![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 16 to 40 of 51. Go back in thread:
Posted by ClearSkies on August 28, 2014, at 11:01:12
In reply to Lou's response-GreytDesptshun » ClearSkies, posted by Lou Pilder on August 28, 2014, at 9:25:41
I am projecting here, to be clear: but I believe it might be a desire to not further pursue a discussion, and nothing more meaningful than that.
Pardon me if I am misconstruing.
ClearSkies
Posted by Lou Pilder on August 28, 2014, at 13:08:06
In reply to Re: Lou's response-GreytDesptshun » Lou Pilder, posted by ClearSkies on August 28, 2014, at 11:01:12
> I am projecting here, to be clear: but I believe it might be a desire to not further pursue a discussion, and nothing more meaningful than that.
>
> Pardon me if I am misconstruing.
> ClearSkiesClearSkies wrote,[...it might be a desire to not further pursue a discussion...].
That is Ok for anyone to have a desire to not pursue a discussion, but for me I want to save lives here and for me to uncover what could mislead you and deceive you needs for me to pursue this discussion.
One of the classic tactics of deceit is to use evasion. To understand how different tactics used in evasion , I want to present examples for readers to use in determining if evasion is being used so they might not be mislead. Let us look at this example and then look at that there are unanswered questions which is the tactic of just not answering that could be seen by a subset of readers as evasion:
Lou
http://www.dr-bob.org/babble/admin/20140304/msgs/1068737.html
Posted by bryte on August 28, 2014, at 23:00:15
In reply to Re: discussion, posted by Dr. Bob on August 28, 2014, at 4:05:05
> > > > > Can you say more about your interest or concern about whether I have insurance?
> > > >
> > > > Yes, I can.
> > >
> > > Great, please do.
> >
> > I did.
>
> I must have missed it, can you post a link? Thanks,
>
> Bob
>
>>>>If guests were attracted to ... the presence of a clinical licensed professional and the relationship proved to be a nuisance because the clinically licensed professional deploys untested techniques that damage the mental tranquility of invitees known to already be at risk, would that comprise an attractive nuisance?http://www.dr-bob.org/babble/admin/20140304/msgs/1069800.html
https://www.google.com/search?q=attractive+nuisance
>>>Section 230 of the Communications Decency Act ... does not shield service providers from liability [for messages] the provider "take[s] responsibility for."www.dr-bob.org/babble/admin/20140304/msgs/1069599.html/msgs/1070152.html
> The poster could feel like I'm throwing a stone at them.>>>Do you select whom you engage in ways that could lead that person to feel you are throwing a stone at them?
>>>Do you have ... a consistent policy for balancing the risk of reinforcement against the advantage of removing a trigger to which you exposed an invitee?
http://www.dr-bob.org/babble/admin/20140304/msgs/1069473.html
>>>Are you saying do not capriciously enforce arbitrary ad hoc rules .... by anybody's definition?>>>Or are you saying that you ... do not knowingly do so?
http://www.dr-bob.org/babble/admin/20140304/msgs/1070152.html
>>>...a common interest in harm reduction... Do you think my concerns are different than your concerns?http://www.dr-bob.org/babble/admin/20140304/msgs/1070108.html
>>>If someone were harmed, would you want to make them or their surviving family whole? Do you believe no harm could result, or that you could in no way be liable [for] harm that results from your activities here?http://www.dr-bob.org/babble/admin/20140304/msgs/1069800.html
Posted by bryte on August 28, 2014, at 23:23:24
In reply to Re: discussion (interjection), posted by ClearSkies on August 28, 2014, at 5:13:12
> > > > > > Can you say more
> How many times have I seen this tactic
"[T]his tactic" could address a broad open ended question that makes only general reference to previously specified concerns.Or, "this tactic" could address a reference to previously described concerns in response to a general open-ended question that does not recognize previously specified concerns.
Even if we presume reference to "this tactic" reveals a bias toward one or the other definition, we cannot count how many times. We cannot count the times because we cannot measure the extent to which observations and experiences in fact revealed signs of the end of a discussion.
Errors in observation can arise from bias and reactivity.
Posted by Dr. Bob on August 28, 2014, at 23:39:33
In reply to Re: discussion, posted by bryte on August 28, 2014, at 23:00:15
> > > > > > Can you say more about your interest or concern about whether I have insurance?
I didn't mean what your concerns were, I meant why you have those concerns, what you hope to accomplish here, etc. Something about you. I-statements.
Bob
Posted by bryte on August 28, 2014, at 23:55:05
In reply to Re: discussion, posted by Dr. Bob on August 28, 2014, at 23:39:33
> > > > > > > Can you say more about your interest or concern about whether I have insurance?
>
> I didn't mean what your concerns were, I meant why you have those concerns, what you hope to accomplish here, etc. Something about you. I-statements.
>
> BobI think my concerns are more about offering support and education than getting some for myself.
Posted by Dr. Bob on August 30, 2014, at 12:39:11
In reply to Re: discussion, posted by bryte on August 28, 2014, at 23:55:05
> I think my concerns are more about offering support and education than getting some for myself.
OK, you're on the altruistic side. That's great. It's always good to have more sources of support and education,
Bob
Posted by bryte on August 30, 2014, at 13:27:42
In reply to Re: discussion, posted by Dr. Bob on August 30, 2014, at 12:39:11
> OK, you're on the altruistic side. That's great. It's always good to have more sources of support and education,
>
> BobInterest in my altruism would be more believable if you would address my concern.
Are you flying without a net, with nothing more than your self-confidence to assure the group that no harm results from the attraction you create?
Posted by pontormo on August 30, 2014, at 21:57:27
In reply to Re: discussion, posted by bryte on August 30, 2014, at 13:27:42
As I recall from my registration, Bob says that he's not directly responsible for posts, and that he doesn't closely monitor and supervise them for either accuracy or wisdom. Plus
there's no suggestion that because a trained mental health professional owns the site, that there's greater protection here for participants. Quite the reverse, I thought.So there is a point at which people assume the risk for things that they do, especially if they're informed that a risk of some sort is involved. So I have always believed that we as posters were assuming some risk by coming here.
I too was wondering why you were so concerned about the issue of insurance and legal liability. i was thinking that usually this would mean that you feel youve observed here that's raised the issue for you. Or that possibly something in your own life makes this particularly important-- since for example and to the contrary I've never even given this a moment's thought.
Posted by bryte on August 30, 2014, at 22:35:29
In reply to Re: discussion, posted by pontormo on August 30, 2014, at 21:57:27
> there's no suggestion that because a trained mental health professional owns the site, that there's greater protection here for participants. Quite the reverse, I thought.
What is "best of both worlds?"
But if it is quite the reverse, my concerns are all the much more relevant.
> I've never even given this a moment's thought.Then either my posts introduce you to new interests, or they do not interest you. I trust some people find these interests important and appreciate an opportunity to consider the matter in a different light.
Posted by pontormo on August 31, 2014, at 0:32:52
In reply to Re: discussion, posted by bryte on August 30, 2014, at 22:35:29
I guess my point in saying that I hadn't thought about it went to the idea that you might have some personal reaction or special concern that you might be willing to communicate.
When I find someone having a puzzling and seemingly somewhat perseverant reaction, it helps if I can see how the reaction might have arisen.
It's not that I don't find the question interesting--- I wouldn't have spent the time I have researching it, if I didn't. But after looking into it, I remain unclear how it would contribute to either my or Bob's sense of security in using or setting up the site.
I may not have considered some element that you see. Or you may have some greater sensitivity to potential harms than I do. Lots of people have left, presumably because it was no longer part of their self-interest or well-being to stay-- most unfortunately. But how would Bob's having insurance have prevented that, or convinced them to be more trusting?
Posted by pontormo on August 31, 2014, at 0:48:59
In reply to Re: discussion, posted by pontormo on August 30, 2014, at 21:57:27
PS Moreover, to clarify: my "quite the reverse"-- I was saying the "IMPRESSION ONE GETS FROM THE REGISTRATION FORM" is quite the reverse from the idea that there is a mental health professional closely monitoring or otherwise assuring the safety of the site for the vulnerable.
Rather one gets the impression that the site is mainly composed of posts from other posters, that while the spirit here is to be civil and there is some oversight of that-- everyone is more or less left to sort it out for themselves.
I was not suggesting that because a mental health professional, was the webmaster, the site was IN FACT any less protective.
Perhaps that was how you had read it?
Posted by bryte on August 31, 2014, at 2:49:29
In reply to Re: discussion, posted by pontormo on August 31, 2014, at 0:32:52
> But how would Bob's having insurance have prevented that, or convinced them to be more trusting?
Insurance demonstrates accountability. Accountability fosters trust.
In so far as Dr. Hsiung wants members to trust his active involvement, communities will inevitably ask him if he is accountable for his actions.
At times, Dr. Hsiung has expressed a desire to trust his community more - perhaps to inspire others to trust the community more. But only he can decide which community he trusts, and how much he will trust the communities of which he is a part.
His community includes graduates of universities trained in various specialties, including experts in actuarial sciences. He has also facilitated establishment of a community that includes a significant proportion of psychologically or mentally at-risk members. Those members often are attracted by the hope of enhancing their efforts to relieve psychological or psychiatric ailments.
Dr. Hsuing at some point added an informed consent procedure to his enrollment process. The procedure alludes to risks involved in participation. The named risks include the potential of receiving bad information, and exposure to sensitive topics.
The risks named in the informed-consent process are foreseeable to the invitee. There may be other, unforeseeable risks. Those can include hazards that result from a premise owner's actions unforeseeable to an invitee.
The named risks do not include a participant's reactions to being told by a doctor it benefits a group to sanction the participant for statements while others who make similar statements do not suffer sanctions. The named risks do not include risks associated with involvement in a research project that is the subject of publications in professional journals without the involvement of a human research protection program.
An HRPP might require a researcher to advise invitees that conversational standards might not be enforced consistently. An HRPP might require notice that a person may suffer reactions caused by inconsistent, public enforcement of standards that place a sole administrator's perceived notion of group benefit ahead of individual's needs - including needs deriving from attachments to the group. An HRPP might advise invitees the group is administered based on one individual's emerging and undocumented sensibilities - sensibilities described as "I know it when I see it."
An insurance policy means experts have assessed risks associated with an activity. It means actuarial scientists, through an insurance agent, have advised the policy holder how much it costs to underwrite indemnity for insured risks.
An insurance policy means the holder cares enough about those who use a service to provide a means to make an invitee or their survivors whole if they suffer harm as a result of hazards associated with an attraction - especially hazards created by the policy holder.
An insurance policy means the holder has contemplated and acknowledged that harm could result from delivery of services the holder offers. An insurance policy means a service providers recognize they cannot competently anticipate every error they might commit that could cause harm or lead to loss of life.
Then the question arises, why do "I" post these concerns? Is it some "...personal reaction or special concern that you might be willing to communicate?"
It is simple compassion. It is a capacity to countenance the suffering of others. Then some might ask, why concern myself with this suffering.
Every day, on average, 10 people in the U.S. die as a result of unintentional, non-boating related drowning. Why would it concern me if I passed by one body of water where one person was drowning?
If I knew waters off of a beach to have a strong undertow and someone was attracting people to that beach but not warning them of the hazard, why would I concern myself with that situation?
Posted by Phillipa on August 31, 2014, at 20:29:06
In reply to Re: discussion, posted by bryte on August 31, 2014, at 2:49:29
Out of curiosity how do you know who the community consists of in professions unless you have been a poster from about the beginning of babble? Phillipa
Posted by pontormo on August 31, 2014, at 21:17:42
In reply to Re: discussion, posted by bryte on August 31, 2014, at 2:49:29
From what I 've read, HRPPs only apply to human research, and from what Bob has said, he's not doing any research on psychobabble now. So that really doesn't apply at the moment. If he were to do research, I'm sure he would go through all the relevant protective procedures, if only because they're required.
But I would think that looking through Bob's bio on the page would be pretty reassuring to anyone who is afraid that Bob doesn't care about the ethics of having an online site. For example he was the Chair of the "Ethical, Legal, and Social Issues Working Group, American Medical Informatics Association" in 2007-8 and President of the International Society for Mental Health Online in 2009 . I just think that his training and the respect that he clearly is held in, would be profoundly reassuring.
Putting that much ti me into thinking about these issues says more about his commitment than just having insurance, which could mostly protect him-- and could just as well suggest that he thinks people will come to harm here and blame him, as much as it could reassure anyone. People take these things in such different ways, that it's not clear that insurance is per se reassuring.
His colleagues have much more information about him than any of us can possibly have-- and their choosing him, as well as his volunteering to do this work, says a lot.
I just find his biosketch incredibly reassuring-- and I hope you've taken at his credentials-- Most people would I think come to have a lot of confidence in him and his judgment and his caring from that.
He himself says that he's not perfect-- that he can only do the best he can do to be fair and make good decisions. That's really all we can ask of anyone. I take him at his word-- and while I've disagreed with decisions, haven't lost the sense that this place is valuable.
But I'm sorry that you don't find it so.
pontormo
Posted by bryte on September 1, 2014, at 1:34:47
In reply to Re: discussion » bryte, posted by Phillipa on August 31, 2014, at 20:29:06
> Out of curiosity how do you know who the community consists of in professions unless you have been a poster from about the beginning of babble? Phillipa
You could be reading reading something into the statement that is not there. It is easy to discern that a medical doctor's professional community includes actuarial scientists. My interest is how much he isolates or includes himself in his professional community.It is obvious that the community of a mental health forum includes mentally or psychologically at risk members.
Maybe you do not understand my post as it was intended it, but those are the communities described.
Posted by bryte on September 1, 2014, at 5:29:42
In reply to Re: discussion, posted by pontormo on August 31, 2014, at 21:17:42
> From what I 've read, HRPPs only apply to human research, and from what Bob has said, he's not doing any research on psychobabble now.
Read more.
"Submitting a message gives me permission to use it as I wish."
http://www.dr-bob.org/babble/admin/20140304/msgs/1068731.html
He failed to mention in the post linked there that he is presenting those research findings - another "case study" as he describes his systematic evaluations - at the XVI World Congress of Psychiatry in Madrid later this month.
In as much as he did not include an HRPP IRB in reviewing his methods and informed consent process, his research presented at XVI WCP might not be acceptable for consideration as research in programs regulated by CFR Title 45 Part 46.
Even if these ongoing publications were mere "case studies" and US HHS exempts case studies, as Dr. Hsiung claims without citing any authority other than CFR 45 part 46.102(d), his conclusion is flawed because quiz answers provided here do not inform participants' capacity to give adequate informed consent to research.
Informed consent at this site requires participants to agree that "The current purpose of this group is: (NOT) to collect research data" but that "Dr. [Robert Hsiung] may publish a case study in an academic journal that includes your message."An IRB might reach a different conclusion, but we do not know because we are not directed in our supposedly informed consent to a related IRB that could tell us what any institutional body concluded. An IRB might conclude that to systematically and repeatedly "publish a case study that includes ... messages" involves systematic collection and evaluation of research data.
An IRB might or might not conclude that such incongruent questions require participants to agree to incongruent conclusions. An IRB might asking mentally disabled individuals to such an incongruent, nuanced offers a promise of group participation as an incentive for consenting to research that could expose them to risks.
An IRB might conclude that the incongruent nuance deliberately or inadvertently selects participants with compromised decision-making capacity, or otherwise forces compromise in decision-making capacity as an initial selector for research compliance. But we do not know, because an IRB has not reviewed the quiz passed off here as informed consent.
>So that really doesn't apply at the moment.
To you. At this moment. Or maybe it does now that you know about his current research. Or non-research citing your involvement to be presented at the World Conference on Psychiatry this month.
Either way, others have different views.
> If he were to do research, I'm sure he would go through all the relevant protective procedures, if only because they're required.
That has not always been the case. It not be the case now. He appears to designate himself the arbiter of what is relevant. Did an HRPP review his use of participants at this website in methods used to reach the conclusion to be presented at XVI WCP that "It is possible to obtain valid informed consent online" -- Implicitly proven possible by using his novel, minimal and unapproved methods?
If it were a case study, and not research, it would present a question - not a conclusion. A case study would ask "is it possible" - not conclude "it is possible."
"Cases are designed to confront readers with specific real-life problems that do not lend themselves to easy answers." http://research-ethics.net/discussion-tools/cases/
You consented, but apparently were misinformed or were not informed that your participation here was currently being used as part of a research method to be presented at the World Congress of Psychiatry that supports a conclusion on the subject of informed consent.The first element of CFR Title 45 informed consent requires: "(1) A statement that the study involves research..."
Dr. Hsiung's purported informed consent requires that we agree with him that his research findings based on evaluation of interaction with us do not comprise research.
To support his claim that the systematic methods he uses to investigate and evaluate subjects including informed consent, online mental health support groups, and reactions to suicide among an online support group are not research, Dr. Hsiung cites CFR 46.102(d):
"Research means a systematic investigation, including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge. Activities which meet this definition constitute research for purposes of this policy, whether or not they are conducted or supported under a program which is considered research for other purposes. For example, some demonstration and service programs may include research activities."
"(f) Human subject means a living individual about whom an investigator (whether professional or student) conducting research obtains
(1) Data through intervention or interaction with the individual, or
(2) Identifiable private information."
Dr. Hsiung's public admonishments, his conversations with participants that produce statements for ostensibly non-research "case study" publication in peer-reviewed research journals and his collection of quiz answers for presentations at global psychiatric conferences are data collected through intervention and interaction with individual participants. He evaluates data obtained through his interaction with individuals.His collection of e-mail addresses and internet addresses sufficient to intervene when he believes he observes a psychological emergency comprises identifiable private information. Public records created when he utilizes local authorities to respond to perceived emergencies create situations where individuals might not anticipate the limitations of his effort to "protect the privacy of subjects and to maintain the confidentiality of data. @46.111(a)(7)"
46.111(b) says an IRB must be assure that "When some or all of the subjects are likely to be vulnerable to coercion or undue influence, such as children, ... mentally disabled persons, or economically or educationally disadvantaged persons, additional safeguards have been included in the study to protect the rights and welfare of these subjects."
There is no age test here, so children may be involved. We do not know. Where the forum is accessed in Europe, those European participants in Dr. Hsiung's systematic evaluations of "an online self-help group hosted by a mental health professional" may not "discontinue participation at any time without... loss of benefits to which the subject is otherwise entitled. [46.116(a)(8)]" The benefit they lose is the European right to be forgotten because Dr. Hsiung claims a perpetual, irrevocable right to do as he wishes with his human subject's written statements.
Dr. Hsiung's individual impression might be that he is not conducting research when he systematically collects material from human subjects for published case studies. He might individually conclude that it he is not conducting research when he publicizes individual's online statements for which he has required them to relinquish all rights - including Europe's newly recognized right to be forgotten.
But he cites no authority that has approved his conclusion other than a federal regulation that, to an average reader, can appear to contradict his conclusion. Contrary to naming an authoritative panel that supports his conclusion, he represents himself as an expert to peers for the purpose of advancing his conclusion.
> His colleagues have much more information about him than any of us can possibly have-- and their choosing him, as well as his volunteering to do this work, says a lot.
Many a misguided investigator has "volunteered" to try methods independently for which they could not otherwise secure institutional approval.
Publication is a requisite of an academic career. That says something, too. It says a lot that most healthcare providers who offer online health forums choose more typical social network practices that do not so much involve a personal brand and personalized, public admonishment of participants when they offer online support and educational services.
> I just find his biosketch incredibly reassuring-- and I hope you've taken at his credentials-- Most people would I think come to have a lot of confidence in him and his judgment and his caring from that.
>
> He himself says that he's not perfect-- that he can only do the best he can do to be fair and make good decisions. That's really all we can ask of anyone.
If "we" is limited to yourself and those who agree with you, yes. Excluding yourself and those others if you will, we can ask more of people than that they use their own best judgement or that they do what they think is "good.""...the judgment of the investigator is not sufficient as a basis for reaching a conclusion concerning the ethical ...set of questions." -- 1963 NIH Panel that investigated research at the Jewish Chronic Disease Hospital in Brooklyn.
We ask of health research professionals that they rely on the judgement of their community. Most institutions with IRB panels require that the oversight community include actuarial scientists trained to assess risks involved with novel activities that can affect the health of participants. Actuaries are involved when institutions require research projects to be insured. They require insurance in part to protect their institutions against liability arising from research errors. They may require insurance because they consider themselves ethically obligated to indemnify participants for harm.
Title 45 Part 46 requires "(6)For research involving more than minimal risk, an explanation as to whether any compensation and an explanation as to whether any medical treatments are available if injury occurs and, if so, what they consist of, or where further information may be obtained;"
The pre-quiz statement on this site, which subjects might or might not understand before answering 10 multiple-choice questions states "It may be hard to deal with issues like suicide that come up."
Does "more than minimal risk" include contagious psychopathology in a group where suicide is something that can "come up" because the researcher allows and promotes that discussion in public groups for reading by non-enrolled invitees, accessible by search engines and promoted by social-media republication? And who publishes ostensibly non-research case studies about multiple members who have committed suicide, including evaluation of how he manages public discussion of those adverse events among the group?
Title 45 Part 46.102(i) says "Minimal risk means that the probability and magnitude of harm or discomfort anticipated in the research are not greater in and of themselves than those ordinarily encountered in daily life or during the performance of routine physical or psychological examinations or tests."
When health research is involved - and especially when the research involves defining informed consent, we can ask more of researchers than that they "...be fair and make good decisions" according to their own discretion.
"Ethical lapses are almost never cases of bad people, doing bad things, for no good reason. Rather, they are good people, doing bad things, for good reasons," says Marcia Angell, MD former Editor-in-Chief, NEJM
Dr. Hsiung will tell the XVI WCP that "Valid informed consent requires assessment of decision-making capacity."
His methods only address decision making capacity of participants. He does not address decision making capacity of the researcher.His methods imply that a capacity of exactly one person might be adequate. CFR Title 45 says otherwise. It says valid informed consent requires the decision making capacity of a compliant IRB. Formal decision making capacity of more than one person is required to determine the sufficiency of informed consent.
As NIH Director James Shannon said in a 1966 statement endorsed by Surgeon General William Steward, "The investigators judgment must be subject to prior peer review to ensure an independent determination of risks and benefits and ...voluntary informed consent,"
Research -- or non-research as we are required to state when we relinquish all rights to content posted here -- that uses methods not reviewed by an IRB cannot reasonably inform the question of whether answers by unidentified participants to unapproved questions demonstrate participants' capacity provide informed consent to a process directed by a lone investigator whose informed consent methodology as not been subject to review.
I believe the hosts' claim of a nuanced claim of a difference between case study and research serves his professional advantage more than it benefits the group as a whole. At best, avoiding IRB review allows him material for professional publication, which is a quid pro quo professional benefit for whatever service he provides here.
I anticipate a greater "probability and magnitude of discomfort anticipated in the research ... greater in and of themselves than those ordinarily encountered in daily life".. for myself and for other participants - especially those who "for how long" have persistently expressed discomfort about inconsistent administration.
To state it succinctly, the adequacy of informed consent must be based upon research to which participants have given informed consent. If participants gave consent to a "case study" that was not research and not subject to IRB review, their agreements do not inform their capacity to give informed consent to research.
>...while I've disagreed with decisions, haven't lost the sense that this place is valuable.
> But I'm sorry that you don't find it so.
>
> pontormo
>There may be little I can do to relieve your sorrow in that regard, but value is not an either-or question.
And now, one more obligatory "I-statement."
In so far as Dr. Hsiung at once invites discussion of his administration and admonishes some invitees who he says might make him feel accused, I consider it inappropriate and unethical for an academic or an investigator to intervene against public discussion of the researcher's ethics in the administration of academic and research processes they conduct with no formal oversight.
As states the Research Ethics Program, UC San Diego in Resources for Research Ethics Education discussion of case studies in the consideration of ethics "unethical behavior is defined by a failure to engage in the process of ethical decision-making. It is always unacceptable to have made no reasonable attempt to define a consistent and defensible basis for conduct."
Posted by pontormo on September 1, 2014, at 12:24:44
In reply to Re: discussion, posted by bryte on September 1, 2014, at 5:29:42
I guess the issues you raise would require a pretty long and detailed (ie footnoted and bibiographed) paper to address.
But I do think on one fundamental, I would disagree with you, which is whether Bob is doing research on "human subjects" as defined by CFR 45 part 46.102(d) and (f).
As the document, and your quote define it,
------(f) Human subject means a living individual about whom an investigator (whether professional or student) conducting research obtains
(1) Data through intervention or interaction with the individual, or
(2) Identifiable private information."To further interpret this, one could add that "definitions" in secton (f), as quoted by you here, explains that:
---
"Intervention includes both physical procedures by which data are gathered (for example, venipuncture) and manipulations of the subject or the subject's environment that are performed for research purposes. Interaction includes communication or interpersonal contact between investigator and subject. "As I wold read it, and as I assume Bob reads it, Bob neither collected data through physical procedures, or manipulation of the subject's environment-- ie we never enter any environment created by Bob, that is being "manipulated" by him-- (ie I don't think Babble constitutes an environment ie place in that sense)-- it would seem that these measures do not apply to what he does here. But you may interpret it differently.
-----
Of course, you make many points, and many of the judgments about these points could be debated-- and, given that neither of us is expert about these, to say the least, or has time, or access to the rulings pertinent to these questions, we can't really make educated arguments about them. At best, we can make naive readings -- not to say that we are not entitled to do so--but we are, again, in the end, forced to decide whether we trust or don't trust Bob's understanding and good faith in subscribing to the requirements of research that legitimately apply and to giving us the protections we are deserving of.
This ultimately is the subtext of our understandings here. I basically trust Bob and you perhaps do not, or at least question reliability or judgment.
Bob did post an announcement of his presentation above on this page, and no one except alexandra responded. So I guess we can assume that no one who reads this page was disturbed by the information. After all, those who read this page could be considered a more concerned or advance minority of gatekeepers for the rest of the community.
But perhaps we should ask Bob to give us a bit more information about his decision-- or to share the text of his study-- so that we can arrive at further conclusions.
Also, I would add that from my conversation with Bob, he never directly contacts anyone or any locality about anyone for whom he has reason to think there is an emergent situation. He regards all identifying information as completely private and inviolable.
But again, perhaps if you queried him privately about your concerns, or perhaps more specifically publicly, he might be able to answer or direct you to answers, that would give you better insight into his thinking.
Posted by 10derheart on September 1, 2014, at 16:59:51
In reply to Re: discussion, posted by pontormo on September 1, 2014, at 12:24:44
>>Also, I would add that from my conversation with Bob, he never directly contacts anyone or any locality about anyone for whom he has reason to think there is an emergent situation.
Well, not literally *direct* contact with the poster, but a "locality" .... I think yes, under certain circumstances only. I understand from my past interactions with him that he might contact a poster's ISP and they in turn might contact the appropriate local authorities with specific location info in the case of a real time suicide attempt (as opposed to ideations or even discussions of specific plans) posted about here.
It seems immoral if a poster writes something like,"Goodbye, Babble, I am going to{insert any place} right now to {fill in a recognized suicide method}," or, "I just swallowed an entire bottle of [blank]," and to then do absolutely nothing to try to help save their life.
I think that well may have happened more than once in the past decade. But, it was a number of years ago and I had second or third hand knowledge, so I can't really say more. I either don't know 100% or can't recall.
Posted by pontormo on September 1, 2014, at 18:04:14
In reply to Re: discussion-**trigger warning** re: suicide » pontormo, posted by 10derheart on September 1, 2014, at 16:59:51
Hi tender--
Thanks for adding that further information.
Bob said that to me also when I met up with him this year in NY.
I got the feeling that he's very committed to the idea that posters here need a strong presumption that their identities will be protected and that therefore he prefers to act by letting ISP webmaster as a free agent- take any further steps.
I too think it would be unfathomable if he didn't take some action if someone were in the process of committing suicide.
But I find it admirable that he doesn't override his concern for the community, as he's said to Lou,-- and it speaks well for his commitment to principle.
Posted by Lou Pilder on September 1, 2014, at 19:57:17
In reply to Re: discussion-**trigger warning** re: suicide » 10derheart, posted by pontormo on September 1, 2014, at 18:04:14
> Hi tender--
>
> Thanks for adding that further information.
>
> Bob said that to me also when I met up with him this year in NY.
>
> I got the feeling that he's very committed to the idea that posters here need a strong presumption that their identities will be protected and that therefore he prefers to act by letting ISP webmaster as a free agent- take any further steps.
>
> I too think it would be unfathomable if he didn't take some action if someone were in the process of committing suicide.
>
> But I find it admirable that he doesn't override his concern for the community, as he's said to Lou,-- and it speaks well for his commitment to principle.
>
> pontormo,
You wrote,[...But I find it admirable that he doesn't override his concern for the community as he's said to Lou,--and it speaks well for his commitment to principle...].
I am unsure as to what you want people to think by what you wrote concerning me here. If you could post answers to the following, then I could have the opportunity to respond accordingly.
A. What is it that Mr. Hsiung has said to me in relation to that you wrote, [I find it admirable that he doesn't override his concern for the community as he's said to Lou]?
B. What do you mean by "overriding"?
C. What is the principle that Mr. Hsiung is committed to that you are referring to here?
Lou
Posted by pontormo on September 1, 2014, at 20:38:07
In reply to Lou's request-ohpnehn » pontormo, posted by Lou Pilder on September 1, 2014, at 19:57:17
>
> A. What is it that Mr. Hsiung has said to me in relation to that you wrote, [I find it admirable that he doesn't override his concern for the community as he's said to Lou]?--- that he balances what's best for the individual and what's best for the community in making decisions
> B. What do you mean by "overriding"?
the dictionary defines "override" as:
"use one's authority to reject or cancel (a decision, view, etc.).
synonyms:disallow, overrule, countermand, veto, quash, overturn, overthrow"
--
> C. What is the principle that Mr. Hsiung is committed to that you are referring to here?-- that it is of great importance to the community for members to feel that their personal identities will not be violated and that their privacy is insofar as possible protected
> Lou
>
Posted by bryte on September 1, 2014, at 23:23:30
In reply to Re: discussion, posted by pontormo on September 1, 2014, at 12:24:44
> "Intervention includes both physical procedures by which data are gathered (for example, venipuncture) and manipulations of the subject or the subject's environment that are performed for research purposes. Interaction includes communication or interpersonal contact between investigator and subject. "
>
> As I wold read it, and as I assume Bob reads it, Bob neither collected data through physical procedures, or manipulation of the subject's environment-- ie we never enter any environment created by Bob, that is being "manipulated" by him-- (ie I don't think Babble constitutes an environment ie place in that sense)-
"...the mental health professional focuses on maintaining the supportive milieu" (Hsiung)The term milieu defines a person's social environment.
"Others would do this privately... that would have the advantage of being less embarrassing." (Hsiung)
"46.102(i) Minimal risk means that the probability and magnitude of ...discomfort anticipated in the research are not greater in and of themselves than those ordinarily encountered in daily life."
What we might disagree on is whether he maintains an environment where he performs more embarrassing rather than less embarrassing manipulations for the purpose of publishing case studies or for the purpose of research.
Either way, research - or case studies - about informed consent obtained for case studies does not inform the adequacy of informed consent for research, including research conducted as part of a service program. Informed consent for research requires more then the principal researcher's opinion about the adequacy of informed consent. The consent process here does not comply with that standard.
Posted by Lou Pilder on September 2, 2014, at 5:29:34
In reply to Re: Lou's request-ohpnehn, posted by pontormo on September 1, 2014, at 20:38:07
> >
> > A. What is it that Mr. Hsiung has said to me in relation to that you wrote, [I find it admirable that he doesn't override his concern for the community as he's said to Lou]?
>
> --- that he balances what's best for the individual and what's best for the community in making decisions
>
> > B. What do you mean by "overriding"?
>
> the dictionary defines "override" as:
>
> "use one's authority to reject or cancel (a decision, view, etc.).
>
> synonyms:disallow, overrule, countermand, veto, quash, overturn, overthrow"
> --
> > C. What is the principle that Mr. Hsiung is committed to that you are referring to here?
>
> -- that it is of great importance to the community for members to feel that their personal identities will not be violated and that their privacy is insofar as possible protected
> > Lou
> >
>
> pontormo,
You wrote,[...he balances what is best for the individual and what's best for the community in making decisions...].
I do not remember Mr. Hsiung saying to me anything like that. What he has said is that he does [...what in his thinking {will be} good for this community as a whole....]. The huge difference here is that in his use of {will be} verses what is best for the community at that moment, places a decision that could effect the community in the future. Those leaders that wanted slavery and genocide and infanticide and segregation and discrimination used that same argument, that it will be good for the community as a whole to commit mass-murder, have slavery, use discrimination and segregation and commit infanticide. Unless one can see the future, people could not know if that argument is a lie or not until the future arrives. This, then, demanded that the people have trust in that leader that made that claim that he/she could see into the future and after committing mass-murder, the country would be "good". And many people put their trust in those leaders that were committing mass-murder and slavery and infanticide and segregation and discrimination for the good of the state and when the future arrived and they found out that genocide and slavery and discrimination and infanticide did not make the state good, the leaders were executed along with their deputies by the people or the leaders committed suicide or were hanged as war-criminals. Some escaped justice
Here, there are posts that could arouse anti-Semitic feelings and put down Jews and defame me that are allowed to be seen where they are originally posted as conducive to the civic harmony and welfare of this community and supportive and will be good for this community as a whole in Mr. Hsiung's thinking. And the mission of the forum in Mr. Hsiung's TOS is for support and to maintain a supportive atmosphere and that {support takes precedence}. What takes precedence is to be supportive, not what {will be} good for this community as a whole in Mr. Hsiung's thinking, and that has not been taken back by Mr. Hsiung. In fact, Mr. Hsiung has posted that if something is not supportive, it should not be posted here and that there is not an excuse to post incivility because of something else.
To say that one can post anti-Semitism and defamation against me here with impunity because Mr. Hsiung thinks that anti-Semitic hate allowed to stand here will be good or this community as a whole could be considered to be a lie by a subset of readers. Those readers could have a rational basis to think that on the grounds that they have read research in psychology/psychiatry that anti-Semitism is not civil or supportive in a community such as this one where hate implanted into the minds of impaired drug dependent, depressed people could induce suicidal and/or homicidal thoughts. A Jewish child reading here,{No non-Christian will enter heaven} and sees it as supportive where it is originally posted because it is not sanctioned as uncivil, and also sees that Mr. Hsiung has an excuse to allow it to stand, and that excuse is that he doesn't want the poster of the antisemitism to have their feelings hurt if he posts his tagline to please be civil to it, could feel devalued as a Jew, dehumanized, and go into a vortex of depression to kill themselves. A subset of readers could think that you are saying that it is in your thinking, that the anti-Semitic statement, and anti-Islamic as well, allowed to stand here will be good for this community as a whole on the basis that it could be that you agree that if Mr. Hsiung was to post his tagline to please be civil to it, that could not be good for this community a whole, which allows Mr. Hsuing to override the mission of the forum to provide a supportive environment by allowing of what is not supportive or civil and could induce antismeitic feelings as being supportive by Mr. Hsiung, then please say so now.
Lou
Posted by Lou Pilder on September 2, 2014, at 7:30:36
In reply to Lou's reply-ohvrryde » pontormo, posted by Lou Pilder on September 2, 2014, at 5:29:34
> > >
> > > A. What is it that Mr. Hsiung has said to me in relation to that you wrote, [I find it admirable that he doesn't override his concern for the community as he's said to Lou]?
> >
> > --- that he balances what's best for the individual and what's best for the community in making decisions
> >
> > > B. What do you mean by "overriding"?
> >
> > the dictionary defines "override" as:
> >
> > "use one's authority to reject or cancel (a decision, view, etc.).
> >
> > synonyms:disallow, overrule, countermand, veto, quash, overturn, overthrow"
> > --
> > > C. What is the principle that Mr. Hsiung is committed to that you are referring to here?
> >
> > -- that it is of great importance to the community for members to feel that their personal identities will not be violated and that their privacy is insofar as possible protected
> > > Lou
> > >
> >
> > pontormo,
> You wrote,[...he balances what is best for the individual and what's best for the community in making decisions...].
> I do not remember Mr. Hsiung saying to me anything like that. What he has said is that he does [...what in his thinking {will be} good for this community as a whole....]. The huge difference here is that in his use of {will be} verses what is best for the community at that moment, places a decision that could effect the community in the future. Those leaders that wanted slavery and genocide and infanticide and segregation and discrimination used that same argument, that it will be good for the community as a whole to commit mass-murder, have slavery, use discrimination and segregation and commit infanticide. Unless one can see the future, people could not know if that argument is a lie or not until the future arrives. This, then, demanded that the people have trust in that leader that made that claim that he/she could see into the future and after committing mass-murder, the country would be "good". And many people put their trust in those leaders that were committing mass-murder and slavery and infanticide and segregation and discrimination for the good of the state and when the future arrived and they found out that genocide and slavery and discrimination and infanticide did not make the state good, the leaders were executed along with their deputies by the people or the leaders committed suicide or were hanged as war-criminals. Some escaped justice
> Here, there are posts that could arouse anti-Semitic feelings and put down Jews and defame me that are allowed to be seen where they are originally posted as conducive to the civic harmony and welfare of this community and supportive and will be good for this community as a whole in Mr. Hsiung's thinking. And the mission of the forum in Mr. Hsiung's TOS is for support and to maintain a supportive atmosphere and that {support takes precedence}. What takes precedence is to be supportive, not what {will be} good for this community as a whole in Mr. Hsiung's thinking, and that has not been taken back by Mr. Hsiung. In fact, Mr. Hsiung has posted that if something is not supportive, it should not be posted here and that there is not an excuse to post incivility because of something else.
> To say that one can post anti-Semitism and defamation against me here with impunity because Mr. Hsiung thinks that anti-Semitic hate allowed to stand here will be good or this community as a whole could be considered to be a lie by a subset of readers. Those readers could have a rational basis to think that on the grounds that they have read research in psychology/psychiatry that anti-Semitism is not civil or supportive in a community such as this one where hate implanted into the minds of impaired drug dependent, depressed people could induce suicidal and/or homicidal thoughts. A Jewish child reading here,{No non-Christian will enter heaven} and sees it as supportive where it is originally posted because it is not sanctioned as uncivil, and also sees that Mr. Hsiung has an excuse to allow it to stand, and that excuse is that he doesn't want the poster of the antisemitism to have their feelings hurt if he posts his tagline to please be civil to it, could feel devalued as a Jew, dehumanized, and go into a vortex of depression to kill themselves. A subset of readers could think that you are saying that it is in your thinking, that the anti-Semitic statement, and anti-Islamic as well, allowed to stand here will be good for this community as a whole on the basis that it could be that you agree that if Mr. Hsiung was to post his tagline to please be civil to it, that could not be good for this community a whole, which allows Mr. Hsuing to override the mission of the forum to provide a supportive environment by allowing of what is not supportive or civil and could induce antismeitic feelings as being supportive by Mr. Hsiung, then please say so now.
> Lou
>
> Friends,
You may be led, or misled to believe particular things as to why there are anti-Semitic statements being allowed by Mr. Hsiung and his deputies of record to stand here where they are originally posted and also defamation toward me.
Since Mr. Hsiung has posted over years that this forum is for support, and that support takes precedence, and that anti-Semitism is uncivil and now he has said that he has "revised" his statement that if a post stands that what is in it is not against the rules here to now be that what is in an unsanctioned post could be uncivil and that he could leave it that way because it will be good for this community as a whole in his thinking to leave hatred toward the Jews as depicted in many posts that I am bringing to his attention in our discussion now. I say not. And I say that all of you that want to support Mr. Hsiung to allow hatred toward the Jews and me to stand here unsanctioned on the basis that you trust him that it will be good for this community as a whole to do so, then I say you that you could be ignorant of he historical record where others said to the community members that antisemitism will be good for their state as a whole and the record proved otherwise.
The historical record shows what happened to states that allowed anti-Semitism to be considered to be good for their community as a whole. And the record shows what happened to those leaders and their deputies when they could not pull off the lie anymore. And here is a video showing what happened to one of those deputies where he murdered his 6 children and then him and his wife killed themselves and then had their bodies drenched with gasoline and set aflame by their deputies. Their bodies were still identifiable as you will see in the following video. Please skip this if you do not want to see what I have said as to what will be in this video.
Now any of you that want to be in concert with Mr. Hsiung and his deputies of record to go along with him in that it will be good for this community as a whole to allow anti-Semitism and defamation against me to stand where it is originally posted in the grounds that you also think that it will be good for this community as a whole to do so, I say to you to stand back and think. Do you really want to be a part of it?
Lou
This video is graphic.
https://www.youtube.com/verify_controversy?next_url=/watch%Fv%3D4qxTCM_dle0
Go forward in thread:
Psycho-Babble Administration | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.