can many other things that are legal.  The patient should consider the impact on his/her family and friends, but it is certainly not a valid reason to make it illegal. 

In case anyone is wondering, no I am not considering this for myself. I still have a few books left to write. But if the time ever comes, I do hope it is an option.

Monday, October 05, 2015

Recommendations 4.0

Have you ever gotten a recommendation from Netflix or Amazon or Spotify for a book or movie or song that you didn’t think you would like, but took a chance and really liked it?  Did you think, “Wow, Netflix knows me better than I know myself!” Or at least their data science/collaborative filtering/content filtering algorithm does. 

This really shouldn’t be surprising.  Algorithms like Amazon’s product recommendation and Pandora’s music genome project can consider thousands of variables, millions of users’ behaviors, and millions of products to find just the right ones for you at that time and place.  If the algorithm is designed well and implemented with the right UX of course.  There are many disasters as well.  But we create disasters of our own too – I can think of a few movies I really wanted to see that turned out to be horrible. 

Now jump ten years into the future when the targeting gets an order of magnitude better.  It adds emotion monitoring (which has actually just been launched as an app by Affectiva), activity monitoring (through your fitness tracker), and whatever else gets invented in the near future. 

This would still not be perfect, but might be reliably better than we are ourselves. Enough that we trust it to be as good as we would be, and more convenient because we don’t have to bother with the search, sort, and choose process. 

Now add another step.  Skip the middle man and let those companies actually make the decision for us. If we read a book a week, Amazon can simple decide what we are most likely to enjoy and ship it. We log on to Netflix and the queue is full of TV shows and movies that it knows we will enjoy.

If that works so well, why not broaden our thinking?  The food vendor knows just what we feel like eating for dinner based on our past eating history, taste preferences, activities that day, current stress levels, and nutritional needs. So as we are getting home from work the drone is dropping off the ingredients we need (or for those who don’t like to cook, the takeout drone delivers dinner ready made).  On stressful days we get our favorite comfort food. On workout days we get a balanced protein/veggie/carb combo.  You get the idea.

Michael Sandel at Harvard gave me an even better application. The frequency of bad dates and the high divorce rate prove that we are not particularly good at finding romantic partners. Maybe Match or eHarmony’s algorithms will get good enough that we can absolve ourselves of that responsibility as well.  Instead of suggesting dates, they will jump right to arranging marriages. 

That has kind of a “full circle” vibe to it, doesn’t it?