15

Should we allow personal medical advice question? I am inclined to say no. What are everyone else's thoughts?

Consider this example question: What can I do to alleviate chronic migraine headaches?

One possible answer might suggest treatment with aspirin. However, suppose that the person asking the question is on blood thinners and/or is allergic to aspirin. The person asking may not be aware that this is relevant information. Most people can take an aspirin to help with migraines, but suggesting it in this case could have dire consequences due to relevant considerations that were not presented with the question.

  1. Increased bleeding risk when taking blood thinners with aspirin

The asker may be injuring him/herself by following advice given by a well-meaning answerer. What is going to happen?

4
  • 1
    How personal are you talking about? Can you please provide some examples? Commented Apr 2, 2015 at 3:22
  • @ZachSaucier I am talking about in general since some sites forbid it. For example, bio doesn't allow it since it is hard to give accurate advice without knowing the persons medical history.
    – user139
    Commented Apr 2, 2015 at 3:27
  • 1
    Without any examples or further details this is a poor question. Commented Apr 2, 2015 at 3:43
  • 2
    @ZachSaucier you are entitled to think that but I beg to differ. Personal medical advice doesn't really need defining. It is advice geared towards one individual and may only be appropriate to that person; however, without full knowledge of the persons history, the advice may be in good faith but utterly wrong which could put the person at risk.
    – user139
    Commented Apr 2, 2015 at 3:46

6 Answers 6

17

I am not a healthcare professional, though I do talk to medical professionals socially, about their professions, very frequently, for what it's worth.

I am, however, a veteran Stack Exchange small-community founder, moderator, and active community member, having put in a combined total of over five years in those roles at Mi Yodeya (Judaism.StackExchange).

At Mi Yodeya, we have a bright-line rule saying that Mi Yodeya does not "offer personal guidance in response to practical questions about Jewish law or attitudes, as a rabbi would," which we back up by closing or editing-to-generalize any question that seeks such advice. We have this rule plastered everywhere on the site we could where it's relevant.

More than once, I've seen point-objections along the lines of "I know we have a rule against giving personal advice, but I think this case ought to be an exception, because this guy clearly needs help." Well, it's a good thing no one had to make that judgement call, because this guy who clearly needs help is also more likely than most to be hurt by following wrong or wrong-for-him advice. Like it or not, the first, best-written, or most likable advice he gets on this site may be wrong, and may remain up and wrong long enough to harm the guy before Stack Exchange peer review fixes the problem. And wrong-for-him is always a possibility on a forum designed for public, atomic, Q&A and not personal dialogue.

But the hearts of good people who like to help others are naturally pulled toward helping the guy who really needs help. The way we prevent our hearts from leading us to reach out inappropriately and tell the guy what to do is that we tie ourselves to the mast before we meet the guy. The way to do that is with a clear rule, clearly documented, and universally implemented.

If healthcare is also a field in which personal advice can only be competently offered by someone who's able to investigate the individual case in detail, if healthcare is also a field in which the consequences of following wrong or wrong-for-you advice could be severe*, and if healthcare professionals also have a tendency to want to help people who need help, then I recommend that you adopt a similar bright-line rule here, and close any question that seeks personal advice.

If your policy is to only close advice-seeking questions that are "dangerous" or "serious," as appears to be suggested here, then every advice-seeking question is potentially going to lead to a meta-discussion about whether it qualifies as "dangerous" or "serious." And while you're arguing about that, someone who's here for content - not meta - is going to go ahead and answer the question. Also, please correct me if I'm wrong, but I suspect that there are diagnostic questions that you'd identify as serious situations if the patient was in front of you (due, say, to some symptom that's obvious and obviously relevant to the trained eye, but not to the untrained one), that present as completely innocuous when written up by the patient.


* Observant Jews believe this to be the case regarding observance of Judaism. That this is the case for health is probably clear to everyone here.

4
  • 2
    +1. Well-thought-out, well-said, and important. Recall the Hippocratic precept, "First, do no harm." Commented Apr 27, 2015 at 7:14
  • I confuse with your choice, even I have read it a couple time. Should they be closed or not? Or are you just trying to define the term?
    – Ooker
    Commented May 25, 2015 at 5:42
  • 2
    @Ooker "If healthcare is also a field in which personal advice can only be competently offered by someone who's able to investigate the individual case in detail, if healthcare is also a field in which the consequences of following wrong or wrong-for-you advice could be severe, and if healthcare professionals also have a tendency to want to help people who need help, then I recommend that you adopt a similar bright-line rule here, and close any question that seeks personal advice." is as clear as I can get, not being a health professional myself. I think it's pretty clear. Commented May 26, 2015 at 2:01
  • 1
    Many questions like "what should I do for my eye watering" can be reworded to something more generic like "what are the causes and typical solutions of watering eyes" for instance, and then the question becomes hugely helpful to the internet community. FWIW in my head the answer to many questions could be "first, go see a doctor, second, he might diagnose this or this or this" Many people use the internet for self diagnosis and it could be hugely beneficial to have a nice site for such things, FWIW.
    – rogerdpack
    Commented Mar 17, 2017 at 17:51
12

SE agenda is "Questions that can be answered", so as long as those medical questions are answer-oriented question, I'd say it is the place.

As per the genuinity and validity of the answers - I believe an answer should always cite and references to the sources quoted from, unless it's something based on personal experience, technical advice, etc.

4
  • 2
    How do you answer a personal medical advice question without knowing the person history? Form your answer, it would seems these questions are unanswerable then.
    – user139
    Commented Apr 2, 2015 at 3:49
  • 4
    @dustin Not all medical questions require that much background. It all depends on what is being asked.
    – Joe W
    Commented Apr 2, 2015 at 3:52
  • 1
    @dustin That's not what I said. The OP's task is to point out noticeable aspects that might change the answer. So should the answerer try to look at the whole picture. In SO it's just the same, sometimes the program will work differently if another 'unrelated' setting is not in order. It's up the doctor's-developer's-answerer's wisdom to point those out. Commented Apr 2, 2015 at 3:53
  • That is problem. Without patient history and charts, the answers will never know enough information.
    – user139
    Commented Apr 2, 2015 at 3:54
12

I think this overlaps this other meta question: What should we do with questions where the answer is clearly 'see a doctor'?.

If the question is personal but satisfies both of these conditions that's fine:

  1. it does not require seeing a doctor
  2. it is useful to others

As soon as the question is medical it is unlikely to satisfy 1) though a few examples exist.

Otherwise the question should be closed (an in my opinion no answer should be given at all but "see your doctor").

3
  • 1
    The question about the weird blue thing on finger is a good opportunity to teach about nevi and melanomas. Why not support the answering of that question?
    – anongoodnurse Mod
    Commented May 26, 2015 at 0:08
  • The will be a bias in my comment: I know you are a doc so I would say yes. The answer should come with a "this is just an expectation, you have too see your doc to confirm" (or anything like that said a better way) though.
    – Shlublu
    Commented May 26, 2015 at 7:41
  • @anongoodnurse Oops, I forgot to mention you, no chance you read that comment!
    – Shlublu
    Commented May 27, 2015 at 8:16
7

On some other SE sites (and it seems that I stir up controversy when I state this, which I'm not trying to do), if an answer will help only the one user - the OP - it's considered not a good fit for the site.

I would say the same principle applies here; if it's about one user alone, it's a personal medical problem.

A question such as "I suddenly got a pain in my right shoulder while stacking heavy boxes. It hurts when I [do this]. I've had it for four hours now. What can it be?" is definitely OT in my opinion. But a lot of people suffer from migraines, and not all of them know the newest treatment options. I would tend to answer this.

In terms of medical advice being sometimes dangerous, the subject of a disclaimer came up. I'm all for that. In one of my answers, I added (after recommending acetaminophen or ibuprofen) "unless it's contraindicated" (i.e. if there is any reason you shouldn't take it) which is a warning of a kind.

6
  • 1
    The issue with warnings is that many patients don't even know what they should or shouldn't take no matter how many times they are told. We could say don't take if contradictory but the person may not remember or know if it is.
    – user139
    Commented Apr 21, 2015 at 18:34
  • @dustin - Any ideas how to handle this? Do you think this deserves a meta question of its own? Commented Apr 21, 2015 at 20:02
  • 1
    I have no idea. I just know from living with a medical professional that patients have this unwillingness to remember their medications and allergies. Therefore, any medical advice that suggest taking anything is risky. One example I remember hearing was that their was a patient who she was speaking with and asked what medications are you on? The patient named a few. However, prior to asking the question, the patient need water to take a prescribed medication for heart disease. This patient didn't mention this medication at all. She asked what about (blank)? The patient said that counts too?
    – user139
    Commented Apr 21, 2015 at 20:08
  • 1
    @dustin - While I'm familiar with exactly the problem you're talking about, this supposes in a way answering to lowest common denominator (or making such answers OT). We don't do this on Biology (answer to the lowest common denominator; if someone doesn't know what a cell is, we tell them to read about it and ask after). Also, there's anxiety when a patient talks to a doctor, which causes both forgetfulness and difficulty concentrating. Commented Apr 21, 2015 at 20:34
  • 1
    "The issue with warnings is that many patients don't even know what they should or shouldn't take no matter how many times they are told." With that kind of argument, then you can't really argue FOR nor AGAINST medical advice being given anywhere at all, whether online or in person. This point has nothing to do with whether medical advice should be given here or not, but has to do with patients taking medical advice in general. Considering your viewpoint on patients, how can you trust a patient to take their medication correctly, even if told in-person by a legitimate doctor? Commented Nov 24, 2015 at 0:43
  • Are any medical questions "applicable to yourself alone" however? It seems to me that followers of "I have these symptoms" could be insanely useful in the interwebs, for instance...for instance the answer could be "go and see a doctor, it could be x,y, or z, and when you do figure it out, please come back and tell us what it was."
    – rogerdpack
    Commented Mar 17, 2017 at 17:46
5

Why? If one person has a question others are likely to have a similar or the same question and it can be of help to them also.

3
  • Because it is hard to give medical advice without knowing patient history. What if someone doesn't know if they are allergic to aspirin and someone says aspirin can alleviate that.
    – user139
    Commented Apr 2, 2015 at 3:28
  • 6
    Well that really is a risk with almost anything you do. The stackexchange site for cooking can deal with the same issues if someone recommends a food with peanuts to someone with a bad peanut allergy. In the long run I think the questions will be useful for general advice. There will always be the need to remember to go to a trusted health professional for the best advice.
    – Joe W
    Commented Apr 2, 2015 at 3:33
  • 2
    if someone doesn't know that they are allergic to aspirin and they decide to take it after only listening to someone online, then I think that person has more pressing issues than what we can help them with. @JoeW gives a perfect example with cooking and peanut butter. It is up to the reader to do their own due diligence when looking things up online. If you aren't comfortable in the knowledge you already have and the knowledge you are looking into, then you probably should not act on it. Internet is about open information, and it loses its effectiveness with restrictions such as these. Commented Nov 24, 2015 at 0:47
-4

I posted a question about a dental xray, the question has been put on hold. If I had an x-ray or mri scan they would often be analysed by someone who did not know the details of my case, AI is now being used to analyse such x-rays and I suspect these applications rarely consider other details, so why coudnt that be done on StackOverflow ?

This is a very different to a question such as ' I have an ache in my head' that could be caused by so many things it really would not be sensible to answer here.

The point is an objective answer could have been given based on the x-ray, it may have been incomplete or inconclusive but it would have been helpful. Now I have to go back to my Dentist who I have lost trust in and I am totally unable to trust what they say. Now you may say go to another Dentist, that may happen, but there are costs and difficulties with that approach.

It seems to me that people are happy to give advise on most things except health and law, for these the advise is speak to a professional. But professionals in these areas are difficult and expensive to engage with, and there is a wide variety of ability in these fields. There are also a wide variety of opioions I have been told by one doctor to take a particular medicine/do particular exercise, only to be told by another the complete opposite.

Just like any other profession there are good and bad doctors, dentists, and solicitors. I have been told things I'm sure are incorrect in the past but as a mere patient have been unable to do anything about it, with better education via a service like stackOveflow I could better protect the health of myself and family.

StackOverflow could be a great place to democractise healthcare, shutting of medical-sciences to non professionals is not a good thing.

5
  • 5
    This should probably be a meta question rather than an answer on this topic. However, if you please read the other answers here, they make it pretty clear why the situation you describe cannot be a question here. MedicalSciences.SE is not to democratize healthcare, and if you look around at attempts to democratize healthcare I find them absolutely terrifying: that's how you get claims that vaccines cause autism, that folk treatments are better than modern medicine, that you can beat cancer by praying about it.
    – Bryan Krause Mod
    Commented Oct 18, 2018 at 17:47
  • 2
    As a further comment, the purpose of StackExchange as a whole is to provide a Q&A that is useful to the broader community. Questions that can only be answered for one person are disallowed at just about every Stack site. Diagnosing a single image is not helpful to anyone else, even if there were no other problems with it.
    – Bryan Krause Mod
    Commented Oct 18, 2018 at 17:49
  • 2
    StackOverflow could be a great place to democractise healthcare, shutting of medical-sciences to non professionals is not a good thing. I totally agree. But we are here to teach you about Health in general, not to play your doctor. You didn't post a question about dental x-ray ("what are indications for dental x-ray" - "what structures can be identified with a dental x-ray"), but you asked us to be your doctor. This is not about educating you, this is about doing healthcare work without even knowing your medical record or looking at you
    – Narusan
    Commented Oct 20, 2018 at 14:58
  • It is ENTIRELY false that imaging studies are ever interpreted without clinical information (i.e., "the details of your case"). The radiologist gets clinical information from the ordering physician. We often even talk (in person or on the phone), or look at the image together. AI decision support tools have not yet become robot radiologists, and if they do, they will absolutely need clinical information. Your suspicions are false.
    – De Novo
    Commented Oct 22, 2018 at 22:40
  • @Narusan i dont think did ask to be doctor really, I pointed that jaw joints looked different to me, but are they really that, is a reasonable general question to ask that would be useful to others. Commented Oct 23, 2018 at 18:58

You must log in to answer this question.