Steven Brudenellsbrudenell@mastodon.social
Oct 29, 2026, 3:20 PM@dramypsyd do you have guidance on how to explain to a non-technical therapist that this is even is unethical? I've had no luck getting through to my therapist.
Replies
Dr. Amy, Psy.D. 🎃dramypsyd@ohai.socialOct 29, 2026, 3:24 PM@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.
- Dr. Amy, Psy.D. 🎃dramypsyd@ohai.socialOct 29, 2026, 3:25 PM
@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)
- Dr. Amy, Psy.D. 🎃dramypsyd@ohai.socialOct 29, 2026, 3:27 PM
@sbrudenell Right now, APA has a statement out but that guidance explicitly says it's permissible for psychologists to work to develop AI for psychology tasks as long as we follow the rest of the ethics code while we do it. Which IMO leaves way too much gray area.
- Dr. Amy, Psy.D. 🎃dramypsyd@ohai.socialOct 29, 2026, 3:28 PM
@sbrudenell (Sorry for blowing up your mentions, I have a lot of feelings)
- Steven Brudenellsbrudenell@mastodon.socialOct 29, 2026, 3:39 PM
@dramypsyd 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?
Irenes (many)ireneista@irenes.spaceOct 29, 2026, 5:00 PM@dramypsyd @sbrudenell one deep truth we have learned is that ethics is a process. it is not a fixed set of rules. the rules are just the peace treaty that marks where the last round of fighting left off.
alas, yes, not everyone sees it that way ><
Oct 30, 2026, 6:17 AM@dramypsyd @sbrudenell someone's ethics shouldn't depend on a code and people outsourcing ethics to formalized codes decided by other people is exactly as bullshit as people trying to make the law the sole arbiter of ethics.
- Dr. Amy, Psy.D. 🎃dramypsyd@ohai.socialOct 30, 2026, 11:41 AM
@elexia @sbrudenell This is true, and also with my license I am required to follow a specific ethical code laid down by APA. Personally I think that’s a bare minimum and we should hold ourselves to a higher standard
⁂ L. Rhodeslrhodes@merveilles.townOct 29, 2026, 9:21 PM@sbrudenell @dramypsyd 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: https://doi.org/10.48550/arXiv.2602.16800
- Dr. Amy, Psy.D. 🎃dramypsyd@ohai.socialOct 29, 2026, 9:21 PM
@lrhodes @sbrudenell Thank you! I had assumed this was the case but backing it up with citations is always better
- ⁂ L. Rhodeslrhodes@merveilles.townOct 29, 2026, 9:26 PM
@dramypsyd @sbrudenell The most prominent companies investing in AI are Big Data and adtech companies like Google and Meta, which have long been interested in extrapolating identities from incomplete data. Think: Target serving ads for maternity goods to people who have not yet announced their pregnancies. Given how much of their research into machine learning was motivated by that desire, it's unsurprising that AI can be put to that use. Health providers should err on the side of caution here.
Martin Taibrmartin_t@mastodon.socialOct 29, 2026, 9:54 PM@lrhodes @dramypsyd @sbrudenell
Or lucrative government contracts for identifying "undesirables". I am pretty certain sexual orientation can be determined from surveillance cameras e.g. by how you look at people.Lip reading is gonna be a big one too. "Our cameras don't have microphones so we're totally not *listening* on your private conversations."
And the US is showing the world how in hierarchical governance systems, anyone can become undesirable overnight by one election.
mathewmathew@universeodon.comOct 29, 2026, 10:41 PM@lrhodes @dramypsyd @sbrudenell Out of curiosity, I went to see if I could find out who BetterHelp were getting their session transcripts processed by, and learned that they were prosecuted for handing customer health questionnaire responses to Facebook.
Anyway, their privacy policy doesn't say, but BetterHelp is owned by Teladoc, and Teladoc use Nuance Dragon for their transcripts, feeding into OpenAI via Microsoft.
https://www.teladochealth.com/newsroom/press/teladoc-health-expands-collaboration-in-ai-with-microsoft-to-address-healthcare-workforce-crisis(I don't use BetterHelp, but their ads are everywhere so I figured it might be important who they hand data to. My therapist doesn't use any kind of AI and is horrified that others do.) #BetterHelp
- Dr. Amy, Psy.D. 🎃dramypsyd@ohai.socialOct 29, 2026, 11:49 PM
@mathew @lrhodes @sbrudenell YUP they got in big trouble for selling client data to advertisers