Josh Briscoe
@jbriscoe.bsky.social
Hospice and Palliative Care Physician
#MedPsych #MedSky #HAPC #Bioethics
Writing @ Notes from a Family Meeting: https://familymeetingnotes.substack.com
#MedPsych #MedSky #HAPC #Bioethics
Writing @ Notes from a Family Meeting: https://familymeetingnotes.substack.com
Pinned
Josh Briscoe
@jbriscoe.bsky.social
· Sep 20
What's a Good Death...
...apart from a good life?
familymeetingnotes.substack.com
A response to a thought-provoking conversation on @geripal.bsky.social familymeetingnotes.substack.com/p/whats-a-go... #medsky #hapc
Reposted by Josh Briscoe
The US administration has reduced resources for the National Library of Medicine and paralyzed government. Unfortunately I am unable to provide you our most recent publications. An alternative to Pubmed is needed for global medical knowledge.
November 8, 2025 at 11:16 AM
The US administration has reduced resources for the National Library of Medicine and paralyzed government. Unfortunately I am unable to provide you our most recent publications. An alternative to Pubmed is needed for global medical knowledge.
Reposted by Josh Briscoe
Sikorav Against the World
A French psychiatrist’s efforts to do right by his patients brought him into conflict with the medical bureaucracy
www.psychiatrymargins.com/p/sikorav-ag...
A French psychiatrist’s efforts to do right by his patients brought him into conflict with the medical bureaucracy
www.psychiatrymargins.com/p/sikorav-ag...
Sikorav Against the World
A French psychiatrist’s efforts to do right by his patients brought him into conflict with the medical bureaucracy
www.psychiatrymargins.com
November 7, 2025 at 2:17 PM
Sikorav Against the World
A French psychiatrist’s efforts to do right by his patients brought him into conflict with the medical bureaucracy
www.psychiatrymargins.com/p/sikorav-ag...
A French psychiatrist’s efforts to do right by his patients brought him into conflict with the medical bureaucracy
www.psychiatrymargins.com/p/sikorav-ag...
Reposted by Josh Briscoe
Looking for an easy way to make a difference this fall? Leave your leaves! 🍂
Leaving your leaves is one way to change some of the forces at work behind climate change and loss of biodiversity. Learn more at keepdurhambeautiful.org/leaveyourleaves
Leaving your leaves is one way to change some of the forces at work behind climate change and loss of biodiversity. Learn more at keepdurhambeautiful.org/leaveyourleaves
November 8, 2025 at 3:55 PM
Looking for an easy way to make a difference this fall? Leave your leaves! 🍂
Leaving your leaves is one way to change some of the forces at work behind climate change and loss of biodiversity. Learn more at keepdurhambeautiful.org/leaveyourleaves
Leaving your leaves is one way to change some of the forces at work behind climate change and loss of biodiversity. Learn more at keepdurhambeautiful.org/leaveyourleaves
A challenge to the conventional approach to VSED from Benjamin Frush, Farr Curlin, and Daniel Sulmasy: agsjournals.onlinelibrary.wiley.com/doi/10.1111/... #hapc #medsky
The Role of the Physician in Caring for Patients Pursuing VSED: Challenging the Conventional Approach
The conventional approach to caring for patients pursuing voluntarily stopping of eating and drinking (VSED) allows physicians to disagree with the patient's decisions to pursue VSED, but it assumes ...
agsjournals.onlinelibrary.wiley.com
November 6, 2025 at 10:06 AM
A challenge to the conventional approach to VSED from Benjamin Frush, Farr Curlin, and Daniel Sulmasy: agsjournals.onlinelibrary.wiley.com/doi/10.1111/... #hapc #medsky
Reposted by Josh Briscoe
The limits of our personal experience and the value of statistics 🧵
How many people do you know by name?
One study found that the average American knows 611.
In a world of 8 billion, that’s less than 0.00001%. A 100,000th of a percent.
We can’t see much of the world through our direct experience
How many people do you know by name?
One study found that the average American knows 611.
In a world of 8 billion, that’s less than 0.00001%. A 100,000th of a percent.
We can’t see much of the world through our direct experience
November 5, 2025 at 10:26 AM
The limits of our personal experience and the value of statistics 🧵
How many people do you know by name?
One study found that the average American knows 611.
In a world of 8 billion, that’s less than 0.00001%. A 100,000th of a percent.
We can’t see much of the world through our direct experience
How many people do you know by name?
One study found that the average American knows 611.
In a world of 8 billion, that’s less than 0.00001%. A 100,000th of a percent.
We can’t see much of the world through our direct experience
Reposted by Josh Briscoe
I do sometimes have writers block, more commonly known as the time you need to sit or pace or stare out the window and let your thoughts form rather than ask the machine to tell you what you think
People who aren’t writers think writer’s block is at least as big and real a problem as I thought quicksand would be, as a child.
AI can help authors beat writer’s block, says Bloomsbury chief
Publisher last week reported jump in revenue in academic and professional arm thanks to AI licensing deal
www.theguardian.com
October 28, 2025 at 9:57 AM
I do sometimes have writers block, more commonly known as the time you need to sit or pace or stare out the window and let your thoughts form rather than ask the machine to tell you what you think
It's remarkable some people don't believe deception is harmful, even if the deception isn't discovered. Furthermore, deception harms the deceiver by making the kind of person who deceives.
Are Slow Codes ever ethical? We dive into the gray area of CPR, shallow compressions, walk don't run, compassion with deceit, outcomes vs values, bioethics vs real world, trust, + more. #medsky
👉 Post: bit.ly/GeriPalEp378
😀 hosts @alexsmithmd.bsky.social | @ewidera.bsky.social
👉 Post: bit.ly/GeriPalEp378
😀 hosts @alexsmithmd.bsky.social | @ewidera.bsky.social
October 24, 2025 at 9:29 AM
It's remarkable some people don't believe deception is harmful, even if the deception isn't discovered. Furthermore, deception harms the deceiver by making the kind of person who deceives.
familymeetingnotes.substack.com/p/a-machine-... Some thoughts on using #AI for surrogate decision-making.
October 22, 2025 at 9:30 AM
familymeetingnotes.substack.com/p/a-machine-... Some thoughts on using #AI for surrogate decision-making.
Reposted by Josh Briscoe
I've never said yes to an interview so quickly as when @ashleybelanger.bsky.social reached out to discuss a topic that – it will surprise no one to learn – I feel pretty strongly about.
October 20, 2025 at 3:52 PM
I've never said yes to an interview so quickly as when @ashleybelanger.bsky.social reached out to discuss a topic that – it will surprise no one to learn – I feel pretty strongly about.
From @arstechnica.com: arstechnica.com/features/202... My answer, as a palliative care physician: never.
Should an AI copy of you help decide if you live or die?
Doctors share top concerns of AI surrogates aiding life-or-death decisions.
arstechnica.com
October 20, 2025 at 11:15 PM
From @arstechnica.com: arstechnica.com/features/202... My answer, as a palliative care physician: never.
Reposted by Josh Briscoe
this was such an informative read. @emilymoin.com is really good at breaking down the problems here
October 20, 2025 at 4:02 PM
this was such an informative read. @emilymoin.com is really good at breaking down the problems here
Reposted by Josh Briscoe
Looking Again at SSRIs in Adolescent Depression and Anxiety
“Society gets the type of adolescent that it expects and deserves.”
A response of sorts to @ploederl.bsky.social‘s recent blogpost
www.psychiatrymargins.com/p/looking-ag...
“Society gets the type of adolescent that it expects and deserves.”
A response of sorts to @ploederl.bsky.social‘s recent blogpost
www.psychiatrymargins.com/p/looking-ag...
Looking Again at SSRIs in Adolescent Depression and Anxiety
“Society gets the type of adolescent that it expects and deserves.”
www.psychiatrymargins.com
October 18, 2025 at 1:23 PM
Looking Again at SSRIs in Adolescent Depression and Anxiety
“Society gets the type of adolescent that it expects and deserves.”
A response of sorts to @ploederl.bsky.social‘s recent blogpost
www.psychiatrymargins.com/p/looking-ag...
“Society gets the type of adolescent that it expects and deserves.”
A response of sorts to @ploederl.bsky.social‘s recent blogpost
www.psychiatrymargins.com/p/looking-ag...
Reposted by Josh Briscoe
So maybe 15 years from now none of this will matter (though I'm skeptical) -- but in the meantime, I think I stand by what I told Dhruv in that story, if we (meaning educators) don't figure out how to train the next gen in this environment, we're all screwed.
October 17, 2025 at 1:19 PM
So maybe 15 years from now none of this will matter (though I'm skeptical) -- but in the meantime, I think I stand by what I told Dhruv in that story, if we (meaning educators) don't figure out how to train the next gen in this environment, we're all screwed.
Reposted by Josh Briscoe
My biggest concern about this technology in the short (and, well, medium)-term is what is does to US, especially the current generation of doctors in training. Even the difference between my third year and first-year residents is pretty stark in their use of AI tools (especially Open Evidence)
October 17, 2025 at 1:14 PM
My biggest concern about this technology in the short (and, well, medium)-term is what is does to US, especially the current generation of doctors in training. Even the difference between my third year and first-year residents is pretty stark in their use of AI tools (especially Open Evidence)
...medicine only has a modest influence over whether someone has a good death... familymeetingnotes.substack.com/p/whats-a-go... #medsky #hapc
What's a Good Death...
...apart from a good life?
familymeetingnotes.substack.com
October 17, 2025 at 9:41 AM
...medicine only has a modest influence over whether someone has a good death... familymeetingnotes.substack.com/p/whats-a-go... #medsky #hapc
Reposted by Josh Briscoe
Editorial by Robert D. Truog, MD, MA, and R. Sean Morrison, MD: Machine Learning Cannot Replace Surrogate Decision-Makers in Resuscitation Decisions for Incapacitated Patients nejm.ai/3Vysymr
#AI #MedSky #MLSky
#AI #MedSky #MLSky
October 14, 2025 at 4:31 PM
Editorial by Robert D. Truog, MD, MA, and R. Sean Morrison, MD: Machine Learning Cannot Replace Surrogate Decision-Makers in Resuscitation Decisions for Incapacitated Patients nejm.ai/3Vysymr
#AI #MedSky #MLSky
#AI #MedSky #MLSky
It's remarkable to see the same mistakes we've made with the EMR be re-made with #AI, as suggested in this article from @jamainternalmed.com jamanetwork.com/journals/jam... #MedSky
How Physicians Can Prepare for Generative AI
This Viewpoint discusses basic skills for using generative artificial intelligence (AI) and how to take an active role implementing AI into patient care.
jamanetwork.com
October 14, 2025 at 9:25 AM
It's remarkable to see the same mistakes we've made with the EMR be re-made with #AI, as suggested in this article from @jamainternalmed.com jamanetwork.com/journals/jam... #MedSky
mbird.com/suffering/re... from Aaron McKethan at Mockingbird
Recovery Through the Storm: A River’s Hard Lesson - Mockingbird
One Year After Hurricane Helene
mbird.com
October 11, 2025 at 12:09 AM
mbird.com/suffering/re... from Aaron McKethan at Mockingbird
I reflect on Frankenstein more than the Kreb cycle. I wonder what that says about #meded. Or me. podcasts.apple.com/us/podcast/p...
Episode #238 ... Frankenstein - Mary Shelley
Podcast Episode · Philosophize This! · 10/08/2025 · 30m
podcasts.apple.com
October 10, 2025 at 11:21 AM
I reflect on Frankenstein more than the Kreb cycle. I wonder what that says about #meded. Or me. podcasts.apple.com/us/podcast/p...
Reposted by Josh Briscoe
I have expertise in both the technical and ethical aspects of clinical AI, so one of my most frequent refrains is that we need to separately address questions of "can we?" and "should we?"
Anyway, absolutely not.
Anyway, absolutely not.
October 8, 2025 at 2:39 PM
I have expertise in both the technical and ethical aspects of clinical AI, so one of my most frequent refrains is that we need to separately address questions of "can we?" and "should we?"
Anyway, absolutely not.
Anyway, absolutely not.
Reposted by Josh Briscoe
Although ML has been shown to outperform surrogate decision-makers in predicting patient preferences for CPR, the authors of a new editorial argue that ML cannot replace surrogates in making decisions for incapacitated patients. nejm.ai/3Vysymr
#AI #MedSky #MLSky
#AI #MedSky #MLSky
October 7, 2025 at 4:30 PM
Although ML has been shown to outperform surrogate decision-makers in predicting patient preferences for CPR, the authors of a new editorial argue that ML cannot replace surrogates in making decisions for incapacitated patients. nejm.ai/3Vysymr
#AI #MedSky #MLSky
#AI #MedSky #MLSky
The sad thing about this is clinicians are so beleaguered by the burdens of the EMR, they'll take any port in a storm without fully appreciating the hidden costs. It looks very official to study things like data privacy but overlook the surveillance risks. #ai #medsky
The ambient AI scribe revolution - how it's going: jamanetwork.com/journals/jam... #medsky #ai and...
Ambient AI Scribe Early Gains and Open Questions
Ambient artificial intelligence (AI) scribes are the fastest adopted and most widely implemented generative AI health care solution to date. Currently, these tools listen to an ambulatory encounter an...
jamanetwork.com
October 4, 2025 at 10:46 AM
The ambient AI scribe revolution - how it's going: jamanetwork.com/journals/jam... #medsky #ai and...
Ambient AI Scribe Early Gains and Open Questions
Ambient artificial intelligence (AI) scribes are the fastest adopted and most widely implemented generative AI health care solution to date. Currently, these tools listen to an ambulatory encounter an...
jamanetwork.com
October 3, 2025 at 9:19 AM
The ambient AI scribe revolution - how it's going: jamanetwork.com/journals/jam... #medsky #ai and...
Reposted by Josh Briscoe
be kind and give your patients a REGULAR DIET
caffeine-free diets ➡️ caffeine withdrawal
sodium-restricted diets aren't evidence-based (use diuretics to balance volume)
treat hyperglycemia with insulin (not by artificially restricting carbs)
(renal diet for hyperkalemic renal failure = exception)
caffeine-free diets ➡️ caffeine withdrawal
sodium-restricted diets aren't evidence-based (use diuretics to balance volume)
treat hyperglycemia with insulin (not by artificially restricting carbs)
(renal diet for hyperkalemic renal failure = exception)
a man in scrubs is eating a piece of food while sitting in a hospital bed .
ALT: a man in scrubs is eating a piece of food while sitting in a hospital bed .
media.tenor.com
October 2, 2025 at 8:02 PM
be kind and give your patients a REGULAR DIET
caffeine-free diets ➡️ caffeine withdrawal
sodium-restricted diets aren't evidence-based (use diuretics to balance volume)
treat hyperglycemia with insulin (not by artificially restricting carbs)
(renal diet for hyperkalemic renal failure = exception)
caffeine-free diets ➡️ caffeine withdrawal
sodium-restricted diets aren't evidence-based (use diuretics to balance volume)
treat hyperglycemia with insulin (not by artificially restricting carbs)
(renal diet for hyperkalemic renal failure = exception)
Reposted by Josh Briscoe
Since it resonated with the audience, I’ll recap my main argument against AGI here. ‘General intelligence’ is like phlogiston, or the aether. It’s an outmoded scientific concept that does not refer to anything real. Any explanatory work it did can be done better by a richer scientific frame. 1/3
This was a truly heartening day, with deeply thoughtful challenges to the dominant narrative framed around AGI, coming from across disciplines and perspectives. Felt like the tide might finally be turning a bit, at least among the scientific community. Thanks @royalsociety.org!
1/2 I'm looking forward to taking part in a panel on AGI and the Turing Test, tomorrow afternoon (Thurs 2nd Oct) at the @royalsociety.org, w/ Dame Wendy Hall, Shannon Vallor, William Isaac, & Sir Nigel Shadbolt. royalsociety.org/science-even...
October 2, 2025 at 10:09 PM
Since it resonated with the audience, I’ll recap my main argument against AGI here. ‘General intelligence’ is like phlogiston, or the aether. It’s an outmoded scientific concept that does not refer to anything real. Any explanatory work it did can be done better by a richer scientific frame. 1/3