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Tags !MOD BOX WARNING! , donald trump , mental illness issues , psychiatry incidents , psychiatry issues , Trump controversies

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Old 17th February 2020, 01:27 PM   #361
theprestige
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Originally Posted by Belz... View Post
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.
Experts have to earn trust the same as everyone else. And at the end of the day, their opinions have to be scrutable to the lay audiences they are trying to address.

Opinions from experts in a poorly regulated, unsupervised profession probably shouldn't be trusted just because they're experts. You don't necessarily want the opinions of Blackwater veterans, on the topic of destroying the village versus saving the village.

Likewise, opinions from experts who break from their profession's regulations or standards probably also shouldn't be trusted just because they're experts. The whole point of regulating and standardizing a profession is to make it more trustworthy. When a professional presents their "expert" opinion, you know it's reliable because it's consistent with the framework of reliability established by their profession. This is the fundamental problem the Yale group faces: They want all the advantages that accrue to a profession that has established its trustworthiness, but also all the advantages of departing from their profession's framework of trustworthiness.
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Old 17th February 2020, 02:33 PM   #362
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Originally Posted by theprestige View Post
Experts have to earn trust the same as everyone else. And at the end of the day, their opinions have to be scrutable to the lay audiences they are trying to address.

Opinions from experts in a poorly regulated, unsupervised profession probably shouldn't be trusted just because they're experts. You don't necessarily want the opinions of Blackwater veterans, on the topic of destroying the village versus saving the village.

Likewise, opinions from experts who break from their profession's regulations or standards probably also shouldn't be trusted just because they're experts. The whole point of regulating and standardizing a profession is to make it more trustworthy. When a professional presents their "expert" opinion, you know it's reliable because it's consistent with the framework of reliability established by their profession. This is the fundamental problem the Yale group faces: They want all the advantages that accrue to a profession that has established its trustworthiness, but also all the advantages of departing from their profession's framework of trustworthiness.
In the particular case of the experts who are the topic of this thread:

There is no evidence that they have contravened the clinical standards of their profession in a way that would bring their assessment of Donald Trumpís mental health into question. Their expert opinion on Donald Trumpís mental heath was arrived at using the standards of their profession. It is reliable. Their opinions are scrutable to the lay audience they are addressing.

They are not practicing in a poorly regulated or unsupervised profession.

There is no evidence that they want ďadvantagesĒ. In what way does their published opinion provide them with advantages?

The argument is that they should not publicize their opinions of Trumpís mental health due to a regulation of an organization that they may or may not belong to. This has nothing to do with the validity of their argument.
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Old 17th February 2020, 03:26 PM   #363
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Originally Posted by Steve View Post
In the particular case of the experts who are the topic of this thread:



There is no evidence that they have contravened the clinical standards of their profession in a way that would bring their assessment of Donald Trumpís mental health into question. Their expert opinion on Donald Trumpís mental heath was arrived at using the standards of their profession. It is reliable. Their opinions are scrutable to the lay audience they are addressing.
You are quite clearly off base here. There is no standard of practice for distant diagnosis. There is no methodology that has been peer reviewed and adopted by the profession.

What they are doing has exactly one, somewhat equivalent, precedent: Barry Goldwater. An ethical rule was created to prevent a similar debacle. In the 50+ years since then, there has not been any research whatsoever on the reliability of clinical impressions formed from public domain information.



Quote:
The argument is that they should not publicize their opinions of Trumpís mental health due to a regulation of an organization that they may or may not belong to. This has nothing to do with the validity of their argument.
Putting aside ethics, what evidence do you have that the Yale Group used the standards of their profession to arrive at a valid and reliable expert opinion?
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Old 17th February 2020, 03:27 PM   #364
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Originally Posted by theprestige View Post
Experts have to earn trust the same as everyone else. And at the end of the day, their opinions have to be scrutable to the lay audiences they are trying to address.
That's a catch 22 in this case. The professionals who publicly reported their duty to warn couldn't have done that if you and xjx had your way. How are they supposed to address a lay audience if they can't speak up?

"We'd like to warn you about Trump but we can't"?

Quote:
Opinions from experts in a poorly regulated, unsupervised profession probably shouldn't be trusted just because they're experts. You don't necessarily want the opinions of Blackwater veterans, on the topic of destroying the village versus saving the village.

Likewise, opinions from experts who break from their profession's regulations or standards probably also shouldn't be trusted just because they're experts. The whole point of regulating and standardizing a profession is to make it more trustworthy. When a professional presents their "expert" opinion, you know it's reliable because it's consistent with the framework of reliability established by their profession. This is the fundamental problem the Yale group faces: They want all the advantages that accrue to a profession that has established its trustworthiness, but also all the advantages of departing from their profession's framework of trustworthiness.
What bull ****.

And at a minimum you should stop calling an opinion of a professional organization a regulation. It is not a regulation.

The Yale report speaks for itself and will stand the test of time. And they've supported their decision not to follow the Goldwater Rule. Something xjx has failed do in supporting the rebuttal other than to stamp his feet and assert, "but but it's a rule!!!"
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Old 17th February 2020, 03:29 PM   #365
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Originally Posted by xjx388 View Post
...what evidence do you have that the Yale Group used the standards of their profession to arrive at a valid and reliable expert opinion?
OMG, you're back to this nonsense?
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Old 17th February 2020, 03:31 PM   #366
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Originally Posted by Steve View Post
In the particular case of the experts who are the topic of this thread:

There is no evidence that they have contravened the clinical standards of their profession in a way that would bring their assessment of Donald Trumpís mental health into question. Their expert opinion on Donald Trumpís mental heath was arrived at using the standards of their profession. It is reliable. Their opinions are scrutable to the lay audience they are addressing.

They are not practicing in a poorly regulated or unsupervised profession.

There is no evidence that they want ďadvantagesĒ. In what way does their published opinion provide them with advantages?

The argument is that they should not publicize their opinions of Trumpís mental health due to a regulation [an official position] statement of an organization that they may or may not belong to. This has nothing to do with the validity of their argument.
This is an excellent post so forgive me that pedantic correction.
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Old 17th February 2020, 03:40 PM   #367
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Originally Posted by Skeptic Ginger View Post
The Yale report speaks for itself and will stand the test of time. And they've supported their decision not to follow the Goldwater Rule. Something xjx has failed do in supporting the rebuttal other than to stamp his feet and assert, "but but it's a rule!!!"
Talk about bull ******

xjx has linked directly to the APA's Ethics Committee opinion several times in this thread. Every point you have raised here has been addressed, not by me; but, by the APA.
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Old 17th February 2020, 03:43 PM   #368
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Originally Posted by Skeptic Ginger View Post
This is an excellent post so forgive me that pedantic correction.
Thank you. I never mind corrections that are informative and increase accuracy.
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Old 17th February 2020, 03:47 PM   #369
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Originally Posted by Skeptic Ginger View Post
OMG, you're back to this nonsense?
You assert it's nonsense but you don't support your assertions.

Can you cite the evidenced-based standard of practice that they are utilizing to make their professional opinion?

Can you rebut this from the ethical opinion of the APA?
Quote:
Basing professional opinions on a subset of behavior exhibited in the public sphere, even in the digital age where information may be abundant, is insufficient to render professional opinions and is a misapplication of psychiatric practice.
When you can do those two things, you might have a point about "nonsense."
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Old 17th February 2020, 04:07 PM   #370
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Originally Posted by Steve View Post
Thank you. I never mind corrections that are informative and increase accuracy.
Oh really? Try this on for size:

Quote:
In the particular case of the experts who are the topic of this thread:

There is no evidence that they have contravened the clinical standards of their profession in a way that would bring their assessment of Donald Trump’s mental health into question. Their expert opinion on Donald Trump’s mental heath was not arrived at using the standards of their profession. It is reliable a misapplication of psychiatric practice.
Now it's an informative and accurate correction.
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Old 17th February 2020, 04:22 PM   #371
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Originally Posted by xjx388 View Post
Oh really? Try this on for size:



Now it's an informative and accurate correction.
Does not fit. Your size is all wrong.
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Old 17th February 2020, 04:35 PM   #372
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Originally Posted by Steve View Post
Does not fit. Your size is all wrong.
Cute quip, and I really didn't expect you to thank me.

But it does seem that another correction is in order:
Originally Posted by steve
Thank you. I never mind corrections that are informative and increase accuracy. confirm my biases.
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Old 17th February 2020, 04:56 PM   #373
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Originally Posted by xjx388 View Post
Talk about bull ******

xjx has linked directly to the APA's Ethics Committee opinion several times in this thread. Every point you have raised here has been addressed, not by me; but, by the APA.
For the most part that simply repeats the rule itself and that they stand by the position.

There is this which clearly notes there are exceptions to diagnosing without a face to face exam:
Quote:
. In some circumstances, such as forensic evaluations, psychiatrists may evaluate individuals based on other legal authorization such as a court order. Psychiatrists are ethically prohibited from evaluating individuals without permission or other authorization
Getting a court order doesn't add to the accuracy of the diagnosis. So let's at least dispense with the nonsense Trump might not have pathologic narcissism.

That get's back to duty to warn. Other than reiterating they don't believe that should be an exception, it's still two groups of professionals who have a different opinions from each other.

None of that addresses a POTUS, or Trump, or the danger of this particular diagnosis, and most importantly, Yale et al haven't used any confidential information acquired in the line of duty so nothing is at issue here except the professional opinion.

Since the APA opinion applies to members, an individual professional has the absolute right to use their expertise as they see fit.

In the end all you have is a difference of opinion.
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Old 17th February 2020, 05:00 PM   #374
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Originally Posted by xjx388 View Post
Talk about bull ******

xjx has linked directly to the APA's Ethics Committee opinion several times in this thread. Every point you have raised here has been addressed, not by me; but, by the APA.
Pretty sure everyone who cares in this thread has already seen that opinion.

Originally Posted by xjx388 View Post
... not by me ...
There's the rub. I think it's your opinion of that opinion that people have an issue with.
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Old 17th February 2020, 07:35 PM   #375
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Originally Posted by Skeptic Ginger View Post
For the most part that simply repeats the rule itself and that they stand by the position.



There is this which clearly notes there are exceptions to diagnosing without a face to face exam:Getting a court order doesn't add to the accuracy of the diagnosis. So let's at least dispense with the nonsense Trump might not have pathologic narcissism.



That get's back to duty to warn. Other than reiterating they don't believe that should be an exception, it's still two groups of professionals who have a different opinions from each other.



None of that addresses a POTUS, or Trump, or the danger of this particular diagnosis, and most importantly, Yale et al haven't used any confidential information acquired in the line of duty so nothing is at issue here except the professional opinion.



Since the APA opinion applies to members, an individual professional has the absolute right to use their expertise as they see fit.



In the end all you have is a difference of opinion.


Ok. Thanks for that.

When a doctor decides not to be a member of a professional association, they are not bound by the ethics code of that organization. I accept that. Thereís no sanction such a doctor could face unless they violate a Medical Board rule or a law.

Does this mean that they get to make up their own ethics rules? Is the law and their conscience the only guide? I canít accept a yes answer to either of those questions.

A doctor either acts ethically or they donít. There has to be some objective standard by which to judge their actions. This idea of idiosyncratic ethics cannot be it.
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Old 17th February 2020, 07:56 PM   #376
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Originally Posted by xjx388 View Post
...
Does this mean that they get to make up their own ethics rules? ....
You keep arguing this all or none straw man. Personally I would not want a physician who didn't override 'the rules' when in their professional judgement it was called for. Dogmatism in medicine is dangerous.
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Old 17th February 2020, 08:08 PM   #377
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Originally Posted by xjx388
Does this mean that they get to make up their own ethics rules? Is the law and their conscience the only guide? I canít accept a yes answer to either of those questions.
Well then don't accept yes because no one in this thread is asking you to. I'd ask why the hell you have such a hard time this with but I think I see your problem.

Originally Posted by xjx388
A doctor either acts ethically or they donít.
This is not true in the world of reality. Gray areas are all over the place.

Originally Posted by xjx388
There has to be some objective standard by which to judge their actions.
No. And this could probably mean that you have no idea what ethics actually are. Ethics are shared opinions about what people want in each others behavior. There is no objective standard built in to nature nor handed down by God.

Originally Posted by xjx388
This idea of idiosyncratic ethics cannot be it.
I don't see a single person in this thread proposing an idiosyncratic idea of ethics.
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Old 18th February 2020, 10:21 AM   #378
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Originally Posted by Skeptic Ginger View Post
You keep arguing this all or none straw man. Personally I would not want a physician who didn't override 'the rules' when in their professional judgement it was called for. Dogmatism in medicine is dangerous.
I agree in the sense that I don't think dogmatism in any endeavor is ever appropriate. I do acknowledge that there are grey areas.

However, even if ethics is not applied dogmatically, there are still ethical guidelines that require consideration and interpretation. You noted that the APA's Ethcs code doesn't apply to nonmembers. Well, ok then: which ethical codes do they use as a guide to their professional judgement?

There has to be some overarching, objective and external set of ethics that apply to the profession as a whole. Reading your words, it almost sounds as if you believe ethics is idiosyncratic, subjective and internal.
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Old 18th February 2020, 11:14 AM   #379
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Originally Posted by RecoveringYuppy View Post
Well then don't accept yes because no one in this thread is asking you to. I'd ask why the hell you have such a hard time this with but I think I see your problem.
Look, I get it. You don't agree with me and you think I'm way off base. Fine. Consider me informed as such.

Quote:
This is not true in the world of reality. Gray areas are all over the place.
Yes, there are gray areas. Still, doctors either act ethically when confronted with a grey area or they don't. We can externally judge whether or not that ethical decision was sound.


Quote:
No. And this could probably mean that you have no idea what ethics actually are. Ethics are shared opinions about what people want in each others behavior. There is no objective standard built in to nature nor handed down by God.
??? You must be confused; I never mentioned God or nature. The profession is responsible for creating the ethics code. Those "shared opinions" have been formalized into a Code of Ethics. That is the objective standard by which we can judge the actions of professionals.

Quote:
I don't see a single person in this thread proposing an idiosyncratic idea of ethics.
Well, let's put it this way: If there is no external and objective ethical code; what else could it be but idiosyncratic?
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Old 18th February 2020, 11:27 AM   #380
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Originally Posted by xjx388 View Post
That is the objective standard by which we can judge the actions of professionals.
No, that is your subjective opinion that we grant it primacy. That does not make it objective. It's hand-waving the subjectivity away.

Originally Posted by xjx388 View Post
Well, let's put it this way: If there is no external and objective ethical code; what else could it be but idiosyncratic?
I quite literally just told you. They are shared opinions. Idiosyncratic means individual. Ethic codes are not individual.


This is what makes people want to make the subject about you. You don't appear to be disagreeing on this point, you appear to be failing to even hear it. You put "shared opinion" in scare quotes. Why?
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Old 18th February 2020, 12:48 PM   #381
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Originally Posted by RecoveringYuppy View Post
No, that is your subjective opinion that we grant it primacy. That does not make it objective. It's hand-waving the subjectivity away.
Ok, if ethical codes are not objective standards and they donít have primacy in judging the actions of professionals...what good are they?
Quote:
I quite literally just told you. They are shared opinions. Idiosyncratic means individual. Ethic codes are not individual.
Those ďshared opinionsĒ are what Iíve said all along: the various ethics codes of the medical profession which all derive from the AMAís code of ethics. If an individual rejects certain parts of the ethics code, itís no longer a shared code; it then becomes idiosyncratic to that individual.

Remember, SG made the argument that if one is not a member of the APA, the APA ethics code does not apply to them. They have, essentially rejected that ethics code and operate based on -well, SG hasnít told me what she thinks but IMO, they must operate on their own internal code. Apparently, her argument is that we canít say they are unethical simply because they donít agree to share the ethics of their profession. They have created a code that is their own: An internal, idiosyncratic code.

Quote:
This is what makes people want to make the subject about you.
They shouldnít do that. Itís against the ethical code we share as members of this forum.
Quote:
You don't appear to be disagreeing on this point, you appear to be failing to even hear it. You put "shared opinion" in scare quotes. Why?
Uh...because Iím using your words? I donít necessarily agree that ethics is as simple as ďshared opinion,Ē but Iíll use it for simplicity and the sake of argument.

I hear the argument and I disagree with it. There is either an external objective code that all in the group agree to or there are only internal, idiosyncratic codes.
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Old 18th February 2020, 06:04 PM   #382
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Originally Posted by xjx388 View Post
Still, doctors either act ethically when confronted with a grey area or they don't.


Hmmm....Looks to me like you're struggling with the concept of "grey area".
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Old 18th February 2020, 06:33 PM   #383
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Originally Posted by Cabbage View Post
Hmmm....Looks to me like you're struggling with the concept of "grey area".

Nope. I donít think there is much grey area in the first place. But maybe if you have an illustrative example?
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Old 18th February 2020, 06:50 PM   #384
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Originally Posted by xjx388 View Post
Nope. I donít think there is much grey area in the first place. But maybe if you have an illustrative example?

I am simply talking about the fundamental concept of a grey area, period. The mere fact that something is a "grey area" means it is not so black and white as your "doctors either act ethically when confronted with a grey area or they don't" makes it out to be. By definition, ethical concerns regarding grey areas are debatable, not simply is or is not ethical.

Maybe you should try looking up the term in the dictionary? That may help your misunderstanding. Here, I'll help you:

Quote:
an area or situation in which it is difficult to judge what is right and what is wrong
https://www.merriam-webster.com/dictionary/gray%20area
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Old 18th February 2020, 08:16 PM   #385
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Originally Posted by Cabbage View Post
I am simply talking about the fundamental concept of a grey area, period. The mere fact that something is a "grey area" means it is not so black and white as your "doctors either act ethically when confronted with a grey area or they don't" makes it out to be. By definition, ethical concerns regarding grey areas are debatable, not simply is or is not ethical.



Maybe you should try looking up the term in the dictionary? That may help your misunderstanding. Here, I'll help you:







https://www.merriam-webster.com/dictionary/gray%20area
Any medical decision is either in accord with ethics or it is not. A particular situation may arise that is difficult to judge what the ethical decision is. This does not imply itís impossible to do so or that the existence of the gray area is justification to eschew ethics altogether.

Those gray areas are the time to seek further guidance, not simply use ďprofessional judgmentĒ to basically make **** up as you go. Thatís the path to bad decisions. Ask yourself why Yale didnít want their name attached to the conference Lee, et. al., organized.

Hospitals, research facilities, universities and larger clinics have ethics committees for the gray areas. Individual doctors can seek ethics opinions from the medical societies, professional organizations, State medical boards and other sources.

Gray areas are navigable with guidance.
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Old 18th February 2020, 08:24 PM   #386
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Originally Posted by xjx388 View Post
Any medical decision is either in accord with ethics or it is not. .....
Stop right there. What kind of black and white world do you live in?

Is abortion ethical? Is it unethical?

(True story) If a married man is diagnosed with an STD and asks you to keep that confidential from his wife, how do you do that?

(Another true story) You diagnose an elderly man with cancer and the family asks you not to tell him. What if that family is from a country in Asia where keeping that diagnosis from one's parents is the cultural norm?

Quote:
Gray areas are navigable with guidance.
Whose guidance?

(Another true story) Non-English speaking family comes in the ED with a vomiting child. They show the doctor a coffee can with the emesis in it. The can also has cigarette butts in it (their ashtray) and the doctor thinks they are trying to say the kid ate cigarettes.

Doctor has the staff give the kid ipecac. Meanwhile the translator arrives and explains what happened.

Now the kid starts vomiting and the family doesn't quite get it why so they insist on medication. The kid was otherwise OK.

Several ED docs consult with each other and decide to prescribe cherry syrup to make the family happy. There are a dozen ethical dilemmas there.
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Old 18th February 2020, 08:37 PM   #387
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Donald Trump has 'dangerous mental illness' say psychiatry experts at Yale... Pt 3

Originally Posted by Skeptic Ginger View Post
Stop right there. What kind of black and white world do you live in?
Well, letís see:



Quote:
Is abortion ethical? Is it unethical?
Done within the confines of the law, ethical. As is the refusal to perform an abortion because of a doctorís personal convictions.



Quote:
(True story) If a married man is diagnosed with an STD and asks you to keep that confidential from his wife, how do you do that?
You donít reveal it to his wife, as the ethics of confidentiality require. Also, HIPAA



Quote:
(Another true story) You diagnose an elderly man with cancer and the family asks you not to tell him. What if that family is from a country in Asia where keeping that diagnosis from one's parents is the cultural norm?
Informed consent trumps cultural issues. You tell the patient: UNLESS, as specified in the ethical code, there is reason to believe some significant harm to the patient might result from the disclosure.


Quote:
Whose guidance?
Ultimately, the AMA code of ethics.

Quote:
(Another true story) Non-English speaking family comes in the ED with a vomiting child. They show the doctor a coffee can with the emesis in it. The can also has cigarette butts in it (their ashtray) and the doctor thinks they are trying to say the kid ate cigarettes.

Doctor has the staff give the kid ipecac. Meanwhile the translator arrives and explains what happened.

Now the kid starts vomiting and the family doesn't quite get it why so they insist on medication. The kid was otherwise OK.

Several ED docs consult with each other and decide to prescribe cherry syrup to make the family happy. There are a dozen ethical dilemmas there.
No ethical dilemmas at all, actually, just really bad medical judgement. Should have waited for the translator and gotten it right from the beginning.
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Old 18th February 2020, 08:53 PM   #388
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Originally Posted by xjx388 View Post
Well, let’s see:

Done within the confines of the law, ethical. As is the refusal to perform an abortion because of a doctor’s personal convictions.
You don't appear to recognize the difference between ethics and local laws. Hint: they are not the same.

The next one though, holy cow! Think about what you said here.
Quote:
You don’t reveal it to his wife, as the ethics of confidentiality require. Also, HIPAA
You think a confidentiality law overrides the obvious duty to warn?

That spouse needs treatment. If it was HIV (in the real case it was, I just didn't want to clutter up the case) that spouse will die without treatment. And you think the ethics of a HIPAA law is more important!

See, there is a real answer here and you and a couple of the doctors in this case are ignorant of the law. Reporting to a person they have been exposed to an infectious disease overrides HIPPA. It's called public health exception.

Once again you are conflating ethics with laws.

Quote:
Informed consent trumps cultural issues. You tell the patient: UNLESS, as specified in the ethical code, there is reason to believe some significant harm to the patient might result from the disclosure.
This has nothing to do with informed consent. And cultural issues are extremely important in medicine.


I edited in another example.
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Old 18th February 2020, 09:02 PM   #389
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Originally Posted by xjx388 View Post
Any medical decision is either in accord with ethics or it is not.

You're still struggling with the concept of "grey area", I see. I've done my part to help; I can't teach if you simply refuse to listen.
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Old 18th February 2020, 09:09 PM   #390
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Originally Posted by Cabbage View Post
You're still struggling with the concept of "grey area", I see. I've done my part to help; I can't teach if you simply refuse to listen.
I wholeheartedly agree; you canít teach.
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Old 18th February 2020, 09:20 PM   #391
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I note again that the Yale doctors are not Trump's doctors, and he is not their patient. They are using their unique knowledge and experience to interpret publicly available information about a notorious public figure and powerful public official. If Trump was appearing in public obviously drunk, or displaying symptoms of Parkinson's or MS, nobody would tell doctors to keep their mouths shut. Nobody would say "The President keeps falling down, but it's none of our business." Obvious psychiatric disturbance is just no different.
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Old 18th February 2020, 10:09 PM   #392
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Originally Posted by Skeptic Ginger View Post
You don't appear to recognize the difference between ethics and local laws. Hint: they are not the same.
They are not the same. But breaking the law is unethical.

Quote:
The next one though, holy cow! Think about what you said here.
You think a confidentiality law overrides the obvious duty to warn?
Hell yes, it does.

Quote:
That spouse needs treatment. If it was HIV (in the real case it was, I just didn't want to clutter up the case) that spouse will die without treatment. And you think the ethics of a HIPAA law is more important!
Now you are moving the goalposts. Still, we have dealt with HIV disclosure issues before. We report to the State, the State handles partner disclosure. We also encourage the patient to self-disclose before that happens.

Quote:
See, there is a real answer here and you and a couple of the doctors in this case are ignorant of the law. Reporting to a person they have been exposed to an infectious disease overrides HIPPA. It's called public health exception.
For certain infectious diseases covered by other law, yes. Paramount in any ethical decision on partner disclosure is complying with the law. If the State mandates or specifically allows partner disclosure directly by the doctor, then do it. If the law does not allow it, then donít.

Quote:
Once again you are conflating ethics with laws.
Ethics requires following the law.

Quote:
This has nothing to do with informed consent. And cultural issues are extremely important in medicine.
Sure, but more important is the duty to the patient. The patient has a fundamental right to know their diagnosis and a fundamental right to consent to treatment. You incorporate the cultural concerns by including the family in the discussion and finding out, ultimately, how the patient wants to handle these issues -itís their choice.


Quote:
I edited in another example.
I saw that and edited mine. In short, bad medical judgement, not really ethics.
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Old 18th February 2020, 10:37 PM   #393
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Originally Posted by xjx388 View Post
I wholeheartedly agree; you canít teach....

...someone who refuses to listen--yes, that is absolutely correct!

You can twist someone's words around to fit your agenda, however--I'll certainly give you that credit.
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Old 18th February 2020, 10:38 PM   #394
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Originally Posted by xjx388 View Post
But breaking the law is unethical.

You have a very naive and ignorant definition of "unethical". So naive and ignorant, in fact, it's absolutely worthless.
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Old 18th February 2020, 10:39 PM   #395
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Originally Posted by xjx388 View Post
Ethics requires following the law.....

according to you. Intelligent people, on the other hand, disagree.


Back in Nazi Germany you would have been turning Jews over to the state left and right--To do so would be unethical.

You said so yourself!

And this is why I treat your opinions with utter contempt.

So now you know.

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Old 18th February 2020, 10:55 PM   #396
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Originally Posted by Cabbage View Post
...someone who refuses to listen--yes, that is absolutely correct!



You can twist someone's words around to fit your agenda, however--I'll certainly give you that credit.


When you edit someoneís post itís polite to point that out.
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Old 18th February 2020, 11:03 PM   #397
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Originally Posted by xjx388 View Post
Hell yes, it does.
No it does not. That's idiotic. I don't care if the guy with the STD doesn't want to tell his sex partners. He can't do that.

Quote:
Now you are moving the goalposts. Still, we have dealt with HIV disclosure issues before. We report to the State, the State handles partner disclosure. We also encourage the patient to self-disclose before that happens.
No one moved any goal post. You don't have enough knowledge to recognize STDs and HIV are treated the same as far as partner notification goes. There are some differences with testing and informed consent but not with post diagnosis requirements to inform partners.

Quote:
For certain infectious diseases covered by other law, yes. Paramount in any ethical decision on partner disclosure is complying with the law. If the State mandates or specifically allows partner disclosure directly by the doctor, then do it. If the law does not allow it, then don’t.
So you'd let an exposed person go un-notified if the legislators in all their practicing medicine without a license wisdom wrote a flawed law?

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

Quote:
Ethics requires following the law.


Quote:
Sure, but more important is the duty to the patient. The patient has a fundamental right to know their diagnosis and a fundamental right to consent to treatment. You incorporate the cultural concerns by including the family in the discussion and finding out, ultimately, how the patient wants to handle these issues -it’s their choice.
Here's your problem. You seem to think there are laws with all the little details on how a medical provider should do this or that. There are no such laws. They would be impossible to write.

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


Quote:
I saw that and edited mine. In short, bad medical judgement, not really ethics.
You didn't appear to recognize the ethical dilemma in prescribing placebos.

Your posts reflect one who is very poorly informed about the difference between ethics, medical judgement and law.
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Old 18th February 2020, 11:10 PM   #398
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Originally Posted by xjx
No ethical dilemmas at all, actually, just really bad medical judgement. Should have waited for the translator and gotten it right from the beginning.
Another answer from ignorance. You would have a child who may have eaten toxic tobacco and nicotine wait for a translator before the physician acted?

Ipecac is relatively harmless. Ingested tobacco in a small child is not.
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Old 18th February 2020, 11:14 PM   #399
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Originally Posted by xjx388 View Post
When you edit someone’s post it’s polite to point that out.

And that's why I called attention to the fact that you edited my post.



No comment about your corrupted view of ethics? Have you decided it is indefensible? LOL!

Last edited by Cabbage; 18th February 2020 at 11:16 PM.
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Old 18th February 2020, 11:17 PM   #400
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Originally Posted by Cabbage View Post
according to you. Intelligent people, on the other hand, disagree.


Back in Nazi Germany you would have been turning Jews over to the state left and right--To do so would be unethical.

You said so yourself!

And this is why I treat your opinions with utter contempt.

So now you know.

And I treat your opinions with utter amusement. I have to admit, I didnít think this thread could be Godwinned, but you did it!
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