Ethics, Transparency, and Public Health at the Intersection of Innovation and Facebook's Suicide Prevention Efforts

Ideas and Opinions16 April 2019Ethics, Transparency, and Public Health at the Intersection of Innovation and Facebook's Suicide Prevention EffortsIan Barnett, PhD and John Torous, MDIan Barnett, PhDUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (I.B.) and John Torous, MDBeth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (J.T.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-0366 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail As clinical evidence for digital health struggles to keep pace with rapid advances in machine learning, the health care field finds itself in a dilemma between evidence-based care and innovative research. Suicide prevention offers an illustrative example of this dilemma with rising suicide rates (1), especially in younger adults (2), underscoring the urgent need for new approaches (3).One less traditional effort that recently caught national attention is Facebook's evolving suicide prevention efforts, where the company now calls emergency services when it believes a user may be at high risk (4). The company has offered some details on its algorithm ...References1. Centers for Disease Control and Prevention. Suicide rates rising across the U.S. press release. 8 June 2018. Accessed at https://www.cdc.gov/media/releases/2018/p0607-suicide-prevention.html on 14 January 2019. Google Scholar2. Olfson M, Blanco C, Wall M, Liu SM, Saha TD, Pickering RP, et al. National trends in suicide attempts among adults in the United States. JAMA Psychiatry. 2017;74:1095-103. PMID: 28903161 doi:10.1001/jamapsychiatry.2017.2582 CrossrefMedlineGoogle Scholar3. Hogan MF, Grumet JG. Suicide prevention: an emerging priority for health care. Health Aff (Millwood). 2016;35:1084-90. PMID: 27269026 doi:10.1377/hlthaff.2015.1672 CrossrefMedlineGoogle Scholar4. Singer N. In screening for suicide risk, Facebook takes on tricky public health role. New York Times. 31 December 2018:A1. Google Scholar5. Muriello D, Donahue L, Ben-David D, Ozertem U, Reshef, S. Under the hood: suicide prevention tools powered by AI. Facebook code blog. 21 February 2018. Accessed at https://code.fb.com/ml-applications/under-the-hood-suicide-prevention-tools-powered-by-ai/ on 14 January 2019. Google Scholar6. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research. Washington, DC: Superintendent of Documents, U.S. Government Printing Office; 1978. Google Scholar7. Kramer AD, Guillory JE, Hancock JT. Experimental evidence of massive-scale emotional contagion through social networks. Proc Natl Acad Sci U S A. 2014;111:8788-90. PMID: 24889601 doi:10.1073/pnas.1320040111 CrossrefMedlineGoogle Scholar8. Neff G, Nagy P. Automation, algorithms, and politics | talking to bots: symbiotic agency and the case of Tay. International Journal of Communication. 2016;10:17. Google Scholar9. Luxton DD, June JD, Fairall JM. Social media and suicide: a public health perspective. Am J Public Health. 2012;102 Suppl 2:S195-200. PMID: 22401525 doi:10.2105/AJPH.2011.300608 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (I.B.)Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (J.T.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0366.Corresponding Author: John Torous, MD, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, 75 Fenwood Road, Boston, MA 02115; e-mail, email protectedharvard.edu.Current Author Addresses: Dr. Barnett: University of Pennsylvania Perelman School of Medicine, 423 Guardian Drive, Philadelphia, PA 19104.Dr. Torous: Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, 75 Fenwood Road, Boston, MA 02115.Author Contributions: Conception and design: I. Barnett, J. Torous.Drafting of the article: I. Barnett, J. Torous.Critical revision for important intellectual content: I. Barnett, J. Torous.Final approval of the article: I. Barnett, J. Torous.Statistical expertise: I. Barnett.Administrative, technical, or logistic support: J. Torous.This article was published at Annals.org on 12 February 2019. 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