Predicting Onset of Visual Hallucinations Using Pareidolias:
A Qualitative Exploration of the Ethics of a Digital App to Detect a Possible Biomarker
Julia Hill '24
Abstract: This study aimed to assess ethical considerations for using digital biomarkers in predicting the onset of neuropsychiatric disease. The study employed semi-structured interviews with 21 people (N = 16 people at-risk for hallucinations and N = 5 current patients who experience visual hallucinations). The interview questions were grounded in the Consolidated Framework for Implementation Research (CFIR). The Rapid and Rigorous Qualitative Data Analysis (RADar) method was used to generate results. Emerging themes included prior knowledge, care partner resources, perception of outcomes, accessibility, interest in the tool, essential safety, organizational capacity, and monetary considerations. Understanding how to address these concerns from a participant's experience may promote engagement and positive attitudes surrounding prodromal biomarker metrics adapted for digital health. Participants mentioned the potential of the digital biomarker to increase access to health care in areas with remote access to in-person health care and offset the trajectory of disease. Participants endorsed coordination with health care providers to provide next steps for modifying the trajectory of disease. Future research should promote team science among researchers, physicians, and individuals with lived experience of mental illness to improve telemedicine practices in accordance with population needs. With the increasing use of telemedicine and other remote health care practices, it is vital to consider the ethics of a stand-alone remote technology to diagnose pre-clinical neuropsychiatric disorders. Read the published paper here.
Family Caregiver Comfort with Telehealth Technologies: Differences by Race and Ethnicity in a Cross-Sectional Survey
Background:Telehealth has seen widespread use since the onset of the COVID-19 pandemic, and 82% patients required assistance in accessing their telehealth appointments. This assistance commonly comes from a family caregiver who may or may not be comfortable using the technologies associated with telehealth. The objective of our study was to analyze a demographically representative survey of U.S. family caregivers to understand the level of comfort using telehealth technologies among family caregivers. Read the published article here.
Exploring the Ethics of Translating Open Biomedical Data into AI-derived Knowledge: From Policy to Practice
Chase Yakaboski, PhD candidate at Thayer
Chase's research paper will be presented at the NeurIPS AI for Science workshop.
Read the paper: ArXiv here.
Remembering in Israel
Mira Darham, Graduate Student
Throughout all my courses in the Master of Arts and Liberal Studies Program I have undertaken underlying themes of memory, personal history and the Holocaust. Utilizing the lens of creativity, I make each project I pursue innovative and striking, producing an experience for both the viewer and me.
My goals within this Independent Study are to spend the term in Israel, doing research at Yad Vashem and interviewing survivors, members of the community and my own family. Not long ago my family discovered that we have relatives in France and Israel who survived the Holocaust. This will provide a foundation for my pursuits in personal history and allow the opportunity to actively witness and become reintegrated into my culture and heritage. I will be making frequent visits to Yad Vashem: The World Holocaust Remembrance Center. Predominantly research based, this activity will give historical context and gravity to my pursuits. From its vast collection of archives, testimonies, documents, and databases on the Holocaust, I will glean information on my family and other survivors and victims whose stories I have yet to find. These interviews would complete a trifecta of experience and information-gathering that would address my current studies in creative writing while incorporating themes of cultural studies. Read Mira's resulting essays here.
Responsible Planning in Assistive Digital Biomarkers: A Qualitative Analysis
Julia Hill '24
Seventy-five million individuals worldwide are impacted due to neuropsychiatric diseases, which include Parkinson's disease, dementia with Lewy bodies, Alzheimer's disease, and schizophrenia spectrum disorders.1 Their prevalence is expected to double by 2040 as the large baby boomer population ages, with patients dying 10 to 20 years earlier than the general population.2 The development and illness trajectory (prognosis) of neuropsychiatric diseases is modifiable if diagnosed early. I feel an urgent need to improve the quality of life and length of life for individuals who suffer from life-altering diseases. Thus, I collaborated with senior researchers: Vinamrita Singh, PhD, Andrew Bohm, PhD, MS, Gajanan Revankar, PhD, MBBS, and Karen L. Fortuna, PhD, LICSW, across multiple disciplines, including sociology, psychology, neuroscience, biology, and physics. I gained an understanding of multidisciplinary research. Then, I produced a novel tool for sustainable change in the disease trajectory. I also mentored two other Dartmouth undergraduates: Morgan Kerber-Folstrom and Margaret Klein, as we constructed the analysis of results. Together, we learned to appreciate the severity of the disease and the importance of scientific methodology in digital biomarker research. Read more about Julia's research here.
UVelona: A Novel Harm-Reduction Method to Disinfect Needles and Syringes
George Gerber '23, Anahita Tewari Kodali '23, Aksheta Saireddy Kanuganti '24, Joel Smith '24
Injection drug use is a major public health issue in the United States; about 1 million individuals in the US inject drugs every year. Individuals who use injection drugs face a severe lack of resources and extreme stigma. For them, a lack of resources can result in unsafe injection practices, including reuse of needles and syringes. Needle/syringe reuse puts individuals who use injection drugs at a high risk of contracting several blood-borne diseases, including HIV, Hepatitis B, and Hepatitis C. Additionally, because of the strain put on the end of the needle, needle reuse can result in distortion of the needle's fine tip, which can cause the tip to fall off and become embedded in the user's skin. This increases the chance of injury and infection. Read more about their research here.
One Year After the U.S. Capitol Attack: Are Racial and Partisan Identities Opportunistic?
Ella Laurent '25
Affective polarization and racial fluidity are constructs that have become rather prevalent in America's political culture. Based on an online survey experiment with a sample of voting-age adults in the U.S., we examined how the exposure to information about violent protestors with strong racial and partisan influences impacted survey respondents' own racial and partisan identities. Read more about Ella's research here.
The Ethics of Language and Language Use
Zachary Lang '23
My research project was focused on exploring the ethics of language and language use. It did so by following a method that numerous philosophers take when approaching issues in conceptual ethics and conceptual engineering: reverse engineering. Reverse engineering, in essence, consists of assessing various descriptive properties of concepts—for example, their semantic content, their cognitive content, the inferences they generate, and their social functions—and then providing normative and prescriptive assessments. Read more about Zach's research here.
Ethics in Making "Sustainable Food" in the Palm Oil Supply Chain of a Multilatina Company
Montserrat Perez Castro Perez (Graduate student)
Palm oil is the most widely produced vegetable oil in the world but has received much attention for its implication in the destruction of tropical forests and smallholder livelihoods. The food industry has responded to the negative claims through corporate sustainability [CS] strategies, such as certifications, and initiatives to trace the origin of the raw material, and monitor land-use changes. But implementing CS strategies has not been easy. These are voluntary projects; producers are not contractually obliged, nor are they required by government regulation to provide information. Even with access to data, the control of all the socio-environmental impacts of a value chain is immeasurable. Further, the creation of CS roles and new internal requirements within the organization, are also complicated organizational changes that don't go unchallenged. Due to the growing popularity of CS to approach the socioenvironmental impact of the industry in a voluntary way, is important to understand how ethics inform different actors' views and practices. The research draws from anthropology and social studies of science to ask, what ethical values, practices, and social relationships are involved in making sustainable food out of palm oil? Read more about Montse's research here.
Mindful User Experiences: The Ethical Future for Persuasive Technologies
Natalie Noelle Svoboda (Graduate student)
Technology is currently designed with very limited ethical standards, leading to the creation of experiences that distract and addict. This is the result of a carefully-crafted system that is set up for monetary value — the more attention the user dedicates to the experience, the better it is for the business. As a result, user experience (UX) designers quantify user engagement by measuring screen time, clicks, and shares, keeping users hooked to their screens, treating attention as a commodity. UX designers create features that ping the user to interact, pressures the user to respond immediately, and provide endless new content for entertainment. Technology, as a result, is currently manipulating the thoughts and actions of millions of people, resulting in the frazzled and mindless consumption of information. What would our digital world look like if it had an ethical standard to protect user attention? Read more about Natalie's research here.
Perceptions of the impact of COVID-19 on healthcare communication in a nationally representative cross-sectional survey of family caregivers
The grant supported a nationally-representative survey of family caregivers, and we were able to have a whole section on the COVID-19 pandemic.
An Introductory Bioethics Podcast for Students at the Geisel School of Medicine and The Dartmouth Institute for Health Policy & Clinical Practice
Ovya Hema Ganesan (Geisel)
There is currently no introductory bioethics podcast available that is targeted to medical and health students. Micro-learning, through the form of a podcast, is becoming more widely used. In particular, podcasts allow students to listen to multiple points of view, follow along with the progression of a thought framework, and avoid reading more content on top of their schoolwork.
We hope to develop a health care ethics podcast meant to increase students' awareness about cases they may face within careers in the healthcare field. Allowing students to develop a framework that can be practiced and applied to real cases is crucial for enabling them to be prepared to face such challenges after graduation.
With each podcast episode, we hope to discuss case-based, practical, ethical issues through an analytical thought process. Through rigorous research and the involvement of expert ethicists, the podcast will cover both novel and classical ethics issues pertinent to health and wellbeing, encouraging listeners to understand that ethical deliberations underlie many of our daily decision-making. Listeners will then be equipped with the framework to address ethical issues in the healthcare field in an equitable fashion. Overall, this podcast seeks to fulfill the aim of the Ethics Institute as an innovative, accessible media: to foster the study and teaching of ethics.
Digital Mental Health Peer Support Intervention for Family Caregivers of People with Dementia
Caroline Collins-Pisano '22 (Thesis)
Family caregivers of people with dementia are critical to the quality of life of care recipients and the sustainability of healthcare systems but face increased risk of emotional distress and negative physical and mental health outcomes. The purpose of this study was to examine the usability, acceptability, and preliminary effectiveness of a technology-based and caregiver-delivered peer support program, "Caregiver Remote Education and Support" (CARES) smartphone/tablet application and to identify barriers and facilitators to the ethical use of former caregivers as technology-based interventionists. Nine family caregivers of people with dementia aged 18 and older received the CARES intervention and three former family caregivers of people with dementia were trained to deliver the CARES system. Quantitative data were collected at baseline and at the end of the two-week field usability study. Qualitative data were also collected at the end of the two-week field usability study. The pilot study demonstrated that a two-week, peerdelivered and technology supported mental health intervention designed to improve burden, stress, and strain levels was experienced by former and current family caregivers of people with dementia as usable, acceptable, and ethical. CARES was associated with non-statistically significant improvements in burden, stress, and strain levels. This pre/post field usability study demonstrated it is possible to train former family caregivers of people with dementia to use technology to deliver a mental health intervention to current family caregivers of people with dementia. Future studies would benefit from a longer trial, a larger sample size, a randomized controlled design, and a control of covariables such as stages of dementia, years providing care, and the severity of dementia symptoms. Read Caroline's thesis here.
Ethical Implications of Media Influence on Altering US Public Opinion
Undergrad student research on how media coverage of the recent demonstrations and violence perpetrated by both the protesters and the pro-China police in Hong Kong affects U.S. public opinion about China and foreign policy preferences towards both China and Hong Kong. Experiment, to be fielded in the U.S., respondents are randomly exposed to either neutral, pro-China, or pro-Hong Kong news about the ongoing demonstrations, and then asked questions about their attitudes and preferences for subsequent U.S. foreign policies.
The State of Social and Political Expression on College Campuses
"What explains variation in student willingness and truthfulness when discussing social and political topics on campus?" Research to determine if a large percentage of undergraduate students across the political spectrum are muting at least some of their beliefs on social or political issues and the reasons behind self-censorship. Some potential reasons include preventing others from being offended, nipping emotionally-exhausting conversations on sensitive issues, being uncomfortable sharing partially-developed thoughts on polarizing topics, or being unwilling to speak on issues in which one lacks personal experience.
Leading Lives and the Normative Significance of Narratives
Xingzhi (Justin) Guo '22
There exists an intuitive connection between living and narrating—when we try to convey to others an understanding of ourselves, we do so by telling the story of our life. An important question ensuing this intuition, then, is whether this connection bears any normative significance upon us—whether narrative concerns matter to our decision-making and actions at all; to what extent can the question of what we should do be reduced to what promotes the narrative coherence of our life story. Some philosophers, like Galen Strawson and Bernard Williams, contended that narratives are without normative importance to us. For the majority of decisions in life, for instance, it is not the case that we consult our life stories up until then and infer what we should do in light of what ought to be done to promote a coherent life story. Rather, actions are often immediate responses to particular circumstances. The relevant considerations concern more immediate projects and ends, and the input/role of large-scale narrative considerations is obscure if not nonexistent. On the other hand, there are philosophers, including Alasdair MacIntyre and Charles Taylor, who argued that we act precisely by pursuing and enacting coherence in the story we are leading. Narrative interests would therefore be decisive in guiding our actions. Indeed, when it comes to important decisions in life, such as career, marriage, and parenthood, the question in the end is always how the decision would impact and/or shed light on the story that our life would amount to (whether, for example, as the result of our choices, our life would become a story of redemption and improvement).
How can we adjudicate between these two positions? Both intuitions seem real and important, and a satisfying account would need to incorporate both. In my project, I want to evaluate two proposals (one coming from each position) that have great promises in addressing this concern. Holding on to Strawson and Williams's position, the first proposal argues that the fact that we tend to refer back to our life stories at certain moments of decision needs not imply that life narrative is somehow indispensable to making decisions and taking actions. Rather, this may be explained in terms of social conventions: we are prescribed the norm of taking narrative considerations into view when it comes to certain moments of decisions, but it is still an open question whether it is inconceivable for us to decide and act in those moments without taking an interest in our life narratives. Another proposal, defending MacIntyre and Taylor's position, argues that the fact that we do not appeal to narrative concerns in each and every action is not sufficient to show that life narratives are irrelevant to ordinary decision making. Indeed, narrative considerations may play a reactive role insofar as it sets the boundaries for actions. It may delineate possible actions that would be considered out of bound in light of their disruption of our narrative coherence. Akin to laws or commandments, the demands of narrative coherence may not legislate positive content for what we ought to do from moment to moment. Nevertheless, it supervises and shapes all actions as it determines what ought not to be done. That narrative considerations do not surface in day-to-day actions would only mean that ordinarily our intentional activities do not threaten our narrative coherence.
I seek to take an interdisciplinary approach to evaluating the two proposals. Because this is mainly a question in contemporary philosophy of action and ethics, I will further delve into important discussions raised by David Velleman (in his book Self to Self as well as in his articles Narrative Explanations, The Self as Narrator, among others). I will also consider relevant chapters in Alasdair MacIntyre's After Virtue and Charles Taylor's Sources of the Self. Beyond (just) philosophy, I want to explore the intersection between philosophy and literary theory, where much theoretical work on narratives in literature has been done. This would encompass Paul Ricoeur's Time and Narrative, Walter Benjamin's Illuminations, and Aristotle's Poetics. Lastly, incorporating the empirical perspective, I seek to include readings in contemporary developmental psychology (works on autobiographical selfhood by Qi Wang) and conduct case studies on the nature of life stories (drawing from the life story database of NPR'S Story Corps). I intend to conduct all of the above through self-initiated reading clubs so that reading and thinking about narratives will not be an impersonal research project but a personal, reflective, and interactive experience.