President Trump:Diagnosis and, if Necessary Therapy: Doing it Ethically

An excellent article written by physician-ethicist  Joseph J. Fins in Harvard Medical  School Bioethics Journal  and it is my reading that he suggests when it comes to the psychiatric fitness of Donald Trump to be the United States President, it should not be a psychiatric diagnosis (such as "sociopathy")  from afar but should be the education of the public in a clinical non-partisan fashion  by the psychiatrists of the symptoms of disease and it will be the public and their government to prescribe and carry out the appropriate treatment. 

In Dr. Fin's words:

In the context of the president’s personality, it is not an outright diagnosis that is needed per se but a public appreciation of what sociopathy is that can help inform a response. Medical diagnosis demands a high evidentiary standard. In the public sphere, mere knowledge of what sociopathy entails may enable the requisite scientific literacy for the citizenry to decide if observed behaviors fit a discernable pattern of psychiatric diagnosis that has a bearing on an ability to govern. This knowledge is especially important in sociopathy, which by its nature can obscure and seduce the observer. Human nature is drawn to sociopathy and vulnerable to its charm. Public awareness of sociopathy’s existence and nature is thus vital to deliberative democracy. This knowledge becomes a component of basic scientific literacy for deliberative democracy. Having said this, this knowledge need not require understanding at the level of clinical nosology. It may constitute essential knowledge like the germ theory of disease: even if they can not diagnostically distinguish an errant gastroenteritis caused by E. Coli or Salmonella, the public knows enough to engage in personal hygiene and perhaps avoid potato salads simmering in the sun at a summer picnic. Public knowledge about sociopathy has a similar utility: it can help guide behaviors and inform responses by our political leaders and journalists in the Fourth Estate as they do their work. 

So read the entire but brief article  and return with your idea of the role, if any, for the psychiatrists in relation to the American public with regard to President Trump.  Remember, this thread is not about presidential policies but about how to make a psychiatric diagnosis and who should be supervising any treatment.  ..Maurice.

GRAPHIC: From Google Images

Patient Modesty: Volume 84

Currently on a bioethics listserv to which I read and contribute there is a discussion about policies within the healthcare system which attempt to protect the participants of the medical institution from demands of patients with regard to race and ethnic background.  One response by a physician was that his hospital institution had a policy to

"employ people on the basis of their skills and competence and without regard to gender, skin color, religion, etc. and when patients or families make discriminatory requests they must be evaluated in light of this commitment.  Some seemingly discriminatory requests may be accommodated if there are good reasons to believe they have good psychological or medical validity and if doing so can be accomplished without compromising patient care pr staff safety (e.g., a teenage girl requesting a female physician for a pelvic exam).  In our experience, the overwhelming majority of these incidents occur with nursing staff and allied health personnel (like phlebotomists or ECG techs). Most never percolate up the chain so that senior folks hear about them and they are usually handled locally by juggling staff assignments."

I responded with : It ain't just a "teenage  girl requesting " a gender selection of a physician or more often that of nursing and allied staff (including scribes!) performing or presence when genitals are being exposed.  And in my 13 year ongoing Bioethics Discussion Blog thread on "Patient Modesty" it is mainly men who are demanding but very often not receiving their gender "discrimination" requests and are left either avoiding necessary medical care or leaving "care" emotionally upset.  Although my blog thread is titled "modesty" there  has  been "no...none" racial or country origin demands ever mentioned or exampled. 

Well, another listserv participant followed up with: "Maurice, maybe that is because discriminatory requests based on race or national origin are not necessarily associated with the heading of 'modesty' ?"  

And so to start off this new Volume,  yes, the title of this thread is "modesty" but is it true as the participant wrote it is inappropriate for me to infer that beyond this issue the writers here are free from racial or ethnic bias or any of the other issues of social inequality because of this thread's directed subject matter?  Or are gender issues lengthily covered here may be or are  related to other medical treatment concerns which could be described as attached to other aspects of social equality or inequality such as race and ethnic origin which also bothers my visitors? Repeating: Is the medical profession not offering all that it should be offering to patient desires to those writing here in terms of social quality, beyond poor attention to modesty.  ..Maurice.

Graphic: From Google Images and modified by me with ArtRage 3.  

THERE WILL BE NO FURTHER POSTING OF COMMENTS ON VOLUME 84.

THE POSTING OF COMMENTS WILL RESUME ON VOLUME 85.