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Monday, August 31, 2009

Publishing Rorschach info lands SK doc in hot water


Most complaints against rural Saskatchewan doctors go unremarked upon in the pages of the United States's paper of record, the New York Times. But not the ones just recently filed with the provincial regulatory college against Moose Jaw emergency physician James Heilman.

According to the Times article, two psychologists have filed complaints against Dr Heilman because he added to Wikipedia the ten famous Rorschach inkblots and common responses and interpretations of those responses -- images and information which some think should have been kept secret from patients to preserve the test's viability. (It should be noted that the images are in the public domain, and Dr Heilman has done nothing illegal.)

It's a fascinating situation. Can the test really be rendered impotent by the publication of the images online? Is Dr Heilman's decision to expand public understanding unethical because of the consequences some psychologists allege it may have? Are those allegations reasonable? Is this Rorschach matter somehow distinguishable from, say, the publication of DSM diagnostic criteria, particularly the criteria that could conceivably garner patients prescriptions to powerful drugs?

None of these are easy questions to answer, but they may be important ones to address as patients increasingly consult the internet about medical questions, and other privileged professional information makes its way online.

For those who are interested, this is the Wikipedia page where the inkblots and information bout them appear. An entire page at Wikipedia is devoted to debating the inclusion of the images, and itself some interesting material to think about.

5 comments:

  1. This paste from the wikipedia puts the good doctor's actions into perspective:

    'outlines of the ten official inkblots were first made publicly available by William Poundstone in his 1983 book Big Secrets, which also described the method of administering the test. The blots are in the public domain in most countries, particularly those with a copyright term of up to 70 years "post mortem auctoris"'

    end of paste

    One might liken these gestures to the times when the Bible and Foxes' Book of Martyrs were" chained to the church pews". The thinking was too easily labelled as " ignorance is bliss" when the truth was the " toothless wolf syndrome"in the clergy.

    As for me, I fear the "bits and bytes" appetite of the medical consumer puts them into the category of " a little learning is a dangerous thing".

    But I also fear that many physicians fit into that category and patient discomfort ends up labelling all physicians under the title " a liitle leaven leavens the whole lump".

    Yikes.... 30 years ago physicians would freak at the concept of the Merck Manual ( their Bible) being available to the public...as it is now.

    What to do?

    The medical practitioner now has a discerning audience...the real challenge is to be skilled enough to meet their challenges and expectations in diagnostic and treatment skill.

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  2. P.S. Inkblot shown is definately a " puppy mill" bat ( too many wings) :)

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  3. very interesting info that I personally really like all

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