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

[Cabbage]

Originally Posted by xjx388

And I treat your opinions with utter amusement. I have to admit, I didn’t think this thread could be Godwinned, but you did it!

You are the one that made the absurd claim that "Ethics requires following the law"; I am merely pointing out the logical implications of it.

Are you now prepared to admit your claim was wrong? If not, my example still holds, and your opinion is deserving of absolute contempt.

[TragicMonkey]

Originally Posted by Skeptic Ginger

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.

Here's a real medical ethical dilemma: in a fit of his obvious madness, Trump eats heaping fistfuls of loose tobacco. He refuses treatment. Should we induce vomiting anyway? On the one hand it would cause a hilariously gross physical reaction that would get a trillion hits on YouTube. On the other hand it would save him from a fatal poisoning. What would be the ethical action there? And would it be bad if I kept handing him more tobacco while we considered the best course of action?

[Skeptic Ginger]

Originally Posted by TragicMonkey

Here's a real medical ethical dilemma: in a fit of his obvious madness, Trump eats heaping fistfuls of loose tobacco. He refuses treatment. Should we induce vomiting anyway? On the one hand it would cause a hilariously gross physical reaction that would get a trillion hits on YouTube. On the other hand it would save him from a fatal poisoning. What would be the ethical action there? And would it be bad if I kept handing him more tobacco while we considered the best course of action?

Not that this isn't funny (it is) but on the serious side:

Standard ethics would treat an adult refusing treatment differently than a child.

OTOH, overriding parental choices is like abortion, some would always do it and some would never.

[xjx388]

Originally Posted by Skeptic Ginger

No it does not. That's idiotic. I don't care if the guy with the STD doesn't want to tell his sex partners. He can't do that.

I agree; it’s completely unethical for a person with an STD to fail to inform their partners. Doctors, on the other hand have competing ethical obligations:

1. Their duty to maintain the confidentiality of their patients
2. Their duty to warn third-parties of potential harm.

The first trumps the second except in cases where the threat of harm is particularly severe. In the case of HIV, yes, the doctor should inform a spouse if the patient refuses to. But it shouldn’t be the first thing the doctor does. The doctor should counsel the patient to do it himself, provide resources to help the patient disclose, etc. As a last resort, the doctor should inform the spouse. In Texas, such spousal disclosure is allowed but I don’t think that’s universal.

Quote:

No one moved any goal post. You don't have enough knowledge to recognize STDs and HIV are treated the same as far as partner notification goes. There are some differences with testing and informed consent but not with post diagnosis requirements to inform partners.

No they aren’t treated the same, not from the clinician perspective. Yes, we report all STDs to the State. However, we don’t have that spousal exception to confidentiality. Aside from the law, the level of risk and harm between HIV and say, gonorrhea, doesn’t justify breaching the confidentiality of the patient. In those cases, the State’s partner tracing and notification programs take care of that.

Quote:

So you'd let an exposed person go un-notified if the legislators in all their practicing medicine without a license wisdom wrote a flawed law?

So you’d break the law to tell someone their husband has gonorrhea? I don’t think you’d put your license and career at risk.

Quote:

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

Most? Are you trying to tell me that most providers break the law on a regular basis? No they don’t.

And let’s bring this back along the lines of the OP. If you were treating a well-known public figure, a womanizer who has HIV, would you Duty to Warn him? Would you make a public statement that he has HIV?

Quote:

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.

Now c’mon . . . You cannot possibly think that the only limit to what an NP can do is what they themselves think they can do? Scope of practice is actually spelled out quite well in the law. An NP’s scope of practice is limited to the certifications they hold.

I really don’t understand where you get this idea that a license = do whatever you want. That’s not even true for doctors. And to bring this back to ethics: Doctors and all other medical providers have an ethical duty to stay within the limits of their training and experience. It would be a grave disservice to the patient for a Family Med doctor to attempt to treat complex psychiatric cases, for example, unless the doctor is dual certified or has extensive other training and experience in psychiatry.

Quote:

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.

No. You seem to think those are all separate things. They aren’t; they are all entangled. Ethics, law, evidence-based standards, clinical experience, training . . . Those are all things that inform professional judgement.

I’m going to start a new thread on this because I think it’s an important area. I hope you will join me there so we can continue the judgement/ethics conversation. But for now, let’s try to get back to the topic:

1. Professional judgement is the exercise of applying the training and experience of a professional in accordance with the ethics and standards of their profession.

2. The ethics code is clear about diagnosing public figures the clinician doesn’t know. There is absolutely no gray area about that; the guidance is clear, well-articulated and supported by good arguments.

3. The “duty to warn” ethics exception applies when there is a specific danger to an identifiable person or group of people. There is no specific danger articulable here.

4. There is no evidence-based or consensus-based clinical standard of practice to assess mental illness and/or dangerousness of subjects based solely on public domain information, without an in-person assessment.

Therefore: A professional is not free to exercise their judgement to comment on a public figure’s mental illness or dangerousness they’ve never personally assessed.

You’ve argued that these professionals may not be part of the organizations that enforce ethics codes. That only means they can’t be censured. Do you argue that ethics codes shouldn’t apply to all members of the profession, regardless of membership in any particular organization?

[jimbob]

Again apologies for Twitter, but it's the most reliable for places in the EU.

https://twitter.com/TomJChicago/stat...097593345?s=20

His incidents of complete inability to speak are getting more obvious and longer

[Skeptic Ginger]

Originally Posted by jimbob

Again apologies for Twitter, but it's the most reliable for places in the EU.

https://twitter.com/TomJChicago/stat...097593345?s=20

His incidents of complete inability to speak are getting more obvious and longer

He doesn't seem to recognize his slurred speech.

[Skeptic Ginger]

Originally Posted by xjx388

I agree; it’s completely unethical for a person with an STD to fail to inform their partners. Doctors, on the other hand have competing ethical obligations:

1. Their duty to maintain the confidentiality of their patients
2. Their duty to warn third-parties of potential harm....

I never answered this.

I am required to see to it partners are notified.

There's no superior confidentiality ethics.

Ryan White Act (Federal) covers the providers' duty to directly inform EMS and hospital staff if they've been potentially exposed to something. And it allows said workers to ask the source be tested if a "substantial" exposure occurred. Substantial means there is a possibility of transmitting a bloodborne infection.

In this state public health ordered that extended to good samaritans exposed to the patient when rendering aid.

Re HIPAA:

Quote:

1) Permitted uses and disclosures. A covered entity may use or disclose protected health information for the public health activities and purposes described in this paragraph to:

(i) A public health authority that is authorized by law to collect or receive such information for the purpose of preventing or controlling disease, injury, or disability, including, but not limited to, the reporting of disease, injury, vital events such as birth or death, and the conduct of public health surveillance, public health investigations, and public health interventions; or, at the direction of a public health authority, to an official of a foreign government agency that is acting in collaboration with a public health authority;

For people unfamiliar with the legalese:
A covered entity includes the provider. It means the law applies to us.

Ryan White Act says I must notify exposed workers and that can be directly. HIPAA says I report to public health so they can inform other people exposed. The provider is not expected to make house calls and do contact tracing.

Then there is the HIV and other STD testing and informed consent that is a state law. In this state you advise the people you are testing that they are required to inform their sexual partners of any positive results and if they are unable to the provider will notify public health who will notify the partners.



I've replied to the rest of your post a dozen times.

Yes NPs (in this state) and MDs are expected to know their own scope of practice. No, it is not prescribed by law other than education and testing requirements. Can you imagine if the law spelled out all the details of medical practice? That's nuts.

[dann]

The danger has become apparent, hasn't it?

YouTube Video This video is not hosted by the ISF. The ISF can not be held responsible for the suitability or legality of this material. By clicking the link below you agree to view content from an external website.

I AGREE

[Safe-Keeper]

Originally Posted by Skeptic Ginger

He doesn't seem to recognize his slurred speech.

I admit I'm hoping his condition will get bad enough before November that he will be un-reelectable. Never thought I'd be wishing dementia on someone. It's a twisted world we live in .

Of course, who knows if his successor will be just as hostile to democracy and the press.

[theprestige]

Originally Posted by dann

The danger has become apparent, hasn't it?

YouTube Video This video is not hosted by the ISF. The ISF can not be held responsible for the suitability or legality of this material. By clicking the link below you agree to view content from an external website.

I AGREE

What danger, exactly?

[Skeptic Ginger]

Originally Posted by theprestige

What danger, exactly?

His paranoid delusions are starting to interfere with managing the coronavirus crisis. He thinks the reaction is a hoax, it's a plot by the Democrats and news media to ruin him, the stock market crash is supposedly based on the news media, like no one understands the shortages of supplies from China and the crashing of the travel industry.

If you don't think that's dangerous, you are in denial.

[bruto]

Of course what you consider dangerous can vary. Some of us think that turning the presidency into a goon show and bringing ridicule on our country, undoing laws that prevent toxic chemicals from killing people, denying the science that suggests we may be unalterably damaging the earth, and so on, might be considered dangerous even if they don't involve a finger on a big red button. Of course opinions on where some lines are drawn can vary widely, but you do not have to blow up the world to be dangerous.

[Bob001]

The evidence of basic information-processing deficits keeps piling up:

Quote:

As a private citizen and presidential candidate, Donald Trump was a proponent of vaccine skepticism -- ignoring the scientific consensus on stuff like how vaccines don’t cause autism. As president, he is now surrounded by experts on the subject, including on Monday when he held a coronavirus roundtable with his task force and the heads of several pharmaceutical companies.

Yet despite the increasingly scary situation involving the disease and preparations having been underway for weeks, he still appears rather clueless on the subject.

https://www.washingtonpost.com/polit...vaccine-event/

[jimbob]

Originally Posted by Bob001

The evidence of basic information-processing deficits keeps piling up:

https://www.washingtonpost.com/polit...vaccine-event/

Why would having a demented President who is interfering in emergency responses be dangerous?

[smartcooky]

Originally Posted by Bob001

The evidence of basic information-processing deficits keeps piling up:

https://www.washingtonpost.com/polit...vaccine-event/

Bloody hell!!

If that is what really happened in that briefing, then its a terrifying situation the USA is in right now... a man at the top who is clueless and incompetent, and no guard rails because he has dismantled them all.

[TragicMonkey]

I heard someone taped a circle of cardboard to the top of Trump's head and he spent all day slinking around close to the floor because he thought the ceiling had been lowered.

[wasapi]

Originally Posted by Bob001

The evidence of basic information-processing deficits keeps piling up:

https://www.washingtonpost.com/polit...vaccine-event/

Wow. I just read at the link.

Holy Hell. Interesting but something scary as well.

[Lurch]

Trump is *desperate* to say everything will be hunky dory well before polling day. Virus vanquished, markets roaring. All that matters is appearances, optics. Never the truth. It all comes down to his *own* political (and hence personal) survival with this empathy-devoid vessel. He'd prefer to rule over a ravaged wasteland than altruistically step aside for the betterment of the nation. Even if he could dimly comprehend the concept of selflessness or sacrifice.

[bruto]

Originally Posted by smartcooky

Bloody hell!!

If that is what really happened in that briefing, then its a terrifying situation the USA is in right now... a man at the top who is clueless and incompetent, and no guard rails because he has dismantled them all.

Originally Posted by Lurch

Trump is *desperate* to say everything will be hunky dory well before polling day. Virus vanquished, markets roaring. All that matters is appearances, optics. Never the truth. It all comes down to his *own* political (and hence personal) survival with this empathy-devoid vessel. He'd prefer to rule over a ravaged wasteland than altruistically step aside for the betterment of the nation. Even if he could dimly comprehend the concept of selflessness or sacrifice.

So what else is new?

[jimbob]

Originally Posted by jimbob

Why would having a demented President who is interfering in emergency responses be dangerous?

And why would someone so ruled by narcissism that they are driven to undo everything their predecessor did be considered unsuitable for office?

Stopping the CDC program looking for the next Ebola was a dangerous act of petulance.

[Bob001]

Doc Lee weighs in:

Quote:

You've often warned of the dangers of Trump's mental health. Do you think his mental state poses a danger as he is forced to respond to the coronavirus outbreak?

I believe it is the biggest threat right now, and people are beginning to see how his distorted view of reality is putting lives at risk. His inability to respond to a real emergency because of his preoccupation with his image and his re-election prospects sent the stock market on its largest one-day plunge in history. But this is just the tip of the iceberg. From coronavirus to the climate threat to a new nuclear arms race to the southern border, he worsens every situation in more ways than we can see, such as by gutting every agency that was set up to prepare for emergencies. This is not by accident. The mind is powerful, and I fear that perhaps the greatest danger is the alternative reality he is creating for his followers — all to buttress his fragile sense of self and to hide his incompetence.

https://www.salon.com/2020/03/06/yal...-enabling-him/

[dudalb]

I just watched Trump CDC news conference.
Now I won't get any sleep tonight....
Might be he most demented one yet.

[Safe-Keeper]

Originally Posted by Bob001

The evidence of basic information-processing deficits keeps piling up:

https://www.washingtonpost.com/polit...vaccine-event/

“Yeah. But, like many people said, we have to be very careful here. If you vaccinate several hundred million people … ”

“You’ve got to make sure it works,” Trump said.

“Works and is safe,” Stoffels said. “Yeah."

“And it doesn’t hurt,” Trump said. “Right.”


Stable genius .

[Bob001]

Originally Posted by dudalb

I just watched Trump CDC news conference.
Now I won't get any sleep tonight....
Might be he most demented one yet.

From the conference (where he was wearing his red "Keep America Great" hat):

Quote:

President Trump likes to say that he fell into politics almost by accident, and on Friday, as he sought to calm a nation gripped with fears over coronavirus, he suggested he would have thrived in another profession — medical expert.

“I like this stuff. I really get it,” Trump boasted to reporters during a tour of the Centers for Disease Control and Prevention in Atlanta, where he met with actual doctors and scientists who are feverishly scrambling to contain and combat the deadly illness. Citing a “great, super-genius uncle” who taught at MIT, Trump professed that it must run in the family genes.

“People are really surprised I understand this stuff,” he said. “Every one of these doctors said, ‘How do you know so much about this?’ Maybe I have a natural ability.”

https://www.washingtonpost.com/polit...bbf_story.html

Let's vote. Is that statement true or false?

[Stacyhs]

Originally Posted by Bob001

From the conference (where he was wearing his red "Keep America Great" hat):

https://www.washingtonpost.com/polit...bbf_story.html

Let's vote. Is that statement true or false?

[smartcooky]

Originally Posted by Bob001

From the conference (where he was wearing his red "Keep America Great" hat):

https://www.washingtonpost.com/polit...bbf_story.html

Let's vote. Is that statement true or false?

Its bollocks as they say here (or in the American south... that's just a bunch o' hooey!)

[Stacyhs]

Originally Posted by smartcooky

Its bollocks as they say here (or in the American south... that's just a bunch o' hooey!)

In the American south....Yeah! We believe that cuz Trump says so! And he doesn't lie!

[Safe-Keeper]

Originally Posted by Bob001

Let's vote. Is that statement true or false?

:image of Hermonie raising hand:

[Bob001]

Interesting article from a couple of years ago. The author notes that the definition of "mental illness" is so broad as to be useless. He contends that Trump is deliberately and maliciously evil.

Quote:

If we are to combat Trump, we must understand how he has elevated and manipulated certain American values, like greed and exceptionalism, to undermine so many others, like truth, justice, and the American Constitution.

This is not madness. And the impulsivity, threats, aggression, ridicule, denial of reality, and mobilization of the mob that he used to get there are not symptoms. It is time to call it out for what it is: evil.

Arendt goes on to explain that we in the West are susceptible to such evil precisely because we cannot conceive of it. We prefer to believe that people are innately good, and evil is some kind of “fall from grace,” an anomaly, a madness perhaps, but one always “explained by comprehensible motives.” We are at a loss to confront Trumpism, because his strategy is evil for its own ends, and thus reflects, as Arendt described, “a system of values so radically different from all others, that none of our traditional legal, moral, or common sense utilitarian categories could any longer help us to come to terms with, or judge, or predict their course of action.”

https://slate.com/technology/2017/03...-hes-evil.html

[Stacyhs]

Trump said today:

Quote:

“it’s a very contagious virus.. something we have tremendous control of.”

What alternate reality does he live in?

[Bob001]

Originally Posted by Stacyhs

Trump said today:

What alternate reality does he live in?

The one largely manufactured and delivered by Fox.
https://www.nytimes.com/2020/03/11/u...ive-media.html

[Stacyhs]

Originally Posted by Bob001

The one largely manufactured and delivered by Fox.
https://www.nytimes.com/2020/03/11/u...ive-media.html

Trump today: "Relax, we're doing great. It all will pass."
Sounds like he's been watching Hannity.
I expect Hannity to be the next Medal of Freedom recipient.

[jimbob]

"They're big white ships with the red cross on the side"

Yes, those are the words of someone who is functioning.

[Bob001]

Originally Posted by jimbob

"They're big white ships with the red cross on the side"

Yes, those are the words of someone who is functioning.

Sure, he's functioning. Like a six-year-old.

[Bob001]

Dr. Lee weighs in:

Quote:

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

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

Now we in America and around the world are living through the horrible results of Trump's behavior. His mental health issues are translating directly into deaths and widespread calamity.

https://www.salon.com/2020/03/23/dr-...navirus-worse/

[Stacyhs]

Originally Posted by Bob001

Dr. Lee weighs in:

https://www.salon.com/2020/03/23/dr-...navirus-worse/

It should be pretty obvious to anyone who isn't blinded by their devotion to Trump that he doesn't live in reality; he live in Trumplandia where the media is out to get him, doctors can't believe how much he knows about a pandemic virus and that he's 'just a natural', the virus will just 'magically disappear" in April, he's a 'stable genius', etc.

[jimbob]

Look at Trump's response to this question:

https://twitter.com/atrupar/status/1242502814640885764

Because the question included the word "perfect" - Trump jumps on that word and goes onto his Ukraine defence, before recovering.

And this word salad, which would rightly get shredded here, barely gets a comment.

[Stacyhs]

Originally Posted by jimbob

Look at Trump's response to this question:

https://twitter.com/atrupar/status/1242502814640885764

Because the question included the word "perfect" - Trump jumps on that word and goes onto his Ukraine defence, before recovering.

And this word salad, which would rightly get shredded here, barely gets a comment.

What the hell does Erdogan and the Kurds policy have to do with social distancing? Trump is nuts.

[Skeptic Ginger]

Originally Posted by Bob001

Dr. Lee weighs in:

https://www.salon.com/2020/03/23/dr-...navirus-worse/

This is exactly how I've been describing Trump's actions. Not that it's a good thing, but, this is what I've been saying since this thread started.

To all the naysayers: Told you so!

[Skeptic Ginger]

Originally Posted by Stacyhs

What the hell does Erdogan and the Kurds policy have to do with social distancing? Trump is nuts.

Bingo.

The whole interview makes sense if you put it in terms of Trump's fantasy world.

Incompetrump is recalling in Trumplandia what great bold actions he took and how he's the greatest POTUS ever.

Most people recognize this magical thinking as "If only I had done X, or I wish I had done X" This is part of the grieving process we use to help us get through a tragedy.

With Trump, the "if only" and "I wish" morphs into the belief he took those actions and the reasons the actions failed... oh wait, they didn't fail. The fantasy goes on into "I took all these great actions, we're doing better than any other country..."