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Tags donald trump , mental illness issues , psychiatry incidents , psychiatry issues , Trump controversies

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Old 25th April 2017, 12:53 PM   #361
Skeptic Ginger
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Originally Posted by WilliamSeger View Post
The ethics of the Goldwater Rule is far from a settled issue. This article is from the Journal of American Psychiatry and the Law:

A synopsis:

In short, the article concludes that the Goldwater Rule was an over-reaction to an embarrassing and irresponsible magazine poll concerning Barry Goldwater's mental health, and that it is really intended to protect the image and reputation of the psychiatry profession itself, rather than either the individuals or the public.
This is why I say people asserting the Goldwater rule simply don't understand what it is.
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Old 25th April 2017, 12:54 PM   #362
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Originally Posted by Skeptic Ginger View Post
And yet: More than a few prestigious psychiatrists disagree with the APA position in this circumstance.


52,168 (so far) professionals have gone public with their names and degrees in a petition.

Several people in this thread keep arguing as if it is forumite opinion vs the APA's position developed decades ago specifically to address professional opinions that came out against Goldwater. The two situations are as different than night and day.

First, the issue is psychiatrist against psychiatrist, let's get that straight.

Second, let's look at the difference between the Goldwater case and the Trump case.

In the Trump case he displays classic symptoms of a well defined personality disorder.

In the Goldwater case, it was Freudian based opinions, something no longer held valid in the US (I understand some countries in Europe still consider Freud valid). Those are not well defined psychiatric diagnoses. Those were psychiatrists' remarks on a survey. Goldwater sued and won.

The HuffPo article is excellent for understanding the issues of the day that led to the Goldwater rule, and for seeing how they do not apply to Trump today.
if he is psychologically incapable of competently discharging the duties of President of the United States, then how is he competently discharging the duties of the president of the United States right now? Did he try to veto a piece of legislation and fail to make the signature? What duty is he not discharging?
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Old 25th April 2017, 12:57 PM   #363
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Originally Posted by xjx388 View Post
Let me get this straight: you think it's a good idea to have pshychiatrists deliver medical opinions in public about people they haven't examined?
Another attempt to argue with a classic strawman. Your claim Trump was not examined ignores the fact he has been examined via his hours and hours and hours of public behavior.
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Old 25th April 2017, 12:58 PM   #364
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Originally Posted by Skeptic Ginger View Post
The APA is a professional association. It's not a regulating body. Like most of these professional organizations they have position papers.
The APA is different in that, unlike other bodies, it does indeed sanction it's members for ethical violations. It also reports more severe violations to the State Medical Board. No, the APA can't revoke a medical license but the State can based on the findings of the APA.

Quote:
<snip>
You all really need to stop acting like the APA is a regulating body or a body that sets practice standards. The APA has opinion positions on practice standards. No one is held to those standards as a matter of law. If one harms a patient, the fact one didn't follow an accepted standard can have an influence on a court decision. It would never be the sole reason a provider lost his/her credentials.
You are quite incorrect here. If a patient is harmed by a medical provider who deviated from the standard of practice of their specialty, they can indeed lose their license. Beyond regulatory bodies, they will almost certainly lose in a malpractice case.

Quote:
For example, I am allowed by law to prescribe outside the FDA approval for a drug as long as the drug is approved for the market. That's a clear-cut example where one can act outside of a practice standard provided one can justify one's actions.
Off-label prescribing carries risks, though. If a patient is harmed by off-label prescribing, that can be viewed as a breech of the standard of care even if it isn't illegal to prescribe off-label. Here in Texas, several doctors have lost their license (and a lot of money) for off-label prescribing that resulted in harm to the patient.

Deviating from the standards of practice and ethics carries risk. Sometimes that risk is personal, sometimes it's societal. In this case, I think it's dangerous to allow psychiatrists to make public declarations about anyone, public figures especially, without having 1)Examined the patient themselves (at the very least reviewed their medical records and actually, you know, meet the patient) and 2)Gotten permission from the patient to discuss their case. The potential for abuse is simply too high.


Quote:
The ignorance in this thread about the significance of an APA position on this matter is a Dunning Kruger effect indeed.
In this case, the ignorance is yours. The APA ethical code is more than a "position paper." It is a code that they can enforce with reprimand, suspension or expulsion and then reporting that to State Medical Boards.
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Old 25th April 2017, 01:00 PM   #365
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Originally Posted by Giz View Post
Trump's "disqualifying behaviors" were on display during the election. The voters decided they didn't care.
Or simply didn't believe said behaviors would continue once Trump was elected.

Looking at it a different way, just because millions of people buy, use and believe in homeopathy doesn't make it any less bogus.
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Old 25th April 2017, 01:04 PM   #366
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Originally Posted by xjx388 View Post
Surely, you are professional enough to admit that your opinion of Trump's mental state, having not personally interviewed/examined him, is not worth anything in the context of coming to an actual diagnosis and that doing so publicly would be ethically wrong. Similarly, these psychiatrists are wrong.

Again, the reason why it's wrong is simple: How does the public differentiate between a profession rendering a professional opinion or a disgruntled private citizen with a medical degree using the veneer of "professionalism" to make a political attack?
Same question for you, the one no one taking your position can answer: which tests or exams would one do in-person to improve on the accuracy of the diagnosis?

You guys just keep asserting the same BS without being able to justify your assertion.

Which tests or exams would one do in-person to improve on the accuracy of the diagnosis?
Which tests or exams would one do in-person to improve on the accuracy of the diagnosis?
Which tests or exams would one do in-person to improve on the accuracy of the diagnosis?

Thought I'd save time in future posts and just ask the question repeatedly here.
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Old 25th April 2017, 01:08 PM   #367
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Originally Posted by xjx388 View Post
At the very least, one would need access to their medical chart which would have notes of previous clinical interviews, psych testing results, etc. I agree that an in person examination may not be strictly necessary, but certainly you need more than watching him on TV.


Sorry, that's the kind of answer one gives on a test to try to BS one's way through the answer.

Interviews? We have thousands of hours of interviews in the public record.

What test? What test would that be? Oh that's right, the imaginary magical test psychiatrists use.

As for more than watching him on TV, that shows your lack of understanding just what one is observing in Trump's behavior that consists of classic behavior of a narcissistic personality disorder.

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Old 25th April 2017, 01:17 PM   #368
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Originally Posted by BobTheCoward View Post
if he is psychologically incapable of competently discharging the duties of President of the United States, then how is he competently discharging the duties of the president of the United States right now?
Not very well.

Originally Posted by BobTheCoward View Post
Did he try to veto a piece of legislation and fail to make the signature? What duty is he not discharging?
He's not staffed the departments he needs to staff.
Of the staff he has hired, several had to be let go because of concerning ties to Russia.
He's put his unqualified kids in positions of power.
He's made dangerous undiplomatic statements both on Twitter and in person.
The dysfunction in the federal government is getting worse.

And that's not even getting into the kleptocracy issues.
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Old 25th April 2017, 01:19 PM   #369
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Originally Posted by Skeptic Ginger View Post
Not very well.



He's not staffed the departments he needs to staff.
Of the staff he has hired, several had to be let go because of concerning ties to Russia.
He's put his unqualified kids in positions of power.
He's made dangerous undiplomatic statements both on Twitter and in person.
The dysfunction in the federal government is getting worse.

And that's not even getting into the kleptocracy issues.
All of that is within the president's prerogative on how he or she wishes to execute the duties of the president. The president doesn't appear to have done something that would actually count as a failure to perform duties.
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Old 25th April 2017, 01:28 PM   #370
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Originally Posted by xjx388 View Post
The APA is different in that, unlike other bodies, it does indeed sanction it's members for ethical violations. It also reports more severe violations to the State Medical Board. No, the APA can't revoke a medical license but the State can based on the findings of the APA.
Link?

We are all required by law to report colleagues for certain behaviors, mostly diversion of narcotics, intoxicated on the job and any kind of patient abuse.

Losing one's license based on the findings of the APA? This is imaginary nonsense. Oh for pity's sake, do you think they hold trials?


Originally Posted by xjx388 View Post
Off-label prescribing carries risks, though. If a patient is harmed by off-label prescribing, that can be viewed as a breech of the standard of care even if it isn't illegal to prescribe off-label. Here in Texas, several doctors have lost their license (and a lot of money) for off-label prescribing that resulted in harm to the patient.
The same is true if a patient is harmed by an on-label use of a med if I'm negligent for any number of reasons. BTW, you don't lose your license because of a malpractice issue by itself.

Your post is full of evidence that you don't know what you are talking about. There's no sense in having this discussion when all you are doing is pulling stuff out or your nether regions.

Look up reasons MDs get their licenses suspended. You will find sexual abuse and drugs/alcohol related offenses almost exclusively dominate the reasons. A small percentage are disciplined for malpractice, usually because they came to work intoxicated or prescribed drugs the provider knew were being diverted.
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Old 25th April 2017, 01:47 PM   #371
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I had a much more thorough response but chrome crash will lead me to shorten this up.

Originally Posted by Skeptic Ginger View Post
The reason why stems from the nature of a personality disorder. There are classic behaviors one exhibits when one has a pathologic narcissistic personality disorder.

Trump displays these behaviors consistently and predictably. Just observing him throughout the campaign process was sufficient to make said diagnosis. The fact he continues to display the same classic behaviors only adds more proof to the pudding.
You in no way answered my question. I asked why state the abundance of resources when there is no evidence the shrinks giving their opinion examined any of them? For a. issue as big as they claim, they have not put forward any breakdown of their analysis, any papers covering how they reached their conclusion, nor any statements that express what they have gone over to reach said conclusions.

Putting forward the amount of footage means nothing. I have only seen one opinion from a psychologist that was based on viewing 600(?) hours of Trump footage (no breakdown of what kind of footage) which lead him to believe Trump has NPD. He also came to the same conclusion about Obama in the past.


Originally Posted by Skeptic Ginger View Post
This is a classic straw man.
I literally quoted the statement by the doctor. He used the word proved. How exactly is that a straw man, especially when I am referring to the implication of his opinion being made up from short random statements by Trump. Feel free to address my argument.

Originally Posted by Skeptic Ginger View Post
"This guy", as in a number of psychologists and psychiatrists who have made public statements?
.. This guy as in the specific guy I referenced. But sure, you can add them all in as well. Show me any statements, papers, evidence of any kind that they have spent the time to form their diagnosis from the vast amount of info available. For an issue so pressing, you would think they would have something to refer to on how they reached their conclusion. Am I really the only one that thinks that is an issue?

As well, the specific event referenced, purposefully stated that the organizer was the only one there that went against the Goldwater Rule. No other doctors on the panel did. So again, why should I base my opinions on the outlier of the group? Why is he right? Could it be because you agree with him?

[Edit] Also, should we ignore the diagnosis of others that don't believe Trump has NPD? As i referenced earlier -
Quote:
For example, I might quote Allen Frances who wrote the criteria most here are using to diagnosis Trump with NPD, who does not think Trump has NPD. I won't try to add any qualifier to his opinion beyond that statement being his opinion on the matter. I have no way of knowing how he came to it, or if it should be given more weight than any other shrinks diagnosis. It will stand on it's own.

Originally Posted by Skeptic Ginger View Post
The APA is a professional association. It's not a regulating body. Like most of these professional organizations they have position papers.

There are a number of psychiatric organizations including the American Psychiatric Nurses Association. You really need to stop denigrating nurses. But I digress.
Huh. You gave you opinion and tried to add weight to it with your occupation as a nurse. I referenced the opinion of the APA, an organization that encompasses a large number of doctors in the related field that disagree with your view. There is no need for them to hold regulatory power to reference their position on something.

Originally Posted by Skeptic Ginger View Post
You all really need to stop acting like the APA is a regulating body or a body that sets practice standards. The APA has opinion positions on practice standards. No one is held to those standards as a matter of law. If one harms a patient, the fact one didn't follow an accepted standard can have an influence on a court decision. It would never be the sole reason a provider lost his/her credentials... [Snip]
So I can't reference an organization that holds an opinion in opposition to yours, but you can reference your opinion and those of professionals who also hold it? As for all the other organizations you stated, which hold opinions in opposition to the APA in regards to this? Feel free to share any public statements they've made that support your view.


Originally Posted by Skeptic Ginger View Post
The ignorance in this thread about the significance of an APA position on this matter is a Dunning Kruger effect indeed.
So if I reference the position of any medical association within the field they specialize in, it is the Dunning Kruger effect? News to me.

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Old 25th April 2017, 02:07 PM   #372
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Originally Posted by xjx388 View Post
<snip>

As for the public right to know about the President's mental/medical state, I think it's sufficient that those who work with him every day -the VP and the Cabinet- can make that judgement call on our behalf.

ETA: Further than that: How does the public know when a professional is rendering a valid medical opinion or simply making a political attack under the guise of professionalism?

It is telling that you believe a group of hand-picked Trump subordinates could be counted upon to set aside their loyalties (and ticket to power) in favor of seeing their boss possibly removed from office, and still question the motives of a large group of medical professionals because of some completely unfounded suspicion that they might be politically motivated.

That says a lot more about your biases than theirs.
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Old 25th April 2017, 02:32 PM   #373
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Originally Posted by rdwight View Post
I had a much more thorough response but chrome crash will lead me to shorten this up.
Hate when that happens.

Originally Posted by rdwight View Post
... I asked why state the abundance of resources when there is no evidence the shrinks giving their opinion examined any of them?
It's a safe assumption given you can't get away from Trump here in the US. You're grasping at straws here.

Originally Posted by rdwight View Post
I literally quoted the statement by the doctor. He used the word proved. How exactly is that a straw man, especially when I am referring to the implication of his opinion being made up from short random statements by Trump. Feel free to address my argument.
You cited one single thing: "A statement on crowd size is proof he's delusional" when it is one of many many delusions we've seen Trump describe. It may well have been a single example but it is by no means the sole evidence Trump is delusional.

Originally Posted by rdwight View Post
.. This guy as in the specific guy I referenced. But sure, you can add them all in as well. Show me any statements, papers, evidence of any kind that they have spent the time to form their diagnosis from the vast amount of info available. For an issue so pressing, you would think they would have something to refer to on how they reached their conclusion. Am I really the only one that thinks that is an issue?
Same answer as to your second quote above, this argument isn't worth addressing.

Originally Posted by rdwight View Post
As well, the specific event referenced, purposefully stated that the organizer was the only one there that went against the Goldwater Rule. No other doctors on the panel did. So again, why should I base my opinions on the outlier of the group? Why is he right? Could it be because you agree with him?
Again, so what? I cited a petition that over 50,000 professionals signed. Even if only 1/4 of those are actual professionals, it's substantially more than one.

Originally Posted by rdwight View Post
[Edit] Also, should we ignore the diagnosis of others that don't believe Trump has NPD? As i referenced earlier -
Since I side with the NPD diagnosis, I can't comment on other professionals that side against it. This came up in an earlier discussion, some bigwig at Harvard IIRC, has a definition of mentally ill that mandates being unable to function. He was on the committee that developed the DSMIV (or 5). That's his prerogative. Not all his colleagues agree. I don't. I think Trump's disorder does indeed interfere with his functioning. Just because you get by doesn't mean you don't have pathology.

Originally Posted by rdwight View Post
Huh. You gave you opinion and tried to add weight to it with your occupation as a nurse. I referenced the opinion of the APA, an organization that encompasses a large number of doctors in the related field that disagree with your view. There is no need for them to hold regulatory power to reference their position on something.
You're mixing apples and oranges.

First, I'm a nurse practitioner, not just a nurse. Second, nurses most definitely have knowledge about psychiatric diagnoses.

As for the APA and regulatory authority, it's tiring to argue with people in this thread who have an imaginary view of what the APA is and what an APA position on practice standards means.

Bottom line, there is nothing here that means a psychiatrist voicing an opinion on Trump's mental health risks the professional's license. You all need to just drop that nonsense.

It's a position paper, nothing more. And as it turns out, it doesn't exactly apply to the current situation. Again, bottom line, this isn't Ginger vs the APA. It's many professionals vs many other professionals.


Originally Posted by rdwight View Post
So I can't reference an organization that holds an opinion in opposition to yours, but you can reference your opinion and those of professionals who also hold it? As for all the other organizations you stated, which hold opinions in opposition to the APA in regards to this? Feel free to share any public statements they've made that support your view.
More straw. I made no such argument. I said people in this thread including you don't have a good grasp on the significance of the Goldwater Rule. And you don't.


Originally Posted by rdwight View Post
So if I reference the position of any medical association within the field they specialize in, it is the Dunning Kruger effect? News to me.
More straw. Twist everything around so you can argue against it.

You conflate the APA with a regulatory body. Given however it was xjx388 who made up the fantasy the APA would report a psychiatrist and have some role in seeking disciplinary action, if you admit that is not your belief as well, then your ignorance of the significance of the Goldwater Rule is less.

But it's still ignorant. We do look to professional organizations for standards. But no one complies to those standards 100% without any objections.

In this case more than a few well qualified professionals have felt it was more important to speak up about Trump than to apply the Goldwater Rule. It's not that relevant to this case. It was written based on completely different circumstances.
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Old 25th April 2017, 02:52 PM   #374
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Originally Posted by xjx388 View Post
It can be regarded however you like. If the President challenges, then Congress has to vote on the matter. It would be hard to pull off such a move on purely political grounds.

<snip>

What a peculiar thing to say. You're kidding, I hope.

All that would be needed would be for a party to have enough control over the two houses to force the result they wanted. A two thirds vote from each house would do the trick. And they don't even have to use the 25th Amendment to do it.


Andrew Johnson was impeached for purely political motives, and only missed being removed from office by one Senate vote.

I suspect that any President actually removed from office will have arrived at that by politically motivated efforts as much if not more than because of any other consideration.
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Old 25th April 2017, 02:57 PM   #375
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In my opinion (with no professional training, just a lot of absorption of information) I'm not that concerned about his narcissistic personality disorder alone. What worries me is that he seems to be showing signs of dementia. He has a family history of Alzheimer's disease, and dementia *combined* with a narcissistic personality is extremely worrisome. Irritability, volatility and possible violent behavior on top of a need to always be the biggest and best, with confabulation to fill in the memory gaps ... does that sound at all familiar? Losing vocabulary and using the same words over and over as a result?

And that can be easily tested in a short screening. It's not a matter of opinion, it's a testable phenomenon. You may not be able to tell if it's officially Alzheimer's easily, but you can certainly diagnose dementia.
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Old 25th April 2017, 03:07 PM   #376
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Originally Posted by Skeptic Ginger View Post
Link?
Earlier, I linked to the APA's site where the "Principles of Medical Ethics." is published. You have to download the PDF.

Quote:
We are all required by law to report colleagues for certain behaviors, mostly diversion of narcotics, intoxicated on the job and any kind of patient abuse.

Losing one's license based on the findings of the APA? This is imaginary nonsense. Oh for pity's sake, do you think they hold trials?
If you review their "Principles of Medical Ethics," you will see where they outline procedures for investigating and resolving ethical complaints.

To wit:

Originally Posted by APA Code of Ethics
Complaints charging members of the American Psychiatric Association (APA) with unethical behavior or practices shall be investigated and resolved in accordance with procedures approved by the APA Assembly and the APA Board of Trustees. These procedures are congruent with the minimum requirements under the Health Care Quality Improvement Act. A District Branch (DB) of the APA may adopt additional requirements to comply with any additional or more stringent requirements of state law. A District Branch should notify the APA if additional requirements are adopted...

The DBEC shall appoint a panel of no less than three members to hear the complaint. All members should be ethics committee members when possible, and at least one must be. One member of the panel shall be selected to chair the Hearing Panel (Hearing Panel Chair) and shall be a voting member of the panel. ...

The Hearing
1. The hearing may consist of:
a An oral opening statement by the Complainant, and the Accused
Member or his/her Counsel;
b Testimony by the Complainant and any witnesses, and any written or
oral cross examination by Accused Member or his/her Counsel;
c Testimony by the Accused Member;
d Questions by the Hearing Panel members; and
e Presentation of any evidence determined to be relevant by the Hearing
Panel Chair, regardless of its admissibility in a court of law.
2. The Accused Member or his Counsel shall be permitted to make an oral
closing statement and/or submit a written statement at the close of the
hearing or within a reasonable time thereafter.
So yeah, they investigate complaints and then determine whether to reprimand, suspend or expel a member. In the latter two cases, they also report the action to the State licensing board and the National Provider Database. The State board can then decide to pursue it's own actions up to and including suspending or revoking a license.

Quote:
The same is true if a patient is harmed by an on-label use of a med if I'm negligent for any number of reasons. BTW, you don't lose your license because of a malpractice issue by itself.
Depends on the severity. The Texas Board of Medicine (and other States) bulletin is filled with docs who lose their licenses because of malpractice. Those docs are often referred to the medical board by peer review committees like the ones outlined by the APAs code of ethics.

Quote:
Your post is full of evidence that you don't know what you are talking about. There's no sense in having this discussion when all you are doing is pulling stuff out or your nether regions.
I've backed up what I've said with actual citations of the APA's code of ethics. You are simply wrong.

Quote:
Look up reasons MDs get their licenses suspended. You will find sexual abuse and drugs/alcohol related offenses almost exclusively dominate the reasons. A small percentage are disciplined for malpractice, usually because they came to work intoxicated or prescribed drugs the provider knew were being diverted.
Yes, those are the big reasons why docs' licenses get suspended/revoked. But they also get suspended/revoked for malpractice. This is venturing off topic but I'll just leave this here . . .

Texas Medical Board
Quote:
<doctor's name and license redacted>, Garland
On June 10, 2016, the Board entered a Final Order against S.S, M.D., which revoked his Texas medical
license. The Board found Dr. S failed to meet the
standard of care with respect to multiple patients by nontherapeutically
prescribing antibiotics without adequately determining
if the patients had a bacterial infection, nontherapeutically
prescribing codeine to patients with chronic bronchitis, by failing
to consider differential diagnoses, failing to maintain adequate
medical records and was in violation of his 2011 Board order.
The action was based on the findings of an administrative law
judge at the State Office of Administrative Hearings. This order
resolves a formal complaint filed at the State Office of Administrative
Hearings. Dr. S has 20 days from the service
of the order to file a motion for rehearing.
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Old 25th April 2017, 03:09 PM   #377
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Originally Posted by quadraginta View Post
It is telling that you believe a group of hand-picked Trump subordinates could be counted upon to set aside their loyalties (and ticket to power) in favor of seeing their boss possibly removed from office, and still question the motives of a large group of medical professionals because of some completely unfounded suspicion that they might be politically motivated.

That says a lot more about your biases than theirs.
All it says is what the Constitution says. No bias needed.
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Old 25th April 2017, 03:12 PM   #378
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If a physician did do an examination of Trump would he/she be able to discuss it without Trumps specific permission?

I'm guessing no.
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Old 25th April 2017, 03:19 PM   #379
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Originally Posted by Skeptic Ginger View Post
But you are misguided, fixated on something that isn't an absolute and isn't valid in this case.
It's obvious that someone in here is misguided. My money's on a family practice nurse who thinks she has more authority on the ethics of psychiatric practice than the APA.

If there are any psychologists reading this I invite them to diagnose the participants in this conversation based on their posts which, after all, constitute "public behavior". No examination required! per the very highest authority in the field.
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Old 25th April 2017, 03:28 PM   #380
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Originally Posted by Fidelio View Post
If a physician did do an examination of Trump would he/she be able to discuss it without Trumps specific permission?

I'm guessing no.

A normal physician visit, no.

Doctors who aren't his doctor can sit around and BS about him to their heart's content, though, if you want to call watching CNN and debates an "examination".
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Old 25th April 2017, 03:45 PM   #381
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Originally Posted by TragicMonkey View Post
It's obvious that someone in here is misguided. My money's on a family practice nurse who thinks she has more authority on the ethics of psychiatric practice than the APA.

If there are any psychologists reading this I invite them to diagnose the participants in this conversation based on their posts which, after all, constitute "public behavior". No examination required! per the very highest authority in the field.
^This^
Quote:
Responding to the criticism, Dr Gartner said: “This notion that you need to personally interview someone to form a diagnosis actually doesn’t make a whole lotta sense. For one thing, research shows that the psychiatric interview is the least statistical reliable way to make a diagnosis.”
Dr. Gartner is either a partisan liar, and/or a hack if he truly believes this. I am working in a mental health clinic, one which diagnoses and treats patients with a range of mental health issues, and an initial assessment(with the patient, not watching him on television) is a mandatory first step in a diagnosis. Dr. Gartner probably doesn't even know what the DSM-5 is and may soon be out of work.
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Old 25th April 2017, 03:46 PM   #382
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Originally Posted by Fidelio View Post
If a physician did do an examination of Trump would he/she be able to discuss it without Trumps specific permission?

I'm guessing no.
No. HIPPA regs are very clear on the privacy of medical records.
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Old 25th April 2017, 03:58 PM   #383
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Originally Posted by Skeptic Ginger View Post
It's a safe assumption given you can't get away from Trump here in the US. You're grasping at straws here.
No, it is literally just an assumption.

Originally Posted by Skeptic Ginger View Post
You cited one single thing: "A statement on crowd size is proof he's delusional" when it is one of many many delusions we've seen Trump describe. It may well have been a single example but it is by no means the sole evidence Trump is delusional.
Again, you literally skip over my point. I'm done repeating since you don't want to have an honest discussion.

Originally Posted by Skeptic Ginger View Post
Same answer as to your second quote above, this argument isn't worth addressing.
Ok, so you have no intention of defending your position. We should just agree, because -blank-.

If you have no interest in defending your position, what is the purpose of offering it? Is my idea that someone providing their opinion on here should show some proof? Do you not expect the same of trained professionals giving their professional opinion? I do, which is why i distrust professionals that provide no basis for how they formed their opinion, especially when they state that the stakes are high in regards to it.

I have a sneaky suspicion this is only the case with ideas you support. Why bother finding support for an argument that you already know is correct, amirite?

Originally Posted by Skeptic Ginger View Post
Again, so what? I cited a petition that over 50,000 professionals signed. Even if only 1/4 of those are actual professionals, it's substantially more than one.
Why bother even referencing a change.org petition. Might as well go reference the Architect and Engineer 911 truth petition in the conspiracy sub forum to support a position.

You would be better off citing the membership of Duty to Warn, which numbers in 2-3 dozen members, all mental health professionals. I'd put more weight in that.

Originally Posted by Skeptic Ginger View Post
Since I side with the NPD diagnosis, I can't comment on other professionals that side against it.
You don't have to comment on his diagnosis. The question remains why the diagnosis you agree with should hold more weight than the one you disagree with in this case.

In your mind, 'the argument isn't worth addressing'.


Originally Posted by Skeptic Ginger View Post
You're mixing apples and oranges.

First, I'm a nurse practitioner, not just a nurse. Second, nurses most definitely have knowledge about psychiatric diagnoses..[Snip]

[Snip]..Again, bottom line, this isn't Ginger vs the APA. It's many professionals vs many other professionals.
I am mixing nothing. You offered your opinion and said others support it. I offered the opinion of an association of professionals in that field that don't support it. No one said it was you against the world.

I referenced a large body of professionals and asked you to support your argument with a counter example of another large organization that agrees with you. Or a group. Or anything besides a vague 'many vs many'. 1,000 vs 100,000 is many vs many, but one is the minority opinion. Would you concede your opinion is in the minority, or back up your claim if you disagree? If posting history is any indication, I shouldn't expect anything at all.

Originally Posted by Skeptic Ginger View Post
More straw. I made no such argument. I said people in this thread including you don't have a good grasp on the significance of the Goldwater Rule. And you don't.
.. You really seem to like to say straw for some reason. I don't need a strong grasp of the Goldwater Rule to offer up the opinion of professionals that DO have a good grasp on it's significance. You are arguing against their opinion, not mine.

As well I have not referenced them in any way besides a differing view than the one you hold.

Again, you referenced a number of Associations in the field. I asked if any publicly hold your position. You didn't respond to that, so I have to assume they don't. So listing them is pointless. I think we all know there are other organizations in the field of mental health. The fact they exist means absolutely squat.


Originally Posted by Skeptic Ginger View Post
You conflate the APA with a regulatory body. Given however it was xjx388 who made up the fantasy the APA would report a psychiatrist and have some role in seeking disciplinary action, if you admit that is not your belief as well, then your ignorance of the significance of the Goldwater Rule is less.

But it's still ignorant. We do look to professional organizations for standards. But no one complies to those standards 100% without any objections.

In this case more than a few well qualified professionals have felt it was more important to speak up about Trump than to apply the Goldwater Rule. It's not that relevant to this case. It was written based on completely different circumstances.
I literally don't care at all about the Goldwater Rule. I didn't reference it in any of my posts besides ones where it was brought up by you. I never put any weight in their ability to enforce said rule, and I certainly am not looking to debate someone else's position on this.

I quoted you in reference to it because you seem to believe others are not capable of referencing professionals that have differing stances than you in regards to it as a counter argument to your claims. I felt and still feel that is a ridiculous notion. If a doctor claims vaccines cause autism, I don't need to understand the exact science to reference etymologists that do and refute the idea. You don't feel this is appropriate in this instance because -blank-.
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Old 25th April 2017, 04:03 PM   #384
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Originally Posted by xjx388 View Post
Politicians always say things that are provably false.

I like how one of the attributes most touted by Trump's supporters is that he's not a politician. Now, apparently, he's just like every other politician.

Originally Posted by Argumemnon View Post
Yeah but one has to take their conclusions with a grain of salt since they didn't do an actual examination of the guy. It's informed (and credible) speculation, but it's still speculation.

What about a personal interview would upgrade the conclusion to something more than speculation? I have yet to see anyone even attempt to answer similar questions.

At this point, the best answer seems to be, "Because reasons." That's a shame.

Originally Posted by Argumemnon View Post
I guess one of the questions boils down to whether Trump is acting up his public persona. Without actually meeting him in private it'd be hard to tell.

If it's a matter of fitness for the position, whether a person is actually crazy, or just acting crazy, is irrelevant. The answer to the question, "Is this person fit for the job," is, "No," in both cases.

Originally Posted by rdwight View Post
A statement on crowd size is proof he's delusional?

By definition. Of course, that depends on whether or not he actually believes it. At best, it's a delusional statement.

But if he insists on frequently making delusional statements, absent a personal evaluation indicating otherwise, there's only one reasonable course of action: treat him as if he's delusional. Even if a personal evaluation indicates otherwise, where's the logic in allowing such a person to continue making such statements in their current role?

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Old 25th April 2017, 04:15 PM   #385
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Originally Posted by xjx388 View Post
Earlier, I linked to the APA's site where the "Principles of Medical Ethics." is published. You have to download the PDF.


If you review their "Principles of Medical Ethics," you will see where they outline procedures for investigating and resolving ethical complaints.

To wit:



So yeah, they investigate complaints and then determine whether to reprimand, suspend or expel a member. In the latter two cases, they also report the action to the State licensing board and the National Provider Database. The State board can then decide to pursue it's own actions up to and including suspending or revoking a license.

Depends on the severity. The Texas Board of Medicine (and other States) bulletin is filled with docs who lose their licenses because of malpractice. Those docs are often referred to the medical board by peer review committees like the ones outlined by the APAs code of ethics.

I've backed up what I've said with actual citations of the APA's code of ethics. You are simply wrong.

Yes, those are the big reasons why docs' licenses get suspended/revoked. But they also get suspended/revoked for malpractice. This is venturing off topic but I'll just leave this here . . .

Texas Medical Board
Your example of discipline for malpractice doesn't even come close to the charge of making a public statement about a person's mental illness or violating the Goldwater Rule. Do you seriously not know the difference?

You continue to conflate the serious with the minor. You can't find a single case where the APA or any medical board cares about violations of the Goldwater Rule. It is a position, it is not a rule or regulation.


By the way, I can't find anything about the Goldwater Rule in that Principles of Medical Ethics citation.

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Old 25th April 2017, 04:19 PM   #386
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Originally Posted by Skeptic Ginger View Post
<snip>

You conflate the APA with a regulatory body. Given however it was xjx388 who made up the fantasy the APA would report a psychiatrist and have some role in seeking disciplinary action, if you admit that is not your belief as well, then your ignorance of the significance of the Goldwater Rule is less.

<snip>

I will await with some interest the impending flood of reports and defrocking of the medical professionals guilty of the heinous crime of expressing their professional opinions in a manner (supposedly) not sanctioned by their professional organizations.


With thousands of them imminent it should make quite a splash in the news.
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Old 25th April 2017, 04:23 PM   #387
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Old 25th April 2017, 04:25 PM   #388
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Originally Posted by Fidelio View Post
If a physician did do an examination of Trump would he/she be able to discuss it without Trumps specific permission?

I'm guessing no.
Only if court ordered.

This is another issue the lay public doesn't always have a complete understanding of.

Anything you learn about a patient in the course of your job is governed by confidentiality laws.

Anything you learn about a person who is not your patient and you didn't learn about through an illegal disclosure is not governed by confidentiality law. The information about Trump is in the public sphere. All these physicians are disclosing is their medical expertise.
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Old 25th April 2017, 04:27 PM   #389
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Originally Posted by TragicMonkey View Post
It's obvious that someone in here is misguided. My money's on a family practice nurse who thinks she has more authority on the ethics of psychiatric practice than the APA.
You're being very dishonest here.

You know damn well it is psychiatrists against psychiatrists and I merely support one side over the other.
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Old 25th April 2017, 04:32 PM   #390
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Originally Posted by Beerina View Post
A normal physician visit, no.

Doctors who aren't his doctor can sit around and BS about him to their heart's content, though, if you want to call watching CNN and debates an "examination".
More straw.

The nature of observations of Trump's behavior is not the equivalence of watching the news.

He is observed lying blatantly specifically when something threatens his ego. He sticks to the lie even in the face of overwhelming evidence it is a lie.

He is constantly obsessed with himself and how he's being portrayed, be it on the news or in any other public sphere, to the exclusion of other matters.

Remember, this is the guy who would call up magazine writers and tell stories about his conquests of women for them to report in their magazines.


Those are the kinds of observations being made.
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Old 25th April 2017, 04:35 PM   #391
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Originally Posted by bytewizard View Post
No. HIPPA regs are very clear on the privacy of medical records.
And for the record, HIPAA is not the only law governing medical confidentiality. We have a slew of state laws in addition.
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Old 25th April 2017, 04:38 PM   #392
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Originally Posted by bytewizard View Post
^This^


Dr. Gartner is either a partisan liar, and/or a hack if he truly believes this. I am working in a mental health clinic, one which diagnoses and treats patients with a range of mental health issues, and an initial assessment(with the patient, not watching him on television) is a mandatory first step in a diagnosis. Dr. Gartner probably doesn't even know what the DSM-5 is and may soon be out of work.
Diagnosing a patient you are then going to treat is a completely different situation.

As for Dr Gartner, I believe these are his credentials.
Quote:
I've been practicing psychotherapy and teaching psychiatrists at Johns Hopkins University Medical School for over twenty years. My areas of specialization are Borderline Personality Disorder (BPD), Bipolar Disorder, and Depression Borderlines have problems with impulsivity, mood swing, unstable relationships, and self destructive behaviors. Despite the seriousness of the condition, contrary to the stereotype, BPD is treatable, and I've had good outcomes in the vast majority of cases. It's intensive long term work, but with a properly trained therapist and a motivated patient the prognosis is good.

And you work in a mental health clinic.
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Old 25th April 2017, 04:40 PM   #393
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Originally Posted by Skeptic Ginger View Post
It's a safe assumption given you can't get away from Trump here in the US.
It most certainly is not. They are impugning the mental health of the President, and demanding he be removed from office on the basis of their opinion. There can be no assumptions here. They need to show their work.
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Old 25th April 2017, 04:42 PM   #394
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Originally Posted by rdwight View Post
No, it is literally just an assumption.

Again, you literally skip over my point. I'm done repeating since you don't want to have an honest discussion.

Ok, so you have no intention of defending your position. We should just agree, because -blank-.

If you have no interest in defending your position, what is the purpose of offering it? Is my idea that someone providing their opinion on here should show some proof? Do you not expect the same of trained professionals giving their professional opinion? I do, which is why i distrust professionals that provide no basis for how they formed their opinion, especially when they state that the stakes are high in regards to it.

I have a sneaky suspicion this is only the case with ideas you support. Why bother finding support for an argument that you already know is correct, amirite?

Why bother even referencing a change.org petition. Might as well go reference the Architect and Engineer 911 truth petition in the conspiracy sub forum to support a position.

You would be better off citing the membership of Duty to Warn, which numbers in 2-3 dozen members, all mental health professionals. I'd put more weight in that.

You don't have to comment on his diagnosis. The question remains why the diagnosis you agree with should hold more weight than the one you disagree with in this case.

In your mind, 'the argument isn't worth addressing'.

I am mixing nothing. You offered your opinion and said others support it. I offered the opinion of an association of professionals in that field that don't support it. No one said it was you against the world.

I referenced a large body of professionals and asked you to support your argument with a counter example of another large organization that agrees with you. Or a group. Or anything besides a vague 'many vs many'. 1,000 vs 100,000 is many vs many, but one is the minority opinion. Would you concede your opinion is in the minority, or back up your claim if you disagree? If posting history is any indication, I shouldn't expect anything at all.

.. You really seem to like to say straw for some reason. I don't need a strong grasp of the Goldwater Rule to offer up the opinion of professionals that DO have a good grasp on it's significance. You are arguing against their opinion, not mine.

As well I have not referenced them in any way besides a differing view than the one you hold.

Again, you referenced a number of Associations in the field. I asked if any publicly hold your position. You didn't respond to that, so I have to assume they don't. So listing them is pointless. I think we all know there are other organizations in the field of mental health. The fact they exist means absolutely squat.

I literally don't care at all about the Goldwater Rule. I didn't reference it in any of my posts besides ones where it was brought up by you. I never put any weight in their ability to enforce said rule, and I certainly am not looking to debate someone else's position on this.

I quoted you in reference to it because you seem to believe others are not capable of referencing professionals that have differing stances than you in regards to it as a counter argument to your claims. I felt and still feel that is a ridiculous notion. If a doctor claims vaccines cause autism, I don't need to understand the exact science to reference etymologists that do and refute the idea. You don't feel this is appropriate in this instance because -blank-.
I didn't skip any point. You claimed a diagnosis was 'proved' because of one of Trump's actions and I pointed out the diagnosis was not based on any one single thing.

What I don't want to do is impart a college education upon you in order to bring you up to speed.
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Old 25th April 2017, 04:44 PM   #395
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Originally Posted by bytewizard View Post
Dr. Gartner is either a partisan liar, and/or a hack if he truly believes this. I am working in a mental health clinic, one which diagnoses and treats patients with a range of mental health issues, and an initial assessment(with the patient, not watching him on television) is a mandatory first step in a diagnosis. Dr. Gartner probably doesn't even know what the DSM-5 is and may soon be out of work.

The Trump Psych Debate: Is It Wrong To Say He's Mentally Ill?

Quote:
...
At the time that Fact exposed Goldwater to this public humiliation, clinicians had no DSM, no book packed with diagnoses and outlining the criteria for each of them. That, Gartner said, is a big distinction between then and now. The DSM, he argued, gives us a set of “simple observable behavioral criteria for every mental disorder.” And he emphatically emphasized the “observable” part.


Each aspect of the quartet of “malignant narcissism,” Gartner said, is part of a diagnosis in the DSM. For all diagnoses, the DSM offers a summary topic sentence, followed by a list of criteria, and a person must meet some minimum number of these criteria to be diagnosed. Gartner had these at his fingertips and walked me through an example of antisocial disorder, which he asserted is the most serious of the quartet that he thinks Trump manifests. As he stepped through each criterion, Gartner cited examples of Trump’s behavior that he has observed—that anyone can have observed, he said—and concluded that with many such examples, Trump does in fact meet the criteria for this disorder.


And Gartner went a step further. “I doubt that interviewing Donald Trump would give them (a professional) a lot of information,” he said. “He runs circles around people, changes topic, never answers questions, I’m not sure that they would get a good deal” more from him. But, he argued, “We have tons of information about his behavior, his words, people who know him well, who have observed his behavior … we have so much information that it is screamingly obvious that he meets these diagnostic criteria.”
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Old 25th April 2017, 04:59 PM   #396
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Originally Posted by Skeptic Ginger View Post
You're being very dishonest here.

You know damn well it is psychiatrists against psychiatrists and I merely support one side over the other.
Accusatory, profane, petulant, and avoidant! Together with an implied ability to read minds. I wonder what our armchair psychologists make of that?
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Old 25th April 2017, 05:39 PM   #397
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Originally Posted by Skeptic Ginger View Post
Your example of discipline for malpractice doesn't even come close to the charge of making a public statement about a person's mental illness or violating the Goldwater Rule. Do you seriously not know the difference?
That example was meant to counter your claim that doctors don't lose their license for malpractice alone, not illustrate violations of the Goldwater Rule. A bit off-topic, perhaps, but responsive to your claim of: "BTW, you don't lose your license because of a malpractice issue by itself. "

Quote:
You continue to conflate the serious with the minor. You can't find a single case where the APA or any medical board cares about violations of the Goldwater Rule. It is a position, it is not a rule or regulation.
You continue to misunderstand the role of the APA in disciplining their members for ethics violations. You have stated several times that these ethical rules are just "position statements" when clearly, as illustrated by the APA's Principles of Medical Ethics, they are enforceable rules. Whether or not the APA would find (or have ever found, for that matter) violations of the "Goldwater Rule" a severe enough matter to suspend or expel anyone or refer them to a State Medical Board is irrelevant. The fact that the APAs ethical rules are enforceable is the important thing.

Quote:
By the way, I can't find anything about the Goldwater Rule in that Principles of Medical Ethics citation.
Section 7, Bullet 3. It's not officially called the Goldwater rule.
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Old 25th April 2017, 05:52 PM   #398
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Originally Posted by Skeptic Ginger View Post
More straw.

The nature of observations of Trump's behavior is not the equivalence of watching the news.

He is observed lying blatantly specifically when something threatens his ego. He sticks to the lie even in the face of overwhelming evidence it is a lie.
Or maybe he just enjoys messing with people who care so much about the size of his inauguration crowd. There are many ways to interpret his behavior and they don't all involve him being mentally ill.

Quote:
He is constantly obsessed with himself and how he's being portrayed, be it on the news or in any other public sphere, to the exclusion of other matters.
I can see how someone would say he's narcissistic. I certainly think so. However, one can be narcissistic without being "malignantly" narcissistic, whatever the hell that means -it's certainly not a diagnostic term. Most famous people are narcissists to some degree but that doesn't imply they are dangerously mentally ill.

Quote:
Remember, this is the guy who would call up magazine writers and tell stories about his conquests of women for them to report in their magazines.
Do you have a link to something documenting him doing this?
Quote:
Those are the kinds of observations being made.
Right. Not a very high quality of clinical information at all. Just various reports that may or may not be true and observations of him in interviews, debates etc. Great doctoring there!
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Old 25th April 2017, 06:26 PM   #399
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Originally Posted by TragicMonkey View Post
Accusatory, profane, petulant, and avoidant! Together with an implied ability to read minds. I wonder what our armchair psychologists make of that?
Damn isn't among the censored words.

It's not me against the experts, it's me on one side of a battle between experts. I merely pointed out your ad hom argument:
Quote:
It's obvious that someone in here is misguided. My money's on a family practice nurse who thinks she has more authority on the ethics of psychiatric practice than the APA.
So unless you were seriously arguing on my side, you are using an ad hom fallacy to make your case.

And now you pile ad homs on: "armchair psychologists".

It's dishonest to leave out the GLARING fact there is a disagreement between professionals.

If anyone here is playing armchair psychology, it's the people who don't understand the lack of relevance of the Goldwater Rule.
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Old 25th April 2017, 06:30 PM   #400
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Originally Posted by xjx388 View Post
That example was meant to counter your claim that doctors don't lose their license for malpractice alone, not illustrate violations of the Goldwater Rule. A bit off-topic, perhaps, but responsive to your claim of: "BTW, you don't lose your license because of a malpractice issue by itself. "

You continue to misunderstand the role of the APA in disciplining their members for ethics violations. You have stated several times that these ethical rules are just "position statements" when clearly, as illustrated by the APA's Principles of Medical Ethics, they are enforceable rules. Whether or not the APA would find (or have ever found, for that matter) violations of the "Goldwater Rule" a severe enough matter to suspend or expel anyone or refer them to a State Medical Board is irrelevant. The fact that the APAs ethical rules are enforceable is the important thing.

Section 7, Bullet 3. It's not officially called the Goldwater rule.
So you cite an example that has no relevance?

No one is being disciplined by the APA for stating publicly that they believe Trump has a pathology. Until you figure that out, all your arguments are irrelevant.

I'm sorry you don't like it but I'm not going to argue this with you anymore. Bump the thread when someone is actually disciplined for this.


Section 7:
Quote:
A physician shall recognize a responsibility to participate in activities contributing to the
improvement of the community and the betterment of public health.
3)
Quote:
On occasion psychiatrists are asked for an opinion about an individual who is in the light
of public attention or who has disclosed information about himself/herself through public media.
In such circumstances, a psychiatrist may share with the public his or her expertise about
psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional
opinion unless he or she has conducted an examination and has been granted proper
authorization for such a statement.
Nothing new here. We already know the APA's position that it is unethical. No one is arguing that.

The problem is, not all psychiatrists agree with this guideline in this case. And the fact it is in the APA's ethics position paper does not mean it will ever be applied to a professional to challenge their license. That is the GLARING part many in this thread don't understand.

Last edited by Skeptic Ginger; 25th April 2017 at 06:35 PM.
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