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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 13th February 2020 03:46 PM

Quote:

Originally Posted by xjx388 (Post 12988742)
I’m more than willing to admit when I’ve made an error. I can’t see it. Can you spell it out?

:sdl:

Here, I'll spell it out for you. Professional judgement is just that, professional judgement. What you described would never be professional judgement.

xjx388 13th February 2020 03:51 PM

Let's be real clear here. Here is the question I asked:

In your view, are ethical codes something professionals can choose to follow or not? Can they cherry pick which rules are gold standard rules and which are not absolute?

SkepticGinger answered, "Yes, it's called professional judgement."

Clearly, SG thinks that professionals can cherry pick which rules are gold standard and which are not absolute by exercising professional judgement.

My scenario is obviously an exercise in bad professional judgement and it's one that happens in the real world all the time. Therefore, "professional judgement," is not a very good tool to use in selecting which ethical rules should apply and which should not.

Where am I wrong?

xjx388 13th February 2020 03:57 PM

Quote:

Originally Posted by Skeptic Ginger (Post 12988748)
:sdl:

Here, I'll spell it out for you. Professional judgement is just that, professional judgement. What you described would never be professional judgement.

You are accusing me of bad logic and that's what you come back with?

That's a circular definition of "professional judgement" and it points out the fatal flaw in your argument. To further illustrate this point: Professional judgement is just that, professional judgement. What the Yale Group is doing would never be professional judgement.

Is that convincing? I didn't think so.

So what is "professional judgement?" and then tell me why the "sex with a patient" scenario isn't a case of using it but the actions of the Yale Group is.

Skeptic Ginger 13th February 2020 07:38 PM

Quote:

Originally Posted by xjx388 (Post 12988750)
Let's be real clear here. Here is the question I asked:

In your view, are ethical codes something professionals can choose to follow or not? Can they cherry pick which rules are gold standard rules and which are not absolute?

SkepticGinger answered, "Yes, it's called professional judgement."

Clearly, SG thinks that professionals can cherry pick which rules are gold standard and which are not absolute by exercising professional judgement.

My scenario is obviously an exercise in bad professional judgement and it's one that happens in the real world all the time. Therefore, "professional judgement," is not a very good tool to use in selecting which ethical rules should apply and which should not.

Where am I wrong?

One of these (highlighted) things is not like the other.

You figure it out.

Skeptic Ginger 13th February 2020 07:41 PM

BTW, can you imagine physicians and other medical practitioners that were so anal they wouldn't override some written guideline that should not be applied?

xjx388 13th February 2020 09:58 PM

Quote:

Originally Posted by Skeptic Ginger (Post 12988968)
One of these (highlighted) things is not like the other.



You figure it out.

Your argument here is that if a doctor decides to sleep with a patient that decision has nothing to do with professional judgement.

There is a professional relationship between the two. The decision to have an intimate relationship in that context is a perfect example of poor professional judgement. How can you say that it isnít?

I mean, you can continue to handwave away my arguments here, but Iíd really like to see you defend it.

Skeptic Ginger 13th February 2020 11:05 PM

Quote:

Originally Posted by xjx388 (Post 12989117)
Your argument here is that if a doctor decides to sleep with a patient that decision has nothing to do with professional judgement.

There is a professional relationship between the two. The decision to have an intimate relationship in that context is a perfect example of poor professional judgement. How can you say that it isnít?

I mean, you can continue to handwave away my arguments here, but Iíd really like to see you defend it.

Really? You're going to keep going around and around with this bull **** pretending we should exchange actual professional judgement with some rules you found on the Internet lest we be so incompetent we think professional judgement is a license to to do anything? Do you not understand what you are saying?

Do you believe they teach following the APA's positions in lieu of professional judgement in med school? Really? :rolleyes:

xjx388 14th February 2020 08:32 AM

Quote:

Originally Posted by Skeptic Ginger (Post 12989160)
Really? You're going to keep going around and around with this bull **** pretending we should exchange actual professional judgement with some rules you found on the Internet lest we be so incompetent we think professional judgement is a license to to do anything? Do you not understand what you are saying?

You keep dismissing the ethical code as just some rules I found on the internet. Do you not think that that the ethical code is an important part of professional judgement?
Quote:

Do you believe they teach following the APA's positions in lieu of professional judgement in med school? Really? :rolleyes:
Do you think they tell students and residents, "Ethics? That's just some rules on the internet. Ignore them and use your professional judgement, instead."

TragicMonkey 14th February 2020 08:40 AM

Even our beloved but obviously insane Lord President knows that "judgment" is properly spelled with only one E. Granted he scribbles the word in crayon or his own waste, and doesn't know what it means, but still.

RecoveringYuppy 14th February 2020 08:40 AM

Quote:

Originally Posted by xjx388 (Post 12989439)
You keep dismissing the ethical code as just some rules I found on the internet.


Isn't that what you've given us? You seem to be demonstrating an "understanding" that is based solely on a couple cherry picked paragraphs.

xjx388 14th February 2020 09:02 AM

Quote:

Originally Posted by RecoveringYuppy (Post 12989448)
Isn't that what you've given us? You seem to be demonstrating an "understanding" that is based solely on a couple cherry picked paragraphs.

This is a preposterous accusation.

I have linked to the pdf containing the entire Code of Ethics. I've also linked to the APAs various position pieces that came out in the wake of this. You are free to peruse them at your leisure and tell me what I've misunderstood. I think you will find that the APA's position on this is crystal clear and their arguments sound.

So please tell me, you, SG, anybody . . . how does professional judgement override those sound arguments?

xjx388 14th February 2020 09:07 AM

Quote:

Originally Posted by TragicMonkey (Post 12989447)
Even our beloved but obviously insane Lord President knows that "judgment" is properly spelled with only one E. Granted he scribbles the word in crayon or his own waste, and doesn't know what it means, but still.

I have used my professional judgement (as a trained reader and writer with experience of over 47 years) and decided that spelling rules are just something you found on the internet and I can ignore them.

TragicMonkey 14th February 2020 09:12 AM

Quote:

Originally Posted by xjx388 (Post 12989490)
I have used my professional judgement (as a trained reader and writer with experience of over 47 years) and decided that spelling rules are just something you found on the internet and I can ignore them.

That's a clear example of #3415 on the official "Doctor Science's Is You Crazy? Diagnostic Tool". Per the guidelines that means you is mentally crazy, and I must urge you not to be a president.

RecoveringYuppy 14th February 2020 10:15 AM

Quote:

Originally Posted by xjx388 (Post 12989483)
This is a preposterous accusation.

I have linked to the pdf containing the entire Code of Ethics. I've also linked to the APAs various position pieces that came out in the wake of this. You are free to peruse them at your leisure and tell me what I've misunderstood. I think you will find that the APA's position on this is crystal clear and their arguments sound.

So please tell me, you, SG, anybody . . . how does professional judgement override those sound arguments?

If their arguments are so sound and "absolute" as you tried to claim earlier can you explain why other professional organizations have explicitly chosen not to adopt this particular one? Similarly, why has it not been codified in to law as some jurisdictions have done with your sex example?

xjx388 14th February 2020 10:44 AM

Quote:

Originally Posted by RecoveringYuppy (Post 12989537)
If their arguments are so sound and "absolute" as you tried to claim earlier can you explain why other professional organizations have explicitly chosen not to adopt this particular one? Similarly, why has it not been codified in to law as some jurisdictions have done with your sex example?

Which professional organizations are those? The American Psychological Association and the American Psychiatric Association are the two biggest professional organizations in control of the mental health profession. The American Psychoanalytic Association has been misconstrued as saying that their members don't have to follow the Goldwater Rule, but that's not what they said (covered extensively in the thread before). So which organizations were those?

Now, I guess you could argue that: Dr. X chooses not to be a member of any professional; therefore, no ethics rules apply to Dr. X. But that seems like a really bad argument. I believe medical ethics is an inextricable part of medical practice that exists independent of membership in a group.

Ethics is independent of law. Sex with a patient is both unethical and a violation of board rules. Not every ethical violation should be a violation of board rules. The absence of a law or board rule about something doesn't render that something ethical.

Minoosh 14th February 2020 11:28 AM

Quote:

Originally Posted by TragicMonkey (Post 12989447)
Even our beloved but obviously insane Lord President knows that "judgment" is properly spelled with only one E. Granted he scribbles the word in crayon or his own waste, and doesn't know what it means, but still.

Wars have been fought over less.

TragicMonkey 14th February 2020 11:29 AM

Quote:

Originally Posted by Minoosh (Post 12989609)
Wars have been fought over less.

Even Jenkins wouldn't misspell "ear".

Skeptic Ginger 14th February 2020 11:37 AM

Quote:

Originally Posted by xjx388 (Post 12989439)
You keep dismissing the ethical code as just some rules I found on the internet. Do you not think that that the ethical code is an important part of professional judgement?
Do you think they tell students and residents, "Ethics? That's just some rules on the internet. Ignore them and use your professional judgement, instead."

You clearly cannot defend your position so you make up a straw man, all or none, to do battle with. You are arguing everyone should anally follow these 'rules' lest they have nothing upon which to base their ethical judgement.

That's a bizarre point of view. What if there is something for which no organization position paper exists?

What if there are two such position papers and they don't agree?

It's like you picture medical providers running around saying, "Oh no, what do I do, what do I do?"

It's mind boggling to me that you could actually believe that. So I don't think you do believe that. You are trying to justify the position you've taken and it takes a straw man to do that.

Skeptic Ginger 14th February 2020 11:44 AM

Quote:

Originally Posted by xjx388 (Post 12989483)
...

So please tell me, you, SG, anybody . . . how does professional judgement override those sound arguments?

It's easy. Take the case of Trump as an example. More than a few highly credentialed professionals have described in detail why they felt the need to override the arguments you seem to think should be burned into one's soul.

Ethics: The Goldwater Rule had to be overridden here given the threat they believe Trump poses.

And if you are still arguing for that in-person exam, you are dismissing the professional judgement of thousands of professionals that can see it would add nothing in this case and Trump's pathologic NPD is blatantly obvious.

RecoveringYuppy 14th February 2020 12:07 PM

Quote:

Originally Posted by xjx388 (Post 12989576)
... (covered extensively in the thread before) ...

Thanks, no need to pointlessly beat this to death again.

xjx388 15th February 2020 12:41 AM

Donald Trump has 'dangerous mental illness' say psychiatry experts at Yale... Pt 3
 
Quote:

Originally Posted by Skeptic Ginger (Post 12989629)
It's easy. Take the case of Trump as an example. More than a few highly credentialed professionals have described in detail why they felt the need to override the arguments

An appeal to popularity?

Quote:

you seem to think should be burned into one's soul.
If you donít think ethics should be the core of a professionals practice. I donít think we will agree on very much.

Quote:

Ethics: The Goldwater Rule had to be overridden here given the threat they believe Trump poses.
Begging the question.

Quote:

And if you are still arguing for that in-person exam, you are dismissing the professional judgement of thousands of professionals that can see it would add nothing in this case and Trump's pathologic NPD is blatantly obvious.
Another argument by popularity. And itís worth pointing out that there is no evidence of ďthousands of professionalsĒ who think this way. At best, there are somewhere around 40 professionals who have publicly spoken about this.

Skeptic Ginger 15th February 2020 04:36 PM

Quote:

Originally Posted by xjx388 (Post 12990122)
An appeal to popularity?

If you donít think ethics should be the core of a professionals practice. I donít think we will agree on very much.

Begging the question.



Another argument by popularity. And itís worth pointing out that there is no evidence of ďthousands of professionalsĒ who think this way. At best, there are somewhere around 40 professionals who have publicly spoken about this.

You seem to be confusing a difference of opinion between professionals as an appeal to popularity.

Wow, that is some twisted logic: one side is valid and the other isn't?

xjx388 16th February 2020 10:24 AM

Quote:

Originally Posted by Skeptic Ginger (Post 12990685)
You seem to be confusing a difference of opinion between professionals as an appeal to popularity.

Iím not confused about anything.

There are thousands of doctors who promote full-blown woo as part of their practice. Their argument is that, in their professional judgement, these woo treatments are safe and effective. Does the fact that so many of them agree with each other make their judgement sound? No, it doesnít.

The fact that a relative handful of MHPs disagree with the Goldwater Rule, similarly, tells us nothing about whether or not they are exercising good professional judgement.





Quote:

Wow, that is some twisted logic: one side is valid and the other isn't?

Yes, there is one side of this that is clearly based on the established standards of practice and ethics. There is another side that is on the complete opposite side with nothing to support them but their own judgement and mutual agreement.

We fundamentally disagree about which side is valid. That doesnít mean Iím being illogical.

Skeptic Ginger 16th February 2020 01:31 PM

Yawn... Doctors who promote woo isn't an example helping your argument. You're back to asserting that without anally following guidelines no professionals would know what to do.

I know you want that to be true, that said position papers are absolute. That's not how it works and no amount of feet stamping is going to make it so.

Nowhere in medicine does any provider not consider professional judgement superior in multiple cases. It's even taught that way in med school. Evidence based medicine, yes, but sometimes it doesn't fit the situation.

xjx388 16th February 2020 02:50 PM

Donald Trump has 'dangerous mental illness' say psychiatry experts at Yale... Pt 3
 
Quote:

Originally Posted by Skeptic Ginger (Post 12991385)
Yawn... Doctors who promote woo isn't an example helping your argument.

My argument is: Professional Judgement is not a good tool for deciding which ethical rules are valid and which are not.

Do you consider advocating and providing unproven, ineffective treatments to be ethical, in general? Is there any situation. In which a professionalís judgement would override that?

If the answer is no to both situations, then thereís nothing wrong with my argument. It illustrates the point that ďprofessional judgement,Ē is not a good tool for deciding which ethical rules are valid and which are not.

Quote:

You're back to asserting that without anally following guidelines no professionals would know what to do.
Not quite: Professional judgement includes knowing and understanding the ethical rules that apply to each situation. There is no mechanism by which a professional says,ĒEh, I reject that ethical rule as invalid.Ē If itís true for ďsex with patients,Ē and ďproviding ineffective treatments,Ē the. Itís true for the Goldwater Rule.

Quote:

Nowhere in medicine does any provider not consider professional judgement superior in multiple cases. It's even taught that way in med school. Evidence based medicine, yes, but sometimes it doesn't fit the situation.
This is nonsense. Doctors are not taught to consider their judgement superior to standards of practice and ethics. That sounds like institutionalized egotism.

Skeptic Ginger 16th February 2020 03:19 PM

Quote:

Originally Posted by xjx388 (Post 12991449)
My argument is: Professional Judgement is not a good tool for deciding which ethical rules are valid and which are not.

Yeah, and your argument is stupid.

Quote:

This is nonsense. Doctors are not taught to consider their judgement superior to standards of practice and ethics. That sounds like institutionalized egotism.
There's no way to help you understand this. But at least try to use legit examples and analogies.

AMA re Ethics
Quote:

The AMA was founded in part to establish the world’s first national codification of medical ethics. Widely recognized as the most comprehensive ethics guide for physicians who strive to practice ethically, the opinions in the AMA Code of Medical Ethics represent the official policy positions of the AMA.
Do you understand why it's a guide and not some absolute law? Why choose that particular word?


AMA Code of Medical Ethics Opinion 4.2.7
Quote:

The Principles of Medical Ethics of the AMA do not prohibit a physician from performing an abortion in accordance with good medical practice and under circumstances that do not violate the law.
You don't think there are professionals that disagree with this ethical position?

Why does this differ from other ethical rules people do not agree on?

Here's another one that not everyone agrees with:
Code of Medical Ethics Opinion 5.6
Quote:

The duty to relieve pain and suffering is central to the physician’s role as healer and is an obligation physicians have to their patients. When a terminally ill patient experiences severe pain or other distressing clinical symptoms that do not respond to aggressive, symptom-specific palliation it can be appropriate to offer sedation to unconsciousness as an intervention of last resort.
It's not ethical to do either of these in a Catholic Hospital.

xjx388 16th February 2020 10:36 PM

Quote:

Originally Posted by Skeptic Ginger (Post 12991475)
Yeah, and your argument is stupid.

That might have been very satisfying for you to write, but it isnít responsive. Hope it made you feel better, though.

Quote:

There's no way to help you understand this. But at least try to use legit examples and analogies.

AMA re Ethics
Do you understand why it's a guide and not some absolute law? Why choose that particular word?
If you read past the highlighted part, you would see the words, ďwho strive to practice ethically.Ē Is it ok to not strive to practice ethically?

I donít see the significance in the word ďguide.Ē You are right in the sense that the ethics code isnít law. But, that word doesnít create an implication that itís merely a set of guidelines to pick and choose. If you want to practice ethically, thereís the guide to do it.
Quote:

AMA Code of Medical Ethics Opinion 4.2.7
You don't think there are professionals that disagree with this ethical position?
What does not agreeing to that ethical opinion look like? The doctor doesnít perform abortions. There is no ethical rule that says doctors must perform abortions so the choice not to is also ethical.

Quote:

Why does this differ from other ethical rules people do not agree on?
Its a permissive rule: you can do this if you choose to without breaching ethics. You can also choose not to do it.

Quote:

Here's another one that not everyone agrees with:
Code of Medical Ethics Opinion 5.6
It's not ethical to do either of these in a Catholic Hospital.
Itís not unethical not to do them either.

Bad examples. You need to find restrictive rules: Donít do this. With a restrictive rule, there is no ďitís still ethical if you choose to do it.Ē

RecoveringYuppy 17th February 2020 10:49 AM

Quote:

Originally Posted by xjx388
Doctors are not taught to consider their judgement superior to standards of practice and ethics.


Basically it sound like you just don't know what you are talking about (and have a very odd fixation to boot). It sounds like you think the phrase "professional judgement" means to do what the doctor wants without any consideration of guidance whatsoever. Professional judgement is what guides every decision a doctor makes and it is supposed to an informed judgement that takes in to consideration everything the doctor knows on the subject including relevant codes of ethics. It is taught as being primary and informed. It was pointed out to me last evening that the three alternative graduation oaths cited to graduates of U of A Medical School mention exercising judgement, two of them in their first sentence. And in the real world all codes of ethics on significant subjects have gray areas and contradictions. It's up to professional judgement to sort it out in any specific instance.

Belz... 17th February 2020 10:58 AM

Quote:

Originally Posted by xjx388 (Post 12988644)
That's all stuff that you yourself have observed.

Yes but pros may be better at intepreting publically-available evidence.

xjx388 17th February 2020 12:18 PM

Quote:

Originally Posted by RecoveringYuppy (Post 12992429)
Basically it sound like you just don't know what you are talking about (and have a very odd fixation to boot).

Do you think the APA knows what it’s talking about?

It’s telling, I think, that so many arguments here focus on me: I have D-K, I don’t know what I’m talking about, I have odd fixations, etc etc ad nauseum.. Very few arguments have addressed the very clear opinions of the professional organizations and their rebuttals to all the arguments raised here.

If I were you I’d focus on that and not so much on me. I have cited ample evidence that the organizations (the AMA, both APAs) responsible for creating the ethics code do not see this as an acceptable exception to ethics code.

Quote:

It sounds like you think the phrase "professional judgement" means to do what the doctor wants without any consideration of guidance whatsoever.
Really? Even though I specifically said that’s not what professional judgement is all about? Even though that’s clearly what SG thinks and I’ve been arguing against?

Perhaps if you took a little time to actually consider the words I write, you wouldn’t be so confused.
Quote:

Professional judgement is what guides every decision a doctor makes and it is supposed to an informed judgement that takes in to consideration everything the doctor knows on the subject including relevant codes of ethics. It is taught as being primary and informed.
I have no quarrel with that at all; it’s my position, restated.

Professional judgement includes consideration of ethics. Such consideration does not entail outright rejection of clear ethical guidance. The professional is not above the profession.


Quote:

It was pointed out to me last evening that the three alternative graduation oaths cited to graduates of U of A Medical School mention exercising judgement, two of them in their first sentence. And in the real world all codes of ethics on significant subjects have gray areas and contradictions. It's up to professional judgement to sort it out in any specific instance.
What I said was: “Doctors are not taught to consider their judgement superior to standards of practice and ethics.” That is 100% true and it does not conflict with what you wrote above.

Is Andrew Wakefield’s (MD who lost his license because of his anti-vax activism) professional judgement superior to ethical codes and standards of practice? No it isn’t. The idea that professional judgement somehow replaces standards is ridiculous on its face.

You talk about grey areas and contradictions. However, in this particular case, there is no grey area or contradiction. There is very clear ethical guidance on whether or not to publicly speak about people they’ve never met. As such, how can you argue that professional judgement can lead to outright rejection of ethical codes? That is also ridiculous on its face.

RecoveringYuppy 17th February 2020 12:21 PM

Quote:

Do you think the APA knows what itís talking about?
Yes. You're not the APA.

Stacyhs 17th February 2020 12:24 PM

Aren't you all getting dizzy reading this? Round and round and round we go....

http://www.internationalskeptics.com...ae87dc59f7.jpg

xjx388 17th February 2020 12:50 PM

Quote:

Originally Posted by Belz... (Post 12992435)
Yes but pros may be better at intepreting publically-available evidence.

Pros are still people, subject to the same biases we all have.

Belz... 17th February 2020 12:53 PM

Quote:

Originally Posted by xjx388 (Post 12992567)
Pros are still people, subject to the same biases we all have.

Yyyyes but being pros they have more knowledge and expertise on the subject matter and, usually, we give more weight to their opinions... unless you think expert opinion isn't worth more than layman opinions.

xjx388 17th February 2020 12:53 PM

Quote:

Originally Posted by RecoveringYuppy (Post 12992520)
Yes. You're not the APA.

If you think the APA knows what they are talking about, then what does it matter who I am?

If you think Iím misrepresenting their position, Iím all ears.

xjx388 17th February 2020 12:55 PM

Quote:

Originally Posted by Belz... (Post 12992569)
Yyyyes but being pros they have more knowledge and expertise on the subject matter and, usually, we give more weight to their opinions... unless you think expert opinion isn't worth more than layman opinions.


Why do we give more weight to their opinions? I think thatís a big problem here. If Dr. Oz tells you your astrological sign influences your health, do you give weight to that opinion?

I give weight to professional opinions not the opinions of professionals.

xjx388 17th February 2020 01:03 PM

Quote:

Originally Posted by Stacyhs (Post 12992525)
Aren't you all getting dizzy reading this? Round and round and round we go....

http://www.internationalskeptics.com...ae87dc59f7.jpg

How is this thread any different than any other thread on this forum? If you find it dizzying, you can always get off the merry-go-round.

Belz... 17th February 2020 01:08 PM

Quote:

Originally Posted by xjx388 (Post 12992574)
Why do we give more weight to their opinions? I think thatís a big problem here.

No, I don't believe you. I think you go see a physician for ailments, a car mechanics for automobile problems, and a plumber for a running faucet.

You don't give equal weight to all opinions because the very concept is laughable.

xjx388 17th February 2020 01:19 PM

Quote:

Originally Posted by Belz... (Post 12992597)
No, I don't believe you. I think you go see a physician for ailments, a car mechanics for automobile problems, and a plumber for a running faucet.

You don't give equal weight to all opinions because the very concept is laughable.

If you go to a physician for an ailment and the physician says you need to take this special herbal supplement he sells, is that an opinion worth giving weight to?

Like I said, I give weight to professional opinions: those opinions that result from application of the standards of practice and ethics of the profession.

I don't give weight to the opinons of professionals: those opinions that are outside the scope of the standards and ethics of the profession.

Stacyhs 17th February 2020 01:25 PM

Quote:

Originally Posted by xjx388 (Post 12992588)
How is this thread any different than any other thread on this forum? If you find it dizzying, you can always get off the merry-go-round.

Oooooooohhhhh....someone is a bit touchy.

It's different because this thread has basically turned into repeating the same things over and over with nothing new added. It all revolves around whether ethics require following the Goldwater Rule or not. At least in other threads the topics tend to evolve. This one is stuck in a repeat cycle. And, yes, I'm getting off this merry-go-round as of now. Nothing new has been said in weeks.
http://www.internationalskeptics.com...af6ae8fc26.jpg


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