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I saw Weird blue thing on my finger? today, and it struck me as a prime example of a personal medical question - not only that, but even asking for diagnosis, one of the hardest thing in medicine.

I went back to the meta question on personal medical advice and noticed that while there are highly upvoted answers against personal advice, there is also the opinion that "if it is useful for more than one user, we can keep it". So the opinion seems to be somewhat divided. Also, a moderator commented on the original question asking for further clarification, so it seems she did not plan on closing. So probably there are reasons to leave the question open.

This being early beta, I think it is good to make some explicit decisions via Meta instead of simply resolving the matter in a more low-key manner.

Do we want this question to stay? Why? Which type of (closable or useful) question does it represent? What criteria do we want to use to justify having it open or closed?

I am posting my own arguments for closing it as an answer, but I am genuinely interested in seeing the whole palette of opinions around this example, not in building my own case against this one question.

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My experience as a moderator on Cooking has shown me that simpler closing rules are better for the community, even if simplification means that one or two not-that-bad questions have to be closed. The Stack Exchange format is already weird for non-programmers, and they are very upset when a closing rule is treated with much leeway.

I see how a small bump on a finger can be a fairly minor problem, and a physician can feel confident that it is in no way dangerous, so even if she makes a wrong guess, the person won't be harmed. From that point of view, it seems possible to amend a future "no personal advice" reason to actually mean "unless [authorative people] feel there is no risk to giving it".

This will be indeed a nice thing for the person who asked the question here. But years later, there will be users coming in with all kind of grave symptoms, requesting that we diagnose them. And when we close the question, they will retort with "but look at that upvoted blue bump question, it is a diagnosis". And if we say "this was an exception, but there will be no exception for you", we appear to be jerks, closing or leaving open questions for our own inscrutable or even evil reasons. This perception is hard to combat even when the rules are strict; but our position gets much harder to defend when the rules are sometimes reinterpreted because a moderator, or a high rep user, or somebody else decided that this one question does not need to abide by the rules.

Even if we can make a small exception from an otherwise closable category (e.g. say that we accept questions on skin conditions when the user provides a picture), I'd be against it. We have such exceptions on Cooking, and over time, they seem to create more trouble than they are worth, leading to endless frustration for users who insist that their question should have been covered by the exception too.

I can fully understand the wish to judge questions individually and leave some of them open when they are not going to cause trouble, even if they nominally fall in a closable category. And I know that an experienced moderator can generally predict the trouble potential of a question pretty accurately. But this strongly diminishes the perceived fairness in the community, and perceived fairness is a very important factor. Its absence can destabilize a community or at least lead to the loss of potentially valuable members. I feel that keeping the perceived fairness high (and keeping the learnability of the community's rules high too, as a side effect) outweighs the benefits of keeping a few edge cases open.

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I am glad you asked this question. (Obviously, since I'm the one who asked for clarification from the OP.)

I admit this goes somewhat against personal advice - well, maybe more than somewhat, and I've invited the other moderators to close; the decision was to leave it up to the community, so I hope you vote to close if you feel that it should be closed. I will not be offended in any way. As a moderator, I want the community to define it's boundaries, on the main site and here - as you've done - in Meta.

I think your answer does an excellent job of pointing out the "cons" of answering this question. But, it kind of uses the slippery slope argument, "if, then". If we answer this one, then everyone will want their questions answered. To me, one difference is not every question can be answered equally.

George Will said

All politics takes place on a slippery slope. The most important four words in politics are up to a point.

That is, in essence, my argument - we can do some good to individuals up to a point.

"I'm light headed and short of breath, and my heart is racing. Is this anxiety?" Yes, it can be. It can also be supraventricular tachycardia, anemia (which of the hundreds of causes?), hypovolemia, atrial fibrillation, congestive heart failure, a pulmonary embolism, hyperthyroidism, or the OP may just have run up four flights of stairs (among other things). We can't tell. We need to take a history, do a physical, get some tests.

"I've had a strange pain on the left side of my face for three days, and there's a lump in front of my left ear that hurts when I poke it. What is wrong with me?" Again, here we need to take a history and do a physical. We can't answer that.

Dermatology - especially to follow 'moles' - is the only specialty to my knowledge that has been shown to be amenable to iPhone-picture diagnosis.1 Also, how does the question differ from this question, this question, or this one?

So sometimes we can answer.

The question is, do we want to?

Shog9 stated

When you see questions that are attracting dangerous answers because they're asking for personal medical advice for serious health issues, close them as off-topic and leave a comment urging the author to see a doctor. (Note: it's not necessary to worry every time a question starts with, "I have..."; look for dangerous answers as the red flag.)

I want what's best for the site, so I'm malleable. On the other hand, I see this and want to help this person, because, unlike the generic "You should see your doctor for personal questions" which he will probably blow off (since he's done so for at least a decade), I want to write, "what you have is a xxx, and I would strongly advise you to see a dermatologist (for zzz reason)."

So, please, vote to close this if you feel that I'm on the wrong track.

Patient-Driven Teledermoscopy for Atypical Nevi Successful

  • Thank you for this detailed answer. Sure, there is a spectrum between having a "whatever the guys on top decide" dictatorship and having everything prescribed by inviolable rules. I agree that a site needs to find a balance somewhere far from both endpoints in the spectrum. I am still somewhat concerned that under your proposal, one of the custom close reasons for the site becomes "unless someone with enough rep thinks it shouldn't be closed". I trust you, and the other pro-tem moderators, to be able to make better decisions than a rigid rule. But the more the community grows, (cont.) – rumtscho May 22 '15 at 19:13
  • the higher the proportion of decision makers who got to the top not because of their domain expertise but because of their expertise in appearing convincing to others. This is why it's so good when in large communities (such as a state) a judge is not allowed to act outside the law. But maybe this site will not fall prey to such problems, or will find a way to combat them if they appear. It will be interesting to observe what happens if your suggestion (exceptions allowed when a mod or 5 users with reopen privilege want them) becomes the way of the site. – rumtscho May 22 '15 at 19:17
  • I don't think there is support for my view (note the lack of up-votes), so I think you might be worried prematurely. Note, I haven't actually answered the question precisely because I'm waiting for a community consensus. So far there appears to be a consensus that it should be closed. Either way, I'm ok. What I want most for this site is that we give good advice, not to have the right to answer some personal questions (though I would have liked to have answered this one). What I oppose, though, is bad advice. – anongoodnurse May 22 '15 at 22:01

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