[WikiEN-l] Health advice from the web

Tue Aug 4 01:53:54 UTC 2009

> I think you forgot to specifically mention the ongoing efforts of  
> the US medical profession and its auxiliaries to prevent meaningful  
> reform.

I was thinking globally. There's the US and its' refusal to change,  
and then there's people in developing countries who can get an  
internet connection, but can't go to the doctor (possibly a  
representation of their governments' refusal to change).

I was also thinking at least somewhat apolitically. Unfortunately,  
health care reform IS political.

Emily

On Aug 3, 2009, at 7:37 PM, David Goodman wrote:

> I think you forgot to specifically mention the ongoing efforts of the
> US medical profession and its auxiliaries to prevent meaningful
> reform.
>
>
> David Goodman, Ph.D, M.L.S.
> http://en.wikipedia.org/wiki/User_talk:DGG
>
>
>
> On Mon, Aug 3, 2009 at 5:45 PM, Emily Monroe<bluecaliocean at me.com>  
> wrote:
>> If I may jump into the conversation with an ethical question:
>>
>> It has occurred to me that sometimes people legitimately can't get to
>> a doctor (or other professional) that will help them. Sometimes they
>> can't even *get* to a doctor to begin with. If they are lucky to have
>> the internet, it would make sense to use it. Wikipedia is on the
>> internet, and so it does make some sense (less sense than say,
>> checking a medical website, but still some sense) to check it.
>>
>> What obligation does Wikipedia have to these people?
>>
>> Emily
>> On Aug 3, 2009, at 3:11 PM, David Goodman wrote:
>>
>>> People are always going to mistreat and misdiagnose; let them at  
>>> least
>>> have correct information, which is more likely to guide them right
>>> than incomplete information. Not doing this when in one's power is  
>>> as
>>> immoral as telling deliberate lies.
>>>
>>> Considering only public information for now, I think there are no
>>> exceptions at all to the requirement to give full information in all
>>> cases and all subjects, except for young children, and except for
>>> information intended to specifically & unjustly harm a private
>>> individual. I mean it quite literally, essentially following JS  
>>> Mill.
>>> For those who do think we have a responsibility not to tell the  
>>> public
>>> what they might use improperly,  I remind them, first, that this is
>>> the explanation used for all censorship--censorship is the classic
>>> valid example of a slippery slope. And second, that this is
>>> information the governments of the English-speaking countries not  
>>> only
>>> permit but require to be publicly available, and that is in fact
>>> widely available. We are not breaking new ground here.
>>>
>>> In any case, I cannot see how standard drug dosage information is  
>>> more
>>> harmful than any other facet of medicine.
>>>
>>>
>>> David Goodman, Ph.D, M.L.S.
>>> http://en.wikipedia.org/wiki/User_talk:DGG
>>>
>>>
>>>
>>> On Mon, Aug 3, 2009 at 12:11 AM, Ben Kovitz<bkovitz at acm.org> wrote:
>>>> David Goodman wrote:
>>>>
>>>>> this is information that essentially
>>>>> everyone in the world considers basic reference information,  
>>>>> that is
>>>>> available in authoritative form for all the english speaking
>>>>> countries
>>>>> (slightly different in each), and could easily be adding with
>>>>> absolutely impeccable official references, but which the medicine
>>>>> wikiproject refuses to add.
>>>>>
>>>>> why? people might misinterpret it; we shouldn't tell people how to
>>>>> treat illnesses, this is the role of physicians, it's different in
>>>>> different countries, it changes frequently, there are all sort of
>>>>> special considerations, and so on. (The arguments against each
>>>>> should
>>>>> be obvious: we tell people everything else about treating the
>>>>> illnesses, physicians should not hold a monopoly of medical  
>>>>> care, we
>>>>> can easily give the different approved dosages just as we give the
>>>>> different drug names, everything else relative to medicine changes
>>>>> also & we update the encyclopedia, everyone understands that there
>>>>> are
>>>>> exceptions  as with everything else in the world.)
>>>>
>>>> Would it accurate to say that the main concern is blame-avoidance?
>>>>
>>>> That is, giving out certain kinds of information carries legal or
>>>> ethical responsibility, because people will take important action
>>>> based on that information.  Legal and medical information are the
>>>> classic examples.
>>>>
>>>> However, the great strength of Wikipedia is its approach of "better
>>>> to
>>>> make errors and let people fix them than to get nowhere by trying  
>>>> to
>>>> prevent errors before they happen".  That's how Wikipedia grew, and
>>>> it
>>>> goes head on against the arguments you mentioned above.  It's a
>>>> strange thing for Wikipedians to oppose including a certain broad
>>>> category of information, which everyone agrees is valuable and
>>>> noteworthy, simply because errors and misinterpretations are
>>>> possible.
>>>>
>>>> Now, medical information is particularly prone to a certain kind of
>>>> dangerous misinterpretation.  Naïve readers want simple claims they
>>>> can rely on, like "X cures Y".  The reality is that drugs always  
>>>> have
>>>> trade-offs, and there's enough variation among people that  
>>>> treatments
>>>> affect different people in different ways.  Naïve readers are prone
>>>> to
>>>> lift statements out of context or simplify them dangerously:
>>>> "Wikipedia said X cures Y, but all I got was hives!" when actually
>>>> the
>>>> text said, "X cures Y in 60% of people, and it causes hives in 0.2%
>>>> of
>>>> people"--perhaps in a big table, mixed in with lots of other
>>>> information.  On top of that, those numbers are usually statistical
>>>> extrapolations, open to debate, and the medical consensus is always
>>>> shifting, and there is always dissent.
>>>>
>>>> Maybe the folks here can brainstorm a way around this.  Can you
>>>> tell a
>>>> few specific bits of information, say, about just one specific  
>>>> drug,
>>>> that would be nice to include, but that raise the blame-related
>>>> objections?
>>>>
>>>> (Or, if I've got the underlying concern wrong, please post about
>>>> that.)
>>>>
>>>> Ben
>>>>
>>>>
>>>>
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