If you see medical advice given in an AskMe and it seems irresponsible, is it better to refute the advice in-thread, ignore, flag?
posted by treehorn+bunny to Etiquette/Policy at 9:58 PM (66 comments total)
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I was frustrated with a question today about shortness of breath and chest tightness
in which an answer suggested "sounds a bit like anaphylactic shock." Anaphylactic shock being a life-threatening diagnosis. To me, that was irresponsible, especially given that the asker had made quite clear that he was very anxious about his symptoms (and it was certainly apparent to many that the symptoms could be anxiety or panic related). I said as much in the thread, but I believe in-fighting amongst answers is discouraged, and I kept my response short. Another poster then stopped by to respond to me saying essentially "well, it could still be anaphylaxis!" which then prompted me to respond back, which I know I probably shouldn't have because it's more arguing with another poster than answering the question at hand. You can delete my response if you deem appropriate.
You know what, it could be anaphylaxis (although I still maintain that it does not sound like anaphylactic shock). It's technically possible. As a doctor I am well aware of that. There are very few absolutes in medicine. However, I would prefer if as a community we could agree that if we're going to offer up diagnoses to people based on a few lines or paragraphs or internet text, we try not to do so in an alarmist manner. A not infrequent question that just came up was about a lump on the abdomen. Yes, we could respond to such questions by saying "hey, did you know that could be metastatic cancer? Maybe ask your doctor about metastatic cancer." But I would argue that is irresponsible and unduly frightening. It could be metastatic cancer, but it's not likely to be. And you can't just say "I don't mean to frighten you, but let me bring up some ways you might be dying." Even if I read a post and thought it was absolutely likely that the person was describing symptoms of metastatic cancer, I would not offer that diagnosis over the internet. Even as an ER doctor, I'd much rather have everyone saying "go to the ER!" than trying to diagnose emergencies themselves. Like many things, I do think this is contextual - if 65 year old gentleman with high cholesterol stops by to ask about his current symptom of chest pressure in a way that seems dismissive or blase, I might think it more appropriate to mention possibilities like "You should take that seriously - it might be a heart attack."
I know that I not infrequently myself offer some suggestions about what a person might have, and perhaps might be guilty of giving irresponsible medical advice at times - although I try hard not to, especially because I know that as a doctor my answer might be given undue weight from what it should be as a medical comment on the internet, despite my constant addition that IANYD/TINMA. If I did do so I would want it to be addressed. I want to know what the protocol is if I read such a comment or if someone else reads a comment of mine and feels that way. Should I not have made a "meta" kind of comment in that thread? Should I have just flagged the answer or contacted a mod? Just let it stand but offered my own answer and reasoning? I checked the FAQ and did not see protocol for this.