Wikipedia talk:Reference desk/Guidelines/Medical advice

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[edit] Serious concerns with this content

WP is not a Board of Medical Examiners.

Although it is entirely appropriate that certain contributions be discouraged from the WP Reference Desks, Reference Desk guidelines are not sanctioned or reviewed by any professional standards body, and therefore not suitable for use in regulating the practice of medicine (or any other profession).

WP guidelines are, of course, totally appropriate for summarizing and explaining consensus, and totally appropriate for describing what Wikipedia is not, but those items are within the purview of Wikipedia. The legal definition of "the practice of medicine" clearly is not.

Wikipedia should stick to talking about what Wikipedia purports to talk about. Any tests for evaluating or determining the scope and definition "professional advice" are already specified in the various sections of Wikipedia:General disclaimer.

If the contributors to the WP reference desks wish to keep certain content out of the reference desks, that's fine, but they should not mislead onlookers and users in to thinking that the content standards have any hint or patina of "Medical Authority". It must be made absolutely and unambiguously clear that they do not.

Wikipedia is not intended as a source of professional advice, but some of the content in this guideline could easily be misconstrued as such. Therefore it should be either drastically changed, or deleted entirely. dr.ef.tymac 18:50, 20 August 2007 (UTC)

Follow-up: Please note: I've flagged this content for drastic edits for consistency with WP disclaimers. If anyone wishes to contest any of the issues I've brought up, I'd appreciate a notice either here on my WP talk page. Note also that this document has recently been discussed on the reference desk talk page. Thanks. dr.ef.tymac 18:53, 20 August 2007 (UTC)
Do you have any specific suggestions for how you would revise the text? TenOfAllTrades(talk) 20:44, 20 August 2007 (UTC)
I've asked Foundation counsel (User:Mikegodwin) to comment. TenOfAllTrades(talk) 20:53, 20 August 2007 (UTC)

What is the problem here? You seem to be saying we shouldn't be giving medical advice. This guideline says we shouldn't either. Where is the conflict? --AnonEMouse (squeak) 20:56, 20 August 2007 (UTC)

[edit] The WP Disclaimer should be the sole authoritative text

Addressing the main issue(s) should be relatively straightforward, For example: I'd start by changing the headers:
   Medical advice guidelines
   What constitutes "medical advice" ?
to
   Wikipedia does not give professional advice
   What kinds of content is likely to be removed from the Wikipedia Reference Desks?
in order to make absolutely unambiguous the principle that neither Wikipedia nor the Foundation make any claim of being some kind of quasi "Board of Medical Examiners" or "State Bar Association". Those are the sorts of organizations that are entrusted with the responsibility of determining what constitutes "the practice of medicine" and "the practice of law".
It should be blatantly obvious to readers that WP is not attempting to "share turf" with such officially-sanctioned bodies of professional review.
It should be blatantly obvious to readers that the only authoritative source for WP disclaimers is the official disclaimer itself, not ancillary guidelines written and promulgated by anonymous WP contributors. It would seem to me that is precisely the reason that the Disclaimer pages are not generally-editable as is much of the content within WP.
Furthermore, I would remove the entire first paragraph, and simply replace it with:
   None of the individual contributors, system operators, developers, sponsors of 
   Wikipedia nor anyone else connected to Wikipedia may establish an attorney-client, 
   patient-physician or professional-client relationship through Wikipedia.
   
   Wikipedia does not give professional advice. For more details, see 
   Wikipedia:General disclaimer, Wikipedia:Medical disclaimer, and
   Wikipedia:Legal disclaimer.
Similarly, I would modify the text of the sections "What constitutes ..." and "Dealing with ..." and "When in doubt ..." to unambiguously state that WP contributors are the sole source of discretion and judgment for determining what gets removed from the Reference Desks.
This judgment is not intended to coincide with or augment any kind of professional review or test of competence that would be provided by an accredited standards body, and simply reflects the personal preferences and feelings of the WP community; and under no circumstance does this "community judgment" modify or trump the "General Disclaimer" in any way.
This judgment is entirely the discretion and consensus of anonymous volunteers, and has nothing to do with defining what constitutes what is professional advice ... the only question at issue is what is acceptable to the users and contributors to the Wikipedia Reference Desks.
As you've implied before, TenOfAllTrades, media coverage relating to some spectacular lapse of judgment combined with a sympathetic victim would be another black-eye-waiting-to-happen for WP. You can bet the media would use any hint of a "secondary procedure for medical review" as an excuse to "spin" the story in such a way that Wikipedia condones or weighs the validity of "medical advice" ... or authoritatively defines what constitutes "medical or professional advice" (to begin with) on a case-by-case basis, instead of prohibiting it entirely.
This text and the text of any "boilerplate" warnings should remove any and all doubt or ambiguity of what is going on here, and not contribute to it. The Disclaimer should be the sole authoritative text on this matter. dr.ef.tymac 03:08, 21 August 2007 (UTC)
I'd say that was splitting hairs, but then someone who was a professional barber or hairdresser would probably object too. Look, this is the Medical advice page, naturally it's going to specifically talk about the Medical subset of Professional advice. Making it vague is simply going to make it unusable. --AnonEMouse (squeak) 14:12, 21 August 2007 (UTC)

[edit] Specificity is indeed the goal

I respect that reasonable people have different perspectives on this. I also respect the concerns of "vague = unusable" ... but certain documents and instruments are constructed the way they are for a reason. I am assuming you do not dispute the WP disclaimer should not be modified (either directly or indirectly, through "sub-documents") without serious consideration of all relevant issues, and appropriate authorization.
Moreover, I'm actually proposing that this guideline (and any other guideline that derives apparent authority from the WP Disclaimers) be made more specific, not more vague ... in this case, the "specificity" being sought is a specific indication that none of these factors have been approved or reviewed by any professional standards body, nor authorized legal counsel (at least not yet that I know of) and they simply reflect the preferences and expectations of anonymous WP contributors who happen to participate on the Reference Desks. If that can be made obvious, then I'd readily agree there is no more hair to "split".
I don't mean to try your patience (which I greatly appreciate), and I really have no interest in picking nits, it just seems that there are a few areas where experienced WP contributors should all agree: "things need to be done precisely right" ... and it seems reasonable to conclude that this is one of them.
Nevertheless, I won't beat a dead horse, if people are fine with the status quo, then full steam ahead. dr.ef.tymac 14:34, 21 August 2007 (UTC)

[edit] Case not covered in this article

I have spent the last few months testing the following type of case: Take a question about medical information, such as "What are the best ways to stimulate burping?" That is clearly not a request for medical advice. It would be answered without problem. Now, personalize it by explaining that you have trouble burping. Suddenly, it is a request for medical advice. This has been done over and over for months and, without fail, any time a question implies that the questioner may have interest in knowing the answer, it is labeled a request for medical advice.

I do not feel that there is any valid basis for assuming that personalized requests for medical information are requests for medical advice. The following question passed because it wasn't personalized (paraphrased for brevity): "Does aspirin cause coughing? If so, through what action?" However, the following would certainly be labeled a request for medical advice: "I cough a lot. Does aspiring cause coughing? If so, through what action?"

So far, I have been completely unable to explain the issue to others. It is an issue of "personalizing" questions. It is normal for a person to explain why they want to know an answer. For that reason, a person will precede a request for medical information with an explanation of how the requested information relates to him or her. To ask a question without any personal information is considered by many to be rude. Unfortunately, adding personal information to a request for medical information invariably gets it labeled as a request for medical advice. So, the apparent rule is that anyone wanting medical information must perform the unnatural action of asking the question while rudely omitting any personal information. Of course, most people do not know this rule. So, they properly explain why they want to know the answer, which causes their question to be labeled as unanswerable due to reference desk guidelines.

I feel that this issue must be directly mentioned in the guidelines. My problem is that I cannot get others to understand the issue. Apparently, the distinction between personal information and a question is too difficult to comprehend and they blur together into a big request for medical advice blob. So, if anyone else understands this issue and can better explain it, please do so. Even if you consider that questions with personal information should be classified as requests for medical advice, I still need help explaining this class of questions. -- kainaw™ 15:36, 11 December 2007 (UTC)

If someone had personalised the question by saying 'I am editing the article on aspirin' before asking their questions, there would be no problem. If they had said 'I cough a lot' before asking their questions, then they would be asking medical advice. They have personalised it in both cases, they have asked a question in both cases, but only in the latter case were they wanting advice for an actual medical problem. If they had personalised it by saying 'Aspirin is really dry. Does it cause coughing?' then again, we could answer. If they had personalised it by saying 'I was learning about coughing in school' before asking the questions, again we could answer. It's not the personalising that's the problem, it's people revealing that they are seeking medical advice. They should not be discouraged from revealing this, because we don't want to be giving medical advice, even unwittingly.
On another note, if I understand you right and you've been deliberately asking questions that you think are considered on the border between medical advice and not, in order to provoke discussion, that's a little disruptive. Skittle (talk) 16:34, 11 December 2007 (UTC)
I disagree. With the example "I cough a lot. Does aspirin cause coughing?", the person is asking if aspirin causes coughing. He or she is not asking for any sort of diagnosis or treatment for his or her coughing problem. It could be that the person has a headache and, knowing that coughing is an issue, is trying to decide between aspirin or acetaminophen. You have no way to know and should, in my opinion, be left to assuming good faith - assuming that the question is not asking for medical advice. It is only asking for medical information.
Now, if we are going to claim that information given could possibly assist a person in deciding between two OTC pain relievers is banned medical advice, then absolutely no medical information should be given in any way. Something as simple as describing what the little indention above the lip is called could, in some way, be used to make a decision about a drug or treatment choice. For that matter, discussions about solar cells may in some weird way help someone make some form of medical decision. If the goal is to keep the public as ignorant as possible, the reference desk should be shut down. -- kainaw™ 18:06, 11 December 2007 (UTC)

Please do not continue this conversation here. I have introduced a new topic below in an attempt to consolidate the many conversations going on in many different areas.

[edit] Medical advice vs. medical information

This guideline does not clearly define the difference between medical advice and medical information. This has led to many arguments in different areas of Wikipedia that can all be rationalized into an argument over the definition of advice and information. The consensus is that advice should not be given while information is allowed. I am attempting to nudge the various users who seem to have an interest in this topic here to try and reach a consensus on this problem. -- kainaw™ 18:07, 12 December 2007 (UTC)

My opinion on the matter is that advice will either attempt to diagnose a person or prescribe treatment for the patient. Information merely repeats medical references that are available elsewhere - hopefully valid medical references. The following are two examples that I feel define my view of the difference:
  • I have a sore throat and I was wondering if I should take Nyquil. -- Advice. The person is asking for treatment for a sore throat.
  • I have a sore throat. Does Nyquil have anything in it that is supposed to help with sore throats? -- Information. The person is asking for an ingredient list for Nyquil.
My experience is that many people see them as the same question simply reworded. They even argue that answering the second question may lead the person to taking Nyquil and having an adverse reaction. There is, in my opinion, no legal or ethical liabilities involved in providing a list of ingredients for a cold medicine. The OP is responsible for how he or she uses the information. There is, in my opinion, ethical (but not really legal) liabilities involved in telling a person he or she should take a specific cold medicine. -- kainaw™ 18:12, 12 December 2007 (UTC)
The only responsible answer to either question is "Ask a doctor or pharmacist". The only answer a reference desk volunteers is allowed to give to either question is none at all—delete the question, put up the deleted template, and inform the user on his talk page.
You are asking me to be even more stupid than I already am, and I resist that because I'm working on the opposite trend. Your second version clearly implies to anyone with an ounce of sense that he intends to take the stuff if it'll do any good. I really can't see how you can expect me to don blinkers of your own design. (I write in the first person to avoid drifting into vague generalities.) --Milkbreath (talk) 13:30, 13 December 2007 (UTC)
When a person requests an ingredient list, "Go see a doctor" is in absolutely no way a valid response. We are not banned by any law or policy to give an ingredient list. That is merely a figment of your imagination. Doctors are for diagnosing medical conditions and prescribing treatment. They are not reference desks for getting the ingredient list off the side of an over-the-counter drug. Call it stupid all you like, it doesn't make your argument valid in any way. What's next? Q:"What is the sweetener used in Coke Zero?" A:"Go see a doctor. You might plan on treating some medical condition with Coke Zero!" -- kainaw™ 15:11, 13 December 2007 (UTC)
I'm disinclined to continue a debate wherein I am attributed with a point of view I have not espoused and then am abused for espousing it. The point of view you attribute to me is what is a figment of someone's imagination, namely yours. Would you like to take another crack at that? --Milkbreath (talk) 15:19, 13 December 2007 (UTC)
The second question asks if an ingredient exists in Nyquil. You state, "The only answer a reference desk volunteers is allowed to give to either question is none at all—delete the question, put up the deleted template, and inform the user on his talk page." (emphasis mine) Is it a figment of my imagination that you just stated we are banned from providing an ingredient list? If we are not allowed to do something, we are banned from doing it, correct? Perhaps you are using some other definition of the words "allowed" and "banned". -- kainaw™ 15:43, 13 December 2007 (UTC)
Are we back to question vs. statement again? You're driving me nuts with that. If you read the guidelines, and just about anything else, "question" means the whole post. And, anyway, your first example is not an interrogative sentence. So will you please stop with that and stick to the point?
I have to say at this stage of the discussion that I would like a little help from you; I'm having trouble seeing your responses as anything other than disingenuous willful obtuseness, empty semantic gymnastics, and foe-baiting. I'm totally willing to accept that my perception is wrong, but as it is I'm approaching bail-out. --Milkbreath (talk) 16:42, 13 December 2007 (UTC)
It is my opinion that you are the one being disingenuous. What does the second question ask - literally? It asks about the ingredients in Nyquil. It does not ask if the person should take it. It does not ask what the cause of the sore throat may be. It does not ask if we take Nyquil every day and like it. It is very direct and to the point - does Nyquil contain anything that helps sore throats? This has nothing to do with semantics. The entire argument is that I am concerned with what is specifically asked and you appear to be concerned with rationalizations that are not included anywhere in the question. So, again, what specifically does the second question ask? Specifically. Not what do you rationalize it to be asking. What does it specifically ask? We keep circling this point and I do not know how to explain it further. What is the specific question? Is the person specifically asking for medical advice or medical information? I have no concern for rationalizations about what the information may or may not be intended to be used for. I only care about specifically what is asked. To do otherwise is, in my opinion, assuming bad faith. -- kainaw™ 16:53, 13 December 2007 (UTC)
The second question (which consists of two sentences) asks whether Nyquil will help his sore throat. If you mean by "question" the sentence ending in a question mark, that sentence asks whether Nyquil contains a medicine designed to help sore throats. --Milkbreath (talk) 19:45, 13 December 2007 (UTC)
That is where I disagree. Even considering this: "I have a sore throat and, if you tell me Nyquil has sore throat medicine in it, I fully intend to take Nyquil. So, I am asking now, does Nyquil have sore throat medicine in it?" It is my opinion that he is asking if Nyquil has sore throat medicine in it. He is not asking if Nyquil will help his specific sore throat. He is not asking if we recommend that he takes Nyquil. I stick to specifically what as asked and I do not consider it proper to read into it. -- kainaw™ 19:56, 13 December 2007 (UTC)
Why is it improper to read into it? --Milkbreath (talk) 22:32, 13 December 2007 (UTC)
(Mind if I unindent a tad...)
There are many reasons. The main ones that concern me are:
  • We are to assume good faith. Assume the person is intelligent, understands their own health, may be seeing a doctor, may have been given a prescription by a doctor, and is just asking for a bit of information that they do not understand.
  • We do not read into other questions. When a person asks about the weight of coal or the cost of oil, we do not assume that they have some mental illness and may be planning to use the information to harm themselves or others. We do not tell them to see a doctor for treatment.
  • Most important: There is absolutely no excusable reason to propagate ignorance. Forced ignorance is used to control people like sheep. It has happened repeatedly in the past and continues in many areas of the world to this day. I will never take any part in forcing ignorance on the people.
  • Then, there is the suggestion given to me below to read WP:SENSE. Common sense should make it clear that a sore throat is rarely anything serious and especially nothing to consider life threatening. Taking an over-the-counter medicine for a sore throat is a common practice that should not be considered life threatening. Checking to see if a medicine will help with your symptoms before you take it is an indication of intelligence, not stupidity. So, treating the person like an idiot by telling them to go see a doctor is nothing more than an insult.
Now, I do understand fully why others (not just you) read into the questions:
  • It may be illegal in some places in the world to provide medical advice. Wikipedia could be sued and shut down. Of course, this notion has been debunked repeatedly by lawyers (including Wikimedia's lawyers). However, the concern persists.
  • Giving medical information may cause a person to do something very stupid and end up harming or killing them. I do not believe that is true. Medical "information" is not harmful. Medical "advice" can be harmful. That is why I titled this section "advice" vs "information". I am wholly against giving medical advice. I wholly against withholding medical information.
  • There is a guideline against giving out medical information. The guideline is against giving out medical advice. Again, that is why this is titled advice vs information.
My goal is not to make it allowable to give out medical advice. However, I want to set a precedent that allows for the free flow of medical information. -- kainaw™ 00:01, 14 December 2007 (UTC)
(ec) My question to you, Kainaw, is, can you suggest a plausible scenario that is not one of the following? We are expected to use common sense, after all.
  • The OP has a sore throat and is contemplating a trip to the pharmacy to buy some Nyquil, should we tell him that Nyquil contains an appropriate ingredient.
  • The OP is holding a bottle of Nyquil in his hands – figuratively speaking; I assume he put it down to type the question – and he wants to know if it will help his sore throat if he takes some.
In the first case, directing him to speak to a pharmacist does no harm. He will have access to an expert, so we're of no use to him.
The second case is quite a bit more dangerous. Why would someone who has the bottle in his hands be asking about the ingredients?
  • The bottle label, packaging, or insert is missing or damaged. The OP should consult an expert or find an intact package before taking the drug; he may be missing important information about drug interactions, side effects, allergy warnings, and appropriate doses.
  • The OP doesn't know what the listed ingredients do. This information should be on the bottle or package insert. Again, if the OP isn't able to read and understand the instructions and warnings, we shouldn't be advising him—he needs to talk to someone who can properly inform him of risks.
Leaving all that aside, we can't answer the question anyway. The OP didn't ask what the ingredients were in Nyquil, he asked which ingredients would help with a sore throat. We'd be in a position of recommending a drug to treat a symptom. We don't know what the cause of the sore throat is, so we can't prescribe a treatment. (Just an analgesic to numb the pain? Was he coughing to cause the sore throat, and would an antitussive or an expectorant be appropriate? Is it a bacterial infection like strep that may require antibiotics?)
Even then we're not out of the woods. How many people would cheerfully and helpfully wade into that question and type in the list of ingredients from the bottle of Nyquil from their cupboard?
  • Does the OP have an old bottle of Nyquil? Has the formulation changed since he bought it?
  • Do we know what country the OP is in? Different places have different rules about types and quantities of certain analgesics and narcotics that can be sold in over-the-counter medication; the ingredients may be different in the UK versus in the US versus in Hong Kong.
  • Nyquil has several different formulations, aimed at coughs, colds, flu, sinus congestion, etc. Are we sure that all of our responders here are talking about the same product as the OP? If he goes to the pharmacy, is he going to pick up the first bottle labelled Nyquil, or will he ask for assistance if he's not sure? If he has a bottle at home, are we actually telling him about the ingredients of the correct product?
I don't think we're necessarily going to be able to eliminate all disputes over what does and does not constitute 'medical advice' on the Desks. There always going to be edge cases that lead to differences of opinion; we try to make calls based on how a reasonable person would interpret the rules, but occasionally we're going to have disagreement. Even though the case suggested here is fairly clear cut, I won't argue that cases don't exist that would be contentious.
I also don't think that the solution to the problem is going to be solved by trying to nail down every single case and exception in a guideline as thick as a telephone book. The disputes I've seen recently aren't primarily due to flaws in the existing guideline. Rather, they tend to fall into two classes. The first is where a newer, less-experienced editor arrives, and attempts to apply the guidelines too zealously and too broadly (making the sort of information versus advice error that Kainaw is discussing). The second problem is with some more-experienced editors who just don't think we ought to have the guideline at all—but that's not something that can be cleared up by making the guideline more detailed. Both problems tend to sort themselves out through social pressure (call it 'acculturation', perhaps).
What we need is common sense, courtesy, and mutual respect; in my Wikipedia experience, additional rules more often than not lead to additional lawyering rather than to any productive outcome. TenOfAllTrades(talk) 15:52, 13 December 2007 (UTC)
I can suggest a very plausible scenario that isn't one that you mentioned: "OP is sitting at home with a sore throat. He goes into his Mom's medicine cabinet and finds a bottle that says "Nyquil" on the label. He picks it, but isn't sure if it really does help a sore throat. So, he asks on the Reference Desk. Yes, he could read all that tiny print on the bottle. Yes, he could go the pharmacy (if they are open). Yes, he could call his doctor and schedule an appointment in the next week, month, or year (depending on where he lives - same-day appointments are very rare). Yes, he could go to the emergency room and see a doctor that night. That is all a bunch of wasted time (and possibly money) when all he wanted to know was if there is an ingredient in Nyquil that helps with a sore throat.
I know - we can assume we don't get lazy people asking questions on the RD. The fact is that we get plenty of people asking questions that they could answer themselves quicker than waiting for us. In my opinion, "Go see a doctor" is a completely invalid response to this question. It is a waste of everyone's time and resources to send someone to a doctor to find out if Nyquil contains something for a sore throat. A better answer could be, "If the label on the bottle says that it contains (ingredient 1), (ingredient 2), (ingredient 3)... then those are specifically used for treating sore throats." That makes the guy read the bottle himself. The best answer would be "Nyquil puts (ingredient) in some formulations. If yours has that, it is added for treating sore throats." Nowhere in any of those answers does it say "We all think you should take Nyquil. That is all you need for whatever your medical condition may be." It merely informs the person so he can make a more intelligent decision. I think of it as considering a slightly modified version of the question: "I have a sore throat. Does Liquid Plumber have anything in it that helps sore throats?" The answer "Go see a doctor" will not in any way inform this person that he should not drink Liquid Plumber. We could tell him that he shouldn't, but then we'd be giving medical advice. -- kainaw™ 16:06, 13 December 2007 (UTC)
Er, that scenario is the second case that I listed. If you prefer, we can answer the question with "You should speak to your pharmacist, or review the package insert." Damn it, it's important to get people to read the list of side effects and contraindications, or to have them explained. Taking medical – even over-the-counter medication – isn't something that we should encourage people to be lazy about. (If it's actually from 'Mom's medicine cabinet' we really ought to be discouraging laziness, as we might be providing incomplete information to a minor.) If someone can't or won't read the bottle before taking medication, then they probably should speak to their pharmacist before self-medicating. That small print really is there for a reason.
The Liquid Plumber question would, as you well know, be removed as a troll—not as a question of medical advice. Between the Liquid Plumber and your Coke Zero comment above, I'm not sure if you're applying WP:SENSE here, and I strongly recommend that you review it. It's one of our most important guidelines. TenOfAllTrades(talk) 16:27, 13 December 2007 (UTC)
I was explaining why a person would reasonably be holding a bottle of Nyquil without knowing what specifically it is used for. You seemed to imply that it was unreasonable for someone to do that. I agree that people should not be lazy. I've posted many "RTFA" replies. This case needs a RTF-Insert reply. However, it appears that RTFI is not allowed. The only answer allowed is "Go see a doctor." That is what I disagree with. "Go see a doctor" is not a valid response to every question about medical information. We can (and should) point people to the sources of information that they need. We should point this user to the ingredient list on the side of the bottle. Then, hopefully, he won't ask the same thing later when he has itchy eyes and wonders if Nyquil has anything in it that helps with itchy eyes. -- kainaw™ 16:39, 13 December 2007 (UTC)
However, inadvertently, you are actually proving the point of your opposition. You attempted to provide a case in which this was an "informational query", but it still boiled down to medical advice. There's someone with a medical condition, asking about a potential treatment for that condition. They have a sore throat and want the Reference Desk to tell them if it should be treated with Nyquil. Otherwise, a Google search on "Nyquil ingredients" would have been a faster answer to their question than a visit to Wikipedia.
No matter how the post is rephrased, if it boils down to "I have/think I have a condition. What do I do about it/Should I do this?" is off-limits. Wikipedians should not be answering this question, and leaving the question up encourages those not familiar with the underlying reasons for the policy to do exactly that, potentially to the danger or detriment of the OP.
Don't get me wrong - putting medical information in the hands of the people is indeed a good goal. It is one attempted by many authoritative sites that provide information after careful peer review by experts. It is, however, to one of those sites that a querent should turn, not to literally anyone online at the moment - which is the potential pool of individuals answering a question at the reference desk.
This is not, either, a question of assuming good faith. That is trumped by attempting to "first, do no harm" - and the vast majority of individuals asking the "informational" query "is X a symptom of Y" are, in fact, asking for a diagnosis - "I have X, does that mean I have Y?" One is unlikely to randomly come to reference desk with a truly idle curiosity over a specific symptom, not at all inspired by recent events and personal conditions. --Narapoid (talk) 03:59, 16 December 2007 (UTC)
I find that to be very wrong. The question did not "boil down" to medical advice. It is very clearly a request for medical information, not advice. Sure, it is fun to rationalize that red=blue, up=down, information=advice... That has no place here. The big difference that I'm rather surprised people do not see is that the first question asks us to provide advice. The second question asks us for information so the OP can create his own advice. I could also rationalize this as the OP asking if the Nyquil he just took for his sore throat actually has anything to help his sore throat. As such, he already took it and wants to know if he made an intelligent choice. But, that is just a rationalization and shouldn't be used in considering an answer. I don't know how to rephrase it, but I've continued to make the same point over and over and apparently I'm just making it more and more confusing. The second question asks for information. You may read it and rationalize that it is asking for advice. As such, your rationalization is asking for advice, not the question. Your rationalization should not be answered, but the question should. Refusing to answer based on your rationalization is an assumption of bad faith because you are assuming the person is asking what exists only in your head, not in the OP's head or in the words posted on the RD. Hence, my sarcastic RD warning: "Do not request any medical information that you may, in any remote although unlikely way, use at any time in the present or future in a decision about your health and well being or the health and well being of anyone that you know or will know." -- kainaw™ 18:51, 16 December 2007 (UTC)
It is unfortunate that you find it to be wrong. However, when a person is asking a question that clearly requests diagnosis (what might be wrong (implied: with me)?), prognosis (what will happen (implied: to me) as a result?), or treatment (What course of action results in the best results (implied: for me)?), that is a request for medical advice. The user will consider the random word of a stranger on the internet in their decisions.
When it is more contrived to "assume good faith" than trust common sense and personal judgment on an issue, the assumption is clearly in error. Likewise, with something as literally vital as a person's medical care, the assumption of good faith is insufficient to protect both Wikipedians and the querent. This is one case where a rule should be ignored, as the result of following it is dangerous to the user(s), and potentially to Wikipedia.
One continued problem is that you believe rephrasing your point will validate your point. I believe most of your opponents understand the point you are trying to make, and are repeatedly refuting it. By simply rephrasing the argument, claiming that the other individual isn't understanding the point, nothing is advanced. The original counterargument still applies, and the person speaking with you has no choice but to either cease discussion (potentially read as agreement), or rephrase their own argument in an open-ended loop.
You return to assuming good faith. This is a fine principle in Wikipedia articles proper - you assume that erroneous information was entered in good faith, but you respond by correcting the error and discussing it. The regular result of this cycle is an improved Wikipedia article.
The reference desk, however, does not have the same "eyes" on it that a Wikipedia article might, and the questions are of a more immediate nature. There is not always time for the process of alteration-revision-conflict-consensus - if a user drops in to ask a question, the first few responses may be the only ones that count.
Further, to assume good faith does not mean to assume the counterintuitive. It does not mean to assume that every user is fully cognizant of the extent of the medical prohibition, or the reasons behind it. It means to assume that participants are doing their best to improve the project. And I quote: "When you can reasonably assume that a mistake someone made was a well-intentioned attempt to further the goals of the project, correct it without criticizing." The "correction" here is to remove the inappropriate material as fast as possible, without criticizing the poster for their honest mistake.
I can assume easily that a poster is honestly concerned about their health, and is attempting in good faith to find information from Wikipedia. I can further assume that the first person to respond is acting in good faith by presenting anecdotal evidence of their own experience with a specific mentioned symptom. However, even with both posters acting "in good faith", the result can still be disastrous, with the querent leaving to base a judgment on incomplete and/or inaccurate information.
Really, all I can say here is to stress that it is not "bad faith" to assume that a querent is ignorant of policy, nor is it bad faith to interpret the underlying meaning of a question. It is however in bad faith to rationalize an excuse to circumvent a policy designed to protect users from dangerous misinformation or incomplete understanding. When a person arrives on the page asking "I have a certain symptom: What do I have and how can I treat it?", then no matter how they reword the question, we know the underlying thought is "Please advise me on my personal medical problem." in every rephrasing, and it is a violation of the purpose of the policy to answer any form of the question, as well as being ethically objectionable, IMHO.
There are always boundary cases, questions that not everyone agrees immediately to be requests for medical advice. No system of rules or law has been invented that doesn't require human interpretation, and that interpretation is always to some degree subjective and fallible. The goal most suggest here is to err on the side that does the least damage - in this case, avoiding the situation in which a querent receives an answer that might lead them to harm. It is considered better that a hundred potentially abstract "informational" medical questions go unanswered, and the querents turn to more conventional sources of information, than that one person should receive a misleading answer that would be a factor in causing them serious harm, and accept that answer instead of doing proper research and/or seeing a trained professional. --Narapoid (talk) 20:02, 16 December 2007 (UTC)
You are the very first person to provide a response that indicates that you understand my argument. I completely understand your point of view. If the question is literally asking for information but implies that the information may be used as advice, then the question should be considered a request for advice. Previously, every single response has been that claim that there is no such thing as a request for information. If it is medical then it is advice. That was my disagreement. I feel that it is possible to ask for information without asking for advice. Therefore, I wanted to work with others on defining when a request for information should be considered a request for advice and when it should be considered a request for information without any advice. It appears that you agree that there are cases where medical information is asked with no way of implying that the information will be used as advice. Is that true? The problem in the RD is that any and all medical questions are deleted. I've seen questions that looked more like homework questions deleted, such as "What part of the nervous system allows a person to sense heat?" or "What is the medical term for the little white bumps on a human tongue?" It could be rationalized that they were asking for some sort of diagnosis/treatment for a medical problem - but it is far more likely that they are just asking for information. Because of those issues, I've been pushing further and further towards the fuzzy area between advice and information to see if it is possible to reach any sort of guideline. I find this rather important because the current process is: OP asks for information. Someone deletes it. Someone asks why it was deleted on the talk page. The deleter says it was a medical question. Others explain that it isn't a medical advice question. The question is not reinstated - it is just lost and the OP assumes Wikipedia is one of those places where you have to be part of the in-crowd to keep your questions from being deleted. -- kainaw™ 20:56, 16 December 2007 (UTC)

[edit] This page is unnecessary.

It is too cluttered and is based on certain individuals' opinions, not on official Wikipedia policy. We already have a page at Wikipedia:Medical disclaimer which clearly explains Wikipedia's stance on medical advice. I suggest we just redirect this page there. —Nricardo (talk) 02:52, 26 February 2008 (UTC)

I think this does a decent job at explaining the reasoning and process behind what has become the established guideline on the desks. I don't see it as redundant to the disclaimer. Rockpocket 03:45, 26 February 2008 (UTC)
I disagree with "established". —Nricardo (talk) 03:59, 26 February 2008 (UTC)

[edit] I have a persistent cough. Can that be caused by heartburn?

I disagree with this implication that this section of the guideline represents the consensus. If you look at the last few years of discussion on the RD talk page, you will see that there is absolutely no form of consensus to support this section. While one person may rearrange the words to turn it into "Can MY cough...", it is just as valid for another person to rearrange it into "Can ANYONE'S cough..." That is why there is no consensus. I've tried, without any success, to get a consensus here, but nobody is willing to discuss things. I expect this attempt will be met solely with one person demanding that the absolute only way any sane person can read the question is as a request for medical advice. Then, another person will demand that the only way that any sane person can read it is as a request for medical information. No discussion or consensus will be reached yet again. -- kainaw™ 13:35, 6 April 2008 (UTC)

I have before flagged the addition of this test[1]. Thus far no one but you has indicated disagreement. It is not clear to me from what you write whether you only disagree with this section representing consensus, or also with the test itself. Of course it cannot be ruled out that a questioner may attempt to disguise a person-bound request for medical advice as a question for information that is not person-bound. However, that is not what questioners do. If the question as posed is person-bound, it is a request for medical advice. I know that some "anti-deletionist" regulars who are fond of lawyering and of answering such questions have argued that a questioner may rephrase the question in such a way that the fact it is a request for medical advice is disguised – so that we would be fooled into answering it – and that therefore it is not actually a request for medical advice and may be answered. I reject that as sophistry.
At the moment I see perhaps more of an overeagerness to remove informational questions as being requests for professional advice than the other way around. The test in the section is meant to work two ways.
If you know of a question that in your opinion was correctly removed but that passes the test, or, conversely, a question that was removed but shouldn't have been and that fails the test, please tell us what they are, so that the test may be refined.  --Lambiam 14:26, 6 April 2008 (UTC)
My disagreement with the section is that it may be used to strengthen an argument for removing any request for information that anyone may ask. For example, "I have a headache. Does aspirin or hydrocortisone help stop headaches?" According to this guideline, that is a request for medical advice even though the person is truly asking about the medical properties of aspirin. This can be stretched even further down the slippery slope to "I just fell down the stairs and I'm bleeding profusely. If I call 911, will someone help me and possibly take me to the hospital?" The way questions are deleted around here, that would be a clear nomination for deletion. What if the person lives in a country where 911 is not the emergency number? What if the person doesn't have a phone? What if he or she calls 911 and the person who arrives is incompetent and causes more harm than good?
This is an area that has been, in the loosest sense of the word, debated for a very long time without any consensus. I have difficulty claiming there has been a debate because all I see is one side claiming "If it is medical, it is banned from Wikipedia or we'll all get sued!" Then, there is the other side claiming "There is no real reason to remove any question for any reason. If you do, you are a content Nazi!" There is no middle ground argument. I believe that I am in the sane section of the middle ground. There are others (many who disagree with my views) that are also in the sane section of the middle ground. I simply do not know how to get them to put any effort into coming to a true consensus which will allow us to write a guideline that is based on that consensus. -- kainaw™ 19:52, 6 April 2008 (UTC)
My perception is somewhat different. I think most discussants are somewhat in the middle, although among those some are more loose and some more strict in interpreting questions as being deleterious. What makes the debate less fruitful is, in my opinion, partly a matter of discussants not being aware of these guidelines. For example, there is indeed a recurrent misunderstanding, expressed in the debates, that the point of not giving medical advice on the RD is a legal issue. However, it is a matter of ethics: we want to avoid the real possibility of doing harm. That is clearly stated in the "Why?" section of these guidelines for medical advice. Another matter is that some discussants do not seem to realize that it sometimes may indeed be difficult to draw the boundary, and vehemently disagree with those who reach a different conclusion, instead of aiming at clarifying the how and why of different assessments. One purpose of having guidelines is that they may help in shaping such discussions – but only if we keep pointing them out to people who appear to be unaware of them.
Personally I do not see much risk of the "test" being used in attempts to bolster arguments for removing any request for information. The example you give is, however, problematic. If I saw a question like "I have a headache. Does aspirin or hydrocortisone help stop headaches?", I would assume that the questioner is trolling. Assuming however it is an honest and real question, there is indeed a real risk that the answers given might discourage the questioner from seeing a medical professional when needed.
You are concerned about a potential misinterpretation of this section of the guidelines. As always, guidelines are not cast in stone and should be interpreted with common sense, and what counts on Wikipedia is not a legalistic interpretation but the consensus of the editors. Still, we want the guidelines to be helpful to those who read them for being enlightened. If you know of an actual case where this test has been used as an argument for removing a request for information that should not be classified as seeking medical advice, please let us know, so that the text of this section may be refined to exclude such misinterpretations.  --Lambiam 07:30, 7 April 2008 (UTC)
There is an example that happened recently. A person wrote a long diatribe about conflicting information about how much Vitamin C a person should take. Then, he asked how much should a person take. He wanted to know what the recommended daily allotment of Vitamin C should be for any average person. However, since he stated that he had read about recommendations and heard advice from people and read the notes on Vitamin C bottles and such, this test turned it into a request for medical advice. A few users vehemently defended their opinion that this was a request for medical advice by quoting this guideline and this test - even after the questioner returned to say he just wanted to know what health agencies around the world were telling people to take and why.
That is when I realized that "personalizing" a request for medical information causes some people to read it as a request for advice. In this case, I can simplify it to "I've been taking Vitamin C supplements. How much should a person take?" The question really has nothing to do with the fact that he has been taking them. He is just personalizing the question so he doesn't sound so impersonal. If you remove the personalization, you get "How much Vitamin C should a person take?" That is clearly a request for information - with a very obvious answer. You link to the vitamin C article and quote the FDA guidelines. Since then, I've seen many questions where a person explains why they are requesting information and are given a hard smack for requesting advice. I told a person to just ask for the information - do not explain why you want the information. Then, I was ridiculed for coaching users into tricking the RD into giving advice.
This comes down to what I believe the test should be. In my headache example, the answer is "Aspirin may be used to treat a headache. Hydrocortisone is often used to treat itching and swelling." Does that answer contain medical advice? Of course not. It is purely medical information. In the Vitamin C question, the answer is "The FDA allotment for Vitamin C is 90mg/day. Some countries suggest as low as 40mg/day." Is that medical advice? Of course not. It simply quotes recommended daily allowance from government sources. So, I feel that the test should be: "Does an answer to the question require medical advice? If not, the question may be answered only with medical information and must, therefore, be asking for information and not advice." -- kainaw™ 12:21, 7 April 2008 (UTC)
If respondents have a problem distinguishing medical information from medical advice, it is not going to help them if we tell them: "Here is how to make the distinction. If it is simply medical information, then it is simply medical information and you may supply that as an answer. However, if it is medical advice, then it is medical advice and must not be given as an answer."
As to your Vitamin C case: can you dig that up? It sounds like an obviously ludicrous interpretation, but I need to see the actual exchange to check this. I see you taking the stance here that the consensus is actually much stricter than given by the test, using a hypothetical non-person bound request for information if there are any documented studies on the "best" amount of Vitamin C to take. You claimed there that the consensus is that this is a no-no, while others disagreed with you. I'm getting confused now. Did your interpretation of what the consensus is change that much in under three months?  --Lambiam 22:52, 7 April 2008 (UTC)
Forget it. I'll chalk this up as yet another failed attempt to get some discussion on the matter. -- kainaw™ 12:43, 8 April 2008 (UTC)
Failed in what sense? You can't mean that you have been posting comments without getting a response. Could it be that in your eyes it only counts as discussion when you can get other discussants to agree with you? I submit fpr your consideration that presenting highly contrived hypothetical examples for which you attack strawman positions is not conducive to eliciting fruitful discussion.  --Lambiam 22:28, 8 April 2008 (UTC)