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-   -   Continuation Donald Trump has 'dangerous mental illness' say psychiatry experts at Yale... Pt 3 (http://www.internationalskeptics.com/forums/showthread.php?t=341507)

Skeptic Ginger 25th March 2020 04:49 AM

I posted this in the COVID thread but it belongs here too.

GZERO World With Ian Bremmer
Preparing for the Pandemic: The Window Is Closing
SEASON 2, EPISODE 38
Pulitzer Prize-winning writer Laurie Garrett talks about mitigating the effect of COVID-19.

This morning.

Garrett said in all their pandemic disease simulations, never did they consider one where the US ignored the outbreak for weeks then addressed it with a confusing and frequently changing plan.

IOW, how do you plan a pandemic simulation when the leader of the free world is mentally ill?

Skeptic Ginger 25th March 2020 05:17 AM

I wonder if Dr Frances will admit he was wrong yet?

NYT letter to the editor: An Eminent Psychiatrist Demurs on Trump’s Mental State
Quote:

Most amateur diagnosticians have mislabeled President Trump with the diagnosis of narcissistic personality disorder. I wrote the criteria that define this disorder, and Mr. Trump doesn’t meet them. He may be a world-class narcissist, but this doesn’t make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder.

Mr. Trump causes severe distress rather than experiencing it and has been richly rewarded, rather than punished, for his grandiosity, self-absorption and lack of empathy. It is a stigmatizing insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr. Trump (who is neither). ....
IMO Trump's imaginary world goes beyond grandiosity, self-absorption and lack of empathy, crossing the line into mental illness.

It was interesting skimming through part one of this thread.

Cabbage 25th March 2020 06:25 AM

Quote:

Originally Posted by Skeptic Ginger (Post 13032037)
I wonder if Dr Frances will admit he was wrong yet?

NYT letter to the editor: An Eminent Psychiatrist Demurs on Trumpís Mental State

Most amateur diagnosticians have mislabeled President Trump with the diagnosis of narcissistic personality disorder. I wrote the criteria that define this disorder, and Mr. Trump doesnít meet them. He may be a world-class narcissist, but this doesnít make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder.

Mr. Trump causes severe distress rather than experiencing it and has been richly rewarded, rather than punished, for his grandiosity, self-absorption and lack of empathy. It is a stigmatizing insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr. Trump (who is neither). ....


IMO Trump's imaginary world goes beyond grandiosity, self-absorption and lack of empathy, crossing the line into mental illness.

It was interesting skimming through part one of this thread.


Maybe I'm reading that wrong, but that just sounds asinine. To me, that means if I reward anyone with, say, $10,000 for whatever issues they have, they are no longer mentally ill, simply because they were rewarded for it. Absurd.

Belz... 25th March 2020 06:31 AM

Quote:

Originally Posted by Bob001 (Post 13030986)
Dr. Lee weighs in:

Quote:

Mental health professionals have been warning for years that Trump's mental health issues would lead to such a dire situation.
https://www.salon.com/2020/03/23/dr-...navirus-worse/

I just realised that this thread was started three years ago.

Where has my life gone?

Bob001 25th March 2020 07:39 AM

Quote:

Originally Posted by Skeptic Ginger (Post 13032037)
I wonder if Dr Frances will admit he was wrong yet?

NYT letter to the editor: An Eminent Psychiatrist Demurs on Trump’s Mental State
IMO Trump's imaginary world goes beyond grandiosity, self-absorption and lack of empathy, crossing the line into mental illness.
....


Also from that letter:
Quote:

Bad behavior is rarely a sign of mental illness, and the mentally ill behave badly only rarely. Psychiatric name-calling is a misguided way of countering Mr. Trump’s attack on democracy. He can, and should, be appropriately denounced for his ignorance, incompetence, impulsivity and pursuit of dictatorial powers.

His psychological motivations are too obvious to be interesting, and analyzing them will not halt his headlong power grab. The antidote to a dystopic Trumpean dark age is political, not psychological.

Doc Frances is not a Trump defender. I think his point is that Trump's behavior is a deliberate choice because it gets him what he wants, despite its impact on everyone else. I wonder if the definition of "mental illness" is too broad to be useful in these circumstances; saying someone does something because they are mentally ill in a sense diminishes their responsibility. Frances says his behavior is intentional.

In a CNN interview, Frances said this:
Quote:

"Calling Trump crazy hides the fact that we’re crazy for having elected him and even crazier for allowing his crazy policies to persist.”

He added, “Trump is as destructive a person in this century as Hitler, Stalin, and Mao were in the last century. He may be responsible for many more million deaths than they were. He needs to be contained, but he needs to be contained by attacking his policies, not his person."
https://thehill.com/homenews/media/4...y-more-million

Skeptic Ginger 25th March 2020 10:35 AM

Quote:

Originally Posted by Cabbage (Post 13032137)
Maybe I'm reading that wrong, but that just sounds asinine. To me, that means if I reward anyone with, say, $10,000 for whatever issues they have, they are no longer mentally ill, simply because they were rewarded for it. Absurd.

It was asinine. IMO (of course) in some bizarre attempt to not malign the mentally ill, he thought we we saying all that evil in Trump made him a horrible person but not a mentally ill person. It was some kind of denial (again IMO) that just because a person fit all the criteria for pathologic narcissism didn't mean his narcissism was representative of mental illness.

I think we are well past that now. Crossing from simple grandiosity into full recreating of reality in Trump is evidence of mental illness.

I imagine if asked Dr Frances would double down in self preservation but I wold like to see if that is the case.

Skeptic Ginger 25th March 2020 10:40 AM

Quote:

Originally Posted by Bob001 (Post 13032210)
Also from that letter:


Doc Frances is not a Trump defender. I think his point is that Trump's behavior is a deliberate choice because it gets him what he wants, despite its impact on everyone else. I wonder if the definition of "mental illness" is too broad to be useful in these circumstances; saying someone does something because they are mentally ill in a sense diminishes their responsibility. Frances says his behavior is intentional.

In a CNN interview, Frances said this:

https://thehill.com/homenews/media/4...y-more-million

Again, what does this mean: "it gets him what he wants"? There are more than a few people whose manipulative behavior is a prominent feature of their mental illness. So if the person is successful at manipulation, that's evidence they aren't mentally ill? I've met a few people with a pathologic paranoid personality disorder that were very convincing. :rolleyes:

Maybe the DSMV should start off the personality disorders with 'must be failing to get through life' for said syndromes to apply.

Stacyhs 25th March 2020 10:49 AM

Quote:

Originally Posted by Cabbage (Post 13032137)
Maybe I'm reading that wrong, but that just sounds asinine. To me, that means if I reward anyone with, say, $10,000 for whatever issues they have, they are no longer mentally ill, simply because they were rewarded for it. Absurd.

Frances is not necessarily referring to only monetary rewards. Trump's behavior has been 'rewarded' by getting him the attention he craves, the adulation, the social status, the power, etc. It got him the presidency.

Skeptic Ginger 25th March 2020 10:59 AM

Quote:

Originally Posted by Stacyhs (Post 13032458)
Frances is not necessarily referring to only monetary rewards. Trump's behavior has been 'rewarded' by getting him the attention he craves, the adulation, the social status, the power, etc. It got him the presidency.

Doesn't change the fact mentally ill people can be successful, that doesn't make them not mentally ill.

Frances made it very clear, he thought if one explained Trump's evil behavior as the result of mental illness, we maligned the real mentally ill.

Stacyhs 25th March 2020 11:04 AM

Quote:

Originally Posted by Skeptic Ginger (Post 13032470)
Doesn't change the fact mentally ill people can be successful, that doesn't make them not mentally ill.

Frances made it very clear, he thought if one explained Trump's evil behavior as the result of mental illness, we maligned the real mentally ill.

I agree. I was just addressing Cabbage's post where he, I think, misunderstood what Frances was saying.

Cabbage 25th March 2020 11:22 AM

Quote:

Originally Posted by Stacyhs (Post 13032458)
Frances is not necessarily referring to only monetary rewards. Trump's behavior has been 'rewarded' by getting him the attention he craves, the adulation, the social status, the power, etc. It got him the presidency.


I wasn't implying he was referring to only monetary rewards. I was merely illustrating the absurdity of the claim.

jimbob 25th March 2020 11:23 AM

Quote:

Originally Posted by Skeptic Ginger (Post 13032037)
I wonder if Dr Frances will admit he was wrong yet?

NYT letter to the editor: An Eminent Psychiatrist Demurs on Trumpís Mental State
Quote:

Most amateur diagnosticians have mislabeled President Trump with the diagnosis of narcissistic personality disorder. I wrote the criteria that define this disorder, and Mr. Trump doesnít meet them. He may be a world-class narcissist, but this doesnít make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder.

Mr. Trump causes severe distress rather than experiencing it and has been richly rewarded, rather than punished, for his grandiosity, self-absorption and lack of empathy. It is a stigmatizing insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr. Trump (who is neither). ....
IMO Trump's imaginary world goes beyond grandiosity, self-absorption and lack of empathy, crossing the line into mental illness.

It was interesting skimming through part one of this thread.

His preferred definition does make sense on one level, but is also pretty useless.

Nero demonstrated pretty much all the characteristics of someone with NPD. For example winning every event in the Olympics.

Eventually his behaviour led to his assassination, so at that time, he fitted Dr Frances' criteria for mental illness.

However,one could argue that he hadn't been harmed by his behaviour right up to the time he was deposed.

In which case, we would be in no better a position than the citizens of Rome, in being unable to call Nero mad, until he was deposed.

Similarly, if someone's mental state drives them to take risks - it seems odd to say that they are only mentally ill if the hazard they're risking actually harms them. Hypothetically, someone's mental state could drive them to take part in Russian roulette, say from a sense of invulnerability, and they'd be likely to survive. By Dr Frances' reckoning, they wouldn't meet the definition of mentally ill, unless they lost.

jimbob 25th March 2020 11:28 AM

Quote:

Originally Posted by Cabbage (Post 13032137)
Maybe I'm reading that wrong, but that just sounds asinine. To me, that means if I reward anyone with, say, $10,000 for whatever issues they have, they are no longer mentally ill, simply because they were rewarded for it. Absurd.

From an earlier part of the thread:


Quote:

Originally Posted by jimbob (Post 11979610)
Yes, but the examples I gave, their behaviour was abnormal, and it eventually caused them problems (Nero included).

The thing was that there was a threshold, mostly of time before which their same behaviour and same underlying ... worldview hadn't caused problems, although the changes were outwith them.

If I believe a magic pixie tells me what cards to pick, and I gamble and win, and then I gamble and lose everything, I was still deluded at the start, even though I actually benefited from it.

I can see why mental illness is defined as causing harm or distress to the subject, but there are sufficient situations where I would say that such a definition is missing something, which a more colloquial definition of "mad" is not.

Did the Yorkshire Ripper suffer harm or distress until he was caught?


Skeptic Ginger 25th March 2020 11:29 AM

It's annoying to me the news media is reporting on Trump's rosy timeline as if it's a real thing and not a fantasy thing. They do follow with the experts contradicting Trump's fantasy.

I just wish they would call it what it is, a Trump fantasy.

xjx388 25th March 2020 07:47 PM

Quote:

Originally Posted by Belz... (Post 13032140)
I just realised that this thread was started three years ago.

Where has my life gone?


Quote:

Originally Posted by Skeptic Ginger (Post 12994242)
No it does not. That's idiotic. I don't care if the guy with the STD doesn't want to tell his sex partners. He can't do that.

I agree; he has an ethical obligation to inform all his partners. His doctor usually does not.

Quote:

No one moved any goal post. You don't have enough knowledge to recognize STDs and HIV are treated the same as far as partner notification goes.
No they arenít, at least not from the doctorís perspective. There are often mandatory partner notification laws in the case of HIV, but not other STDs. In Texas, we can disclose HIV status to the spouse, but we donít have to; the State can do it as part of the reporting process. We canít notify spouses for other STDs but we can refer to the State and they can help with partner tracing and notification.
Quote:

So you'd let an exposed person go un-notified if the legislators in all their practicing medicine without a license wisdom wrote a flawed law? :rolleyes:
Fortunately most medical providers recognize flawed laws and aren't afraid to stand up.

:rolleyes:

Here's your problem. You seem to think there are laws with all the little details on how a medical provider should do this or that. There are no such laws. They would be impossible to write.

So guess what? It's up to the provider. We went around on this at the beginning when you tried to tell me what my scope of practice was. In this state nurse practitioners are independent medical providers. It's up to me to know what my scope of practice is. The details are not spelled out in the law.


You didn't appear to recognize the ethical dilemma in prescribing placebos.

Your posts reflect one who is very poorly informed about the difference between ethics, medical judgement and law.[/quote]



Holy ****, man....

xjx388 26th March 2020 01:17 PM

I donít understand what happened with the above post. I only meant to respond to Belz with ďHoly ****, man...Ē

Skeptic Ginger 26th March 2020 04:12 PM

Quote:

Originally Posted by xjx388 (Post 13033042)
I agree; he has an ethical obligation to inform all his partners. His doctor usually does not.

No they arenít, at least not from the doctorís perspective. There are often mandatory partner notification laws in the case of HIV, but not other STDs. In Texas, we can disclose HIV status to the spouse, but we donít have to; the State can do it as part of the reporting process. We canít notify spouses for other STDs but we can refer to the State and they can help with partner tracing and notification.

Fortunately most medical providers recognize flawed laws and aren't afraid to stand up.

:rolleyes:

You don't see the problem claiming that last sentence while denying said providers can recognize when 'duty to warn' supercedes the ethical positions you seem to think are inviolable?

Quote:

Originally Posted by xjx388 (Post 13033042)
Here's your problem. You seem to think there are laws with all the little details on how a medical provider should do this or that. There are no such laws. They would be impossible to write.

This is a straw man.

Quote:

Originally Posted by xjx388 (Post 13033042)
So guess what? It's up to the provider. We went around on this at the beginning when you tried to tell me what my scope of practice was. In this state nurse practitioners are independent medical providers. It's up to me to know what my scope of practice is. The details are not spelled out in the law.

Yeah, we went round and you apparently forgot the outcome of that.

Are you claiming providers aren't legally required to report certain infectious diseases? Think that's only about data collection, nothing to do with contact tracing? The report form includes the name and contact information for the patient.

Part of pre-test counseling for HIV testing is informing the person they are obligated to inform sexual partners but if they feel unable to do that, the health department will help them including informing partners without naming the infected person. So you are claiming the provider isn't obligated BY LAW to report that HIV to public health with the expectation public health will do contact tracing and informing?

The Ryan White Act requires a patient's HIV status (when known or discovered) be reported to any EMS provider reporting they've been exposed to the person.

HIPAA also has a "public health clause" that allows contagious disease information to be shared with exposed or potentially exposed persons.

Where do you get the idea physicians are exempt from these important public health laws?

Quote:

Originally Posted by xjx388 (Post 13033042)
You didn't appear to recognize the ethical dilemma in prescribing placebos.

Your posts reflect one who is very poorly informed about the difference between ethics, medical judgement and law.

:rolleyes:

Understanding ethical dilemmas involves a lot more thought than a position paper and some 'rules'. Its clear you are never going to admit there are always going to be exceptions to rules of ethics.

A duty to warn is one such exception a fair number of psychiatrists and psychologists have taken the position it overrides the rules you keep repeating. They disagree with you. I disagree with you.

Skeptic Ginger 26th March 2020 04:14 PM

Quote:

Originally Posted by xjx388 (Post 13033856)
I donít understand what happened with the above post. I only meant to respond to Belz with ďHoly ****, man...Ē

What, the post typed itself? :boggled:

Cabbage 26th March 2020 05:58 PM

Quote:

Originally Posted by xjx388 (Post 12994209)
Ethics requires following the law.


is now followed by:


Quote:

Originally Posted by xjx388 (Post 13033042)
Fortunately most medical providers recognize flawed laws and aren't afraid to stand up.


It looks to me like your position on ethics/legality may finally be starting to evolve beyond foolishly naive.

Congratulations on making this big step!

I do have a question. It may be somewhat challenging for you:

Does ethics require following a flawed law?

xjx388 26th March 2020 11:35 PM

Quote:

Originally Posted by Skeptic Ginger (Post 13034077)
What, the post typed itself? :boggled:


Not exactly, I figured it out. I actually started writing a response to a post of yours awhile back. Then I asked myself...ĒDo I really want to go round and round? No, no I donít; we simply arenít going to agree.Ē Iím using Tapatalk so I guess I saved the draft. When I responded to Belzís post, I must have restored that draft, didnít pay attention and hit ĎReply.Ē

xjx388 26th March 2020 11:46 PM

Quote:

Originally Posted by Cabbage (Post 13034157)
is now followed by:





It looks to me like your position on ethics/legality may finally be starting to evolve beyond foolishly naive.

Congratulations on making this big step!

I do have a question. It may be somewhat challenging for you:

Does ethics require following a flawed law?


Youíve been the victim of a cruel deception.

Ethics requires adherence to laws, full stop. This whole COVID thing is a great example. Texas State Board of Pharmacy made a rule that that says hydroxychloroquine/azithromycin can only be issued with a written diagnosis consistent with the evidence for their use. Obviously, ďhaving some on hand in case I get COVID,Ē isnít such a diagnosis. Should a doctor fudge a script to reflect a bogus diagnosis so that a patient (more likely their family/colleagues) has it on hand in case they get sick? Many doctors are doing this thinking the law is flawed and they should be allowed to. I say bull; a doctor follows the law, regardless of what they think. They work to change the law if they think itís flawed.

xjx388 27th March 2020 12:07 AM

The problem is: who decides a law or rule is flawed? That simply canít be up to an individual to decide.

The current rules keeping most of us home these days: I say the rule is flawed. Does my saying so make me ethically right?

Disagreement is not a license.

Cabbage 27th March 2020 06:24 AM

Quote:

Originally Posted by xjx388 (Post 13034422)
Youíve been the victim of a cruel deception.

Ethics requires adherence to laws, full stop. This whole COVID thing is a great example. Texas State Board of Pharmacy made a rule that that says hydroxychloroquine/azithromycin can only be issued with a written diagnosis consistent with the evidence for their use. Obviously, ďhaving some on hand in case I get COVID,Ē isnít such a diagnosis. Should a doctor fudge a script to reflect a bogus diagnosis so that a patient (more likely their family/colleagues) has it on hand in case they get sick? Many doctors are doing this thinking the law is flawed and they should be allowed to. I say bull; a doctor follows the law, regardless of what they think. They work to change the law if they think itís flawed.


How silly of me. I foolishly give you credit for your position on ethics evolving, and then you demonstrate that position is as naive as it ever was.

"Ethics requires following the law" can never be justified by giving a single example of just one law that it is ethical to follow. To support your claim, you actually need to demonstrate that ethics requires following Every. Single. Law. Otherwise, the claim is merely Ethics requires following some laws. Now having said that:


Youíve been the victim of a cruel deception.

Ethics is independent of laws. Full stop. To demonstrate this, I need only exhibit a single law that it would be unethical to follow. It, of course, is irrelevant where this law comes from; it's existence alone falsifies your claim. I submit that it would have been unethical to follow the anti-Jewish laws in Nazi Germany.

I brought this up before and you accused me of "Godwinning" the thread. Absolute rubbish. As I just explained, it is absolutely relevant to your universal claim that "Ethics requires following the law"--It demonstrates that claim is as foolish as it ever was.

I invite you once again to answer the question in my previous post. And please, try giving it some serious thought for a change.

dann 27th March 2020 06:57 AM

Quote:

Originally Posted by xjx388 (Post 13034422)
Youíve been the victim of a cruel deception.


Come on!!! There's no comeback from this. Can't you at least acknowledge that Cabbage has exposed your contradiction in terms?

Quote:

Originally Posted by Cabbage (Post 13034157)
Quote:

Originally Posted by xjx388 (Post 12994209)
Ethics requires following the law.


is now followed by:


Quote:

Originally Posted by xjx388 (Post 13033042)
Fortunately most medical providers recognize flawed laws and aren't afraid to stand up.


It looks to me like your position on ethics/legality may finally be starting to evolve beyond foolishly naive.

Congratulations on making this big step!

I do have a question. It may be somewhat challenging for you:

Does ethics require following a flawed law?


xjx388 27th March 2020 11:37 AM

Quote:

Originally Posted by dann (Post 13034630)
Come on!!! There's no comeback from this. Can't you at least acknowledge that Cabbage has exposed your contradiction in terms?


Another victim of a mangled post. I tried to explain what happened. That second bit you posted was actually uttered by SkepticGinger. I never said that. There was no contradiction.

Cabbage 27th March 2020 11:45 AM

Quote:

Originally Posted by xjx388 (Post 12994252)
And I treat your opinions with utter amusement. I have to admit, I didnít think this thread could be Godwinned, but you did it!


Oh, I see that now: You're correct; I attributed to you a quote which actually came from Skeptic Ginger.

In that case, I see that I was wrong when I thought your position on ethics was evolving. Nope. It's still hopelessly naive.

xjx388 27th March 2020 11:53 AM

Quote:

Originally Posted by Cabbage (Post 13034597)
How silly of me. I foolishly give you credit for your position on ethics evolving, and then you demonstrate that position is as naive as it ever was.

"Ethics requires following the law" can never be justified by giving a single example of just one law that it is ethical to follow. To support your claim, you actually need to demonstrate that ethics requires following Every. Single. Law. Otherwise, the claim is merely Ethics requires following some laws. Now having said that:


Youíve been the victim of a cruel deception.

Ethics is independent of laws. Full stop. To demonstrate this, I need only exhibit a single law that it would be unethical to follow. It, of course, is irrelevant where this law comes from; it's existence alone falsifies your claim. I submit that it would have been unethical to follow the anti-Jewish laws in Nazi Germany.

I brought this up before and you accused me of "Godwinning" the thread. Absolute rubbish. As I just explained, it is absolutely relevant to your universal claim that "Ethics requires following the law"--It demonstrates that claim is as foolish as it ever was.

I invite you once again to answer the question in my previous post. And please, try giving it some serious thought for a change.


How silly of me for assuming that the doctors under discussion do not live in a society with laws like Nazi Germany but instead live in the good olí US of A. Medical ethics requires adhering to the laws.

I do recognize that ethics is a separate thing from the law but they go hand in hand in a medical context. For example: should doctors feel ethically free to perform abortions outside of the law if they disagree with the law? I donít see how the answer is ďyes.Ē The law comes first; medical ethics covers adherence to legal requirements AND other non-legal issues. Doctors canít separate the two.

It would be unethical for a doctor to recommend an illegal drug/treatment/diagnostic AND to recommend unproven drugs/treatments/diagnostics, even if those drugs/treatments/diagnostics arenít illegal. At core, thatís the issue here: advocating for unproven diagnostics -assessing/diagnosing people theyíve never met.

Trumpís response to Covid-19 is a perfect example of what Iím talking about. His advice/action is stupid, dangerous and just plain wrong and whether or not he has a mental illness is immaterial. Itís plain to see on its face. We could have predicted it without a diagnosis/ďdangerousnessĒ assessment just by simple observation of him by laypeople. Medicine has no place either practically or scientifically.

Cabbage 27th March 2020 01:04 PM

Quote:

Originally Posted by xjx388 (Post 13035181)
How silly of me for assuming that the doctors under discussion do not live in a society with laws like Nazi Germany but instead live in the good olí US of A. Medical ethics requires adhering to the laws.

You're ignoring the fact that I merely presented that as a counter example: There do exist laws which are unethical to follow, falsifying your original statement.

Yes, I will acknowledge that the set of laws in America corresponds more closely (to my code of ethics, anyway) than would the set of Nazi Germany laws. That doesn't imply, however, that I (or anyone) should ever simply abdicate my own personal judgment of ethics to whatever the law does or does not allow. I'm not prepared to ever abdicate my own judgment that way, and you shouldn't, either.

Quote:

I do recognize that ethics is a separate thing from the law but they go hand in hand in a medical context. For example: should doctors feel ethically free to perform abortions outside of the law if they disagree with the law? I donít see how the answer is ďyes.Ē The law comes first; medical ethics covers adherence to legal requirements AND other non-legal issues. Doctors canít separate the two.

I think the answer is absolutely yes. If a law outlawing abortion were to be passed in America, I'm not going to suddenly change my mind that abortion is now suddenly unethical. I am strongly pro-choice, and I think it is ethical to allow a woman the right to choose, independent of what the law may say. Please note that I am also OK with a doctor refusing to perform an abortion if it violates his own code of ethics (even if the law permits it).

Quote:

It would be unethical for a doctor to recommend an illegal drug/treatment/diagnostic AND to recommend unproven drugs/treatments/diagnostics, even if those drugs/treatments/diagnostics arenít illegal. At core, thatís the issue here: advocating for unproven diagnostics -assessing/diagnosing people theyíve never met.

Trumpís response to Covid-19 is a perfect example of what Iím talking about. His advice/action is stupid, dangerous and just plain wrong and whether or not he has a mental illness is immaterial. Itís plain to see on its face. We could have predicted it without a diagnosis/ďdangerousnessĒ assessment just by simple observation of him by laypeople. Medicine has no place either practically or scientifically.


With respect to your position on Trump's response to Covid-19: I have no issue with any of that. I agree with you there. But obviously not saying all laws are unethical; that's absurd. Of course it's ethical to follow many laws. That simply does not imply that all laws are ethical.

xjx388 27th March 2020 02:52 PM

Quote:

Originally Posted by Cabbage (Post 13035262)
You're ignoring the fact that I merely presented that as a counter example: There do exist laws which are unethical to follow, falsifying your original statement.

Your counter example is inapplicable to the context in which we are debating.
Quote:

Yes, I will acknowledge that the set of laws in America corresponds more closely (to my code of ethics, anyway) than would the set of Nazi Germany laws. That doesn't imply, however, that I (or anyone) should ever simply abdicate my own personal judgment of ethics to whatever the law does or does not allow. I'm not prepared to ever abdicate my own judgment that way, and you shouldn't, either.
I agree in a general way, but not in specific contexts. Medicine is a context in which ethics are fundamental. Practicing medicine, for better or worse, is a license extended to those who pledge to follow 1) the laws of the State in which they are licensed and 2)the ethical codes of the profession. Doctors do have to abdicate their own judgement to the law and ethics of their profession.

Quote:

I think the answer is absolutely yes. If a law outlawing abortion were to be passed in America, I'm not going to suddenly change my mind that abortion is now suddenly unethical. I am strongly pro-choice, and I think it is ethical to allow a woman the right to choose, independent of what the law may say. Please note that I am also OK with a doctor refusing to perform an abortion if it violates his own code of ethics (even if the law permits it).
Violating the law puts the doctor and, more importantly, the patient at risk. It would be better for doctors to band together and fight the law -which is possible in a Democracy. Breaking the law is unethical because, in an environment where abortion is illegal, abortions cannot be performed safely. If the procedure goes wrong, the doctor is less likely to send the patient to a hospital for fear of risking her license/jail time, which puts the patient at risk.

Quote:

With respect to your position on Trump's response to Covid-19: I have no issue with any of that. I agree with you there. But obviously not saying all laws are unethical; that's absurd. Of course it's ethical to follow many laws. That simply does not imply that all laws are ethical.
Not quite: I never said all laws are ethical. There are flawed laws. I asked the question earlier: If one doctor says the law is flawed, is that then license for the doctor to break the law? Who decides when a law is flawed? I would say that the decision lies with the professional organizations: "We, as a profession, feel the law is flawed; we make an exception in the ethical code so that doctors don't feel obligated to follow that law." This is exactly what happened with the duty to warn -the organizaitons acted before it was made legal in the courts. It can't be up to individual judgement; individuals can easily be wrong.

Cabbage 27th March 2020 03:25 PM

Quote:

Originally Posted by xjx388 (Post 13035406)
Your counter example is inapplicable to the context in which we are debating.

No, it's not inapplicable. You made a universal statement. Don't whine to me whine I point out how ignorant the statement was.

Quote:

I agree in a general way, but not in specific contexts. Medicine is a context in which ethics are fundamental. Practicing medicine, for better or worse, is a license extended to those who pledge to follow 1) the laws of the State in which they are licensed and 2)the ethical codes of the profession. Doctors do have to abdicate their own judgement to the law and ethics of their profession.
None of that proves that every medical law is perfectly ethical, and therefore I continue to disagree.

Quote:

Violating the law puts the doctor and, more importantly, the patient at risk. It would be better for doctors to band together and fight the law -which is possible in a Democracy. Breaking the law is unethical because, in an environment where abortion is illegal, abortions cannot be performed safely. If the procedure goes wrong, the doctor is less likely to send the patient to a hospital for fear of risking her license/jail time, which puts the patient at risk.
Whether or not violating the law puts anyone at risk really depends on the law. For example, suppose abortion is outlawed tomorrow. A doctor who has the facilities to perform abortion today is not suddenly putting any patient at any unusual risk for using those same facilities to violate the anti-abortion law tomorrow.

Quote:

Not quite: I never said all laws are ethical. There are flawed laws. I asked the question earlier: If one doctor says the law is flawed, is that then license for the doctor to break the law? Who decides when a law is flawed? I would say that the decision lies with the professional organizations: "We, as a profession, feel the law is flawed; we make an exception in the ethical code so that doctors don't feel obligated to follow that law." This is exactly what happened with the duty to warn -the organizaitons acted before it was made legal in the courts. It can't be up to individual judgement; individuals can easily be wrong.
You said, "Ethics requires following the law". There were no caveats listed. There were no exceptions noted. The natural interpretation is that this was intended as a universal comment. Sure, I can see a distinction that "Ethics requires following the law" is not the same claim as "All laws are ethical"; indeed, that is why I initially raised my objection: Ethics does not require following unethical laws.

Are you now walking back your claim that "Ethics requires following the law", subject to some restrictions?

xjx388 27th March 2020 05:10 PM

Quote:

Originally Posted by Cabbage (Post 13035449)
No, it's not inapplicable. You made a universal statement. Don't whine to me whine I point out how ignorant the statement was.

The situation in Nazi Germany is wholly inapplicable to the situation in todayís America.
Quote:

None of that proves that every medical law is perfectly ethical, and therefore I continue to disagree.
Iím not trying to prove every law is ethical; Iím trying to argue that ethics requires following the law.
Quote:

Whether or not violating the law puts anyone at risk really depends on the law. For example, suppose abortion is outlawed tomorrow. A doctor who has the facilities to perform abortion today is not suddenly putting any patient at any unusual risk for using those same facilities to violate the anti-abortion law tomorrow.
The patient is at legal risk. The doctor is at legal risk. If the patient has a complication, they will be less likely to seek care and the doctor will be less likely to send to the hospital because of that risk.

And then you have to think of the sociocultural paradigm in which a society would pass such a law. Obviously there would be widespread opposition to abortion and any doctor doing it would be viewed as a bad doctor. A bunch of bad doctors denigrates the profession. In such a dystopian society, ethics is very different. Again, ethics requires following the law, for a lot of reasons.

Quote:

You said, "Ethics requires following the law". There were no caveats listed. There were no exceptions noted. The natural interpretation is that this was intended as a universal comment. Sure, I can see a distinction that "Ethics requires following the law" is not the same claim as "All laws are ethical"; indeed, that is why I initially raised my objection: Ethics does not require following unethical laws.

Are you now walking back your claim that "Ethics requires following the law", subject to some restrictions?
In medicine, I canít think of any exceptions in modern America. You can let me know what you think would be an exception. Whatís a current unethical law that you think doctors should not follow?

Skeptic Ginger 27th March 2020 05:28 PM

The Yale doctors felt they had a duty to warn. They were accused of wanting to sell books and taking their position for political reasons.

Now we are in the middle of a crisis that has turned into a disaster needlessly directly as the result of Trump's pathologic narcissism.

Dr Lee and her colleagues were absolutely right to choose a duty to warn over the Goldwater Rule that really isn't applicable. Trump is really ill, unlike Goldwater, the circumstances are not even close.

But it's too late. Not enough people listened.

Dr. Bandy Lee: Trump is spreading a "mental health pandemic" that's making coronavirus worse
Quote:

This a real crisis, both in terms of Trump's presidency and in terms of his psyche. At first Trump tried to manage the coronavirus in his mind by pretending that it was nothing. It was something that would go away in no time; the virus would somehow magically disappear. That is Trump's fantasy world. When that wasn't happening, and the stock market was in crisis and tumult, Trump then tried to look like he was in charge by giving a speech to the whole country. Trump continues to have these televised speeches and press conferences to make it look like he is control of the coronavirus crisis, all while he has Mike Pence and other government officials praise him on TV.

Trump is not in touch with reality. He cannot control the coronavirus with his mind and by living in a fantasy world, as he has done for most of the crisis. Mental health professionals have been warning for years that Trump's mental health issues would lead to such a dire situation. Trump is not showing just a lack of presidential leadership. What he is doing is so irresponsible and inept that having him as president is in some ways worse than having no leadership in the country at all. Trump is spreading disinformation, suppressing reality, and threatening those experts and other people who are telling him things about the coronavirus pandemic that he doesn't want to hear.

Now we in America and around the world are living through the horrible results of Trump's behavior. His mental health issues are translating directly into deaths and widespread calamity.
So there it is. You can't get any more specific than that. De Lee and colleagues were right. We are on part 3 of this thread and at least one person is still trying to make the case this was not a valid case for overruling an outdated ethics position*. Professionals should have instead followed "the rules" and not their professional judgement.


*Hopefully we are long past the stupidity of claiming Trump's diagnosis still needs an in-person exam.

Cabbage 27th March 2020 05:44 PM

Quote:

Originally Posted by xjx388 (Post 13035539)
The situation in Nazi Germany is wholly inapplicable to the situation in todayís America.


But it's applicable in pointing out the ignorance of the "Ethics requires following the law" statement.

Quote:

Iím not trying to prove every law is ethical; Iím trying to argue that ethics requires following the law.

I noted the difference in my previous post. I'm still unclear on your position, and you haven't been forthcoming: Does ethics require following an unethical law? I've asked that multiple times now. I've yet to get an answer. It's absolutely relevant, you know.


Quote:

The patient is at legal risk. The doctor is at legal risk.

That's circular reasoning, you know--the only risk is getting caught. That's not justification for the law itself, however. There's no unusual medical risk.


Quote:

If the patient has a complication, they will be less likely to seek care and the doctor will be less likely to send to the hospital because of that risk.
I'll give you that. I disagree that it makes the doctor's actions unethical. I claim that makes the law itself unethical.

Quote:

And then you have to think of the sociocultural paradigm in which a society would pass such a law. Obviously there would be widespread opposition to abortion and any doctor doing it would be viewed as a bad doctor.
How is that obvious? The modern GOP seems determined to restrict abortion regardless of the demographics of popular opinion, for example. Not only is this not obvious, it is obviously wrong.


Quote:

A bunch of bad doctors denigrates the profession.

Now you're even getting yourself confused. You led into this sentence saying they "would be viewed as a bad doctor". Now you're claiming they actually are bad doctors and not simply viewed that way.

You're getting even sloppier than usual with your reasoning.


Quote:

In such a dystopian society, ethics is very different. Again, ethics requires following the law, for a lot of reasons.

I'll ask again: Does ethics require following unethical laws? Yeah, like I said: Challenging question, I know. So challenging you evidently refuse to answer. :rolleyes:


Quote:

In medicine, I canít think of any exceptions in modern America. You can let me know what you think would be an exception. Whatís a current unethical law that you think doctors should not follow?
I'll admit I don't know medical law well enough to give an answer. That does not prohibit me from seeing the naive simplicity of your claim. I've already demonstrated real world laws that it would be a travesty to follow....and you whined that I wasn't being fair. :rolleyes:

Skeptic Ginger 27th March 2020 06:40 PM

Quote:

Originally Posted by Cabbage (Post 13035565)
Quote:

In medicine, I canít think of any exceptions in modern America. You can let me know what you think would be an exception. Whatís a current unethical law that you think doctors should not follow?
I'll admit I don't know medical law well enough to give an answer. That does not prohibit me from seeing the naive simplicity of your claim. I've already demonstrated real world laws that it would be a travesty to follow....and you whined that I wasn't being fair.

There are many, especially in the anti-abortion states.

xjx388 27th March 2020 09:47 PM

Quote:

Originally Posted by Skeptic Ginger (Post 13035607)
There are many, especially in the anti-abortion states.


Ok, then...examples please.

Skeptic Ginger 27th March 2020 10:21 PM

Quote:

Originally Posted by xjx388 (Post 13035759)
Ok, then...examples please.

Pretty friggin obvious. Too far off topic. Seems you'd like to change the subject.

xjx388 30th March 2020 10:04 AM

Quote:

Originally Posted by Skeptic Ginger (Post 13035778)
Pretty friggin obvious. Too far off topic. Seems you'd like to change the subject.


Yeah, Iím gonna start a new thread about ethics, the law and medicine soon. Hopefully you will join me there and we can debate that further. I donít want to change the subject; I just think that angle is worth exploring further.

Skeptic Ginger 30th March 2020 10:10 AM

Quote:

Originally Posted by xjx388 (Post 13038338)
Yeah, Iím gonna start a new thread about ethics, the law and medicine soon. Hopefully you will join me there and we can debate that further. I donít want to change the subject; I just think that angle is worth exploring further.

Gonna be hard to do if you don't recognize some people see anti-abortion laws as unethical. Go ahead, start the thread. I have a dozen examples to start off the conversation.

xjx388 30th March 2020 11:44 AM

Quote:

Originally Posted by Skeptic Ginger (Post 13038346)
Gonna be hard to do if you don't recognize some people see anti-abortion laws as unethical. Go ahead, start the thread. I have a dozen examples to start off the conversation.

That discussion is now here:
http://www.internationalskeptics.com...d.php?t=342972

Bob001 30th March 2020 12:17 PM

The evidence piles uip:
Quote:

No one could make up a character as narcissistic and lacking in human empathy as President Trump. Trumpís own words make the point better than any analysis or commentary:

Quote:

ďPresident Trump is a ratings hit. Since reviving the daily White House briefing Mr. Trump and his coronavirus updates have attracted an average audience of 8.5 million on cable news, roughly the viewership of the season finale of ĎThe Bachelor.í Numbers are continuing to rise...
ó Donald J. Trump (@realDonaldTrump) March 29, 2020
More than 2,400 Americans had died by Sunday. Governors around the country are screaming for more assistance from the federal government. Trump? He obsesses over ratings. It is hard to comprehend how indifferent he is to human suffering.
https://www.washingtonpost.com/opini...ore-dangerous/


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