Wikipedia talk:Conflicts of interest (medicine)/Archive 2

Archive 1

Archive 2

Multiple accounts limited to separate topic sets, cont.

Previously proposed was the change "You might be eligible for two separate accounts if you want to separate your work-related editing from non-work-related editing" would convey more detail if replaced with "...if you want to separate your editing in work-related topics from editing in non-work-related topics." Would others like to comment on the proposed language, or propose other language that might be more clear and detailed? BitterGrey (talk) 04:18, 24 February 2011 (UTC)

The current wording is more compact, yours may be slightly easier to parse except that it's longer. A wash, in my opinion. -- Scray (talk) 04:28, 24 February 2011 (UTC)

I've made a change, it's a fair bit longer but I think the suggestions are helpful such as disclosing the second account to a bureaucrat (I think I've heard of that before, but I'll bow to more experienced editors). It's now more directive, which could be good or bad. I like clear instructions but it does reduce flexibility. WLU (t) (c) Wikipedia's rules:^simple/_complex 04:33, 24 February 2011 (UTC)

Thought of a way to clarify WLU's wording, and replaced text on emailing an admin with text from the policy (checkuser or arbcom instead). Adjust if needed. We might want to clarify "editing will attract scrutiny". Perhaps same topics or promotion to admin?BitterGrey (talk) 05:28, 24 February 2011 (UTC)

I don't think we want to get into the mechanics. For one thing, instruction creep like this has a way of losing sync with the main page. WhatamIdoing (talk) 05:57, 24 February 2011 (UTC)

Fresh start

In the interest of precluding further discussion of matters unrelated to this page, I have archived everything. Anyone who is still interested in the page, please revisit the current version with fresh eyes and suggest improvements, point out areas they think are acceptable, or even great, and just generally focus on how we can improve WP:MEDCOI. For instance, I have a possibly-related article stub/essay I wrote on pharmanoia (User:WLU/Pharmanoia). WAID mentioned it might find a home here. Does anyone else agree? Can anyone see a neat (as in simple and tidy) way of integrating that content or otherwise improving on it? WLU (t) (c) Wikipedia's rules:^simple/_complex 04:05, 24 February 2011 (UTC)

User:WLU/Pharmanoia looks reasonably good, but seems to be more industry-focused instead of user-focused like WP:MEDCOI. One also deals with mainly off-wiki beliefs while the other is mainly an application of wiki policy. These two contrasts don't mean they can't be combined, but it might be more than just copying and pasting. Thanks for posting the invite to be bold on a user space essay: I'm tempted to add spaces between the claim/reality pairs for clarity. BitterGrey (talk) 04:30, 24 February 2011 (UTC)

(edit conflict)The Pharmanoia essay is interesting but it's not really about WP editing; at least, no more than any article about perceptions of a group of people who might be WP editors. It seems to be more about the perception than about the editor. So, I enjoyed the essay, but I only see little bits of it here at COI(Med) - unless we expand the page's discussion to include perceptions and misperceptions about each group of editors. -- Scray (talk) 04:34, 24 February 2011 (UTC)

It's also a pretty polemical (and I'd like to think a little funny) piece. Perhaps it could be a see also. I've always seen it's substantive use as being a rebuttal to the (generally CAM True Believers) claims that you can't trust science because it's all a big conspiracy. It's almost the corollary of this page - while COI can be, and is a definite problem, you can't simply dismiss evidence you don't agree with because of a real or perceived COI. WLU (t) (c) Wikipedia's rules:^simple/_complex 04:36, 24 February 2011 (UTC)

Agree - it's a candidate See Also, or a wikilink from a relevant statement in the article. -- Scray (talk) 04:51, 24 February 2011 (UTC)

I think it's funny, and I'd like to see it developed. One thought I had (and why I pinged you about it) is that it might be possible to develop this into a 'why we want you being transparent' explanation aimed at people in the medical industries. Feel free to give it a try: We can always remove it later if it just isn't working. WhatamIdoing (talk) 05:56, 24 February 2011 (UTC)

I've had a go but I'm sure it's too long, too detailed, and rambles a lot. Please edit ruthlessly. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:39, 24 February 2011 (UTC)

I love the section heading.

I think this sentence will be confusing: "The source of an argument matters less than the quality..."

Is that source the Wikipedian, or the drug company website, or something else? I tried to fix it, but all of my fixes made it worse, so I gave up for now. WhatamIdoing (talk) 20:25, 24 February 2011 (UTC)

Like a fine wine, content sometimes improves if given a bit of time. How's this? I don't think it's quite there yet, but I think this is a bit closer.

I think the section heading is also great and important; no matter what changes this page experiences, we should keep our eye on how it could be misused lest we beans it up. WLU (t) (c) Wikipedia's rules:^simple/_complex 21:21, 24 February 2011 (UTC)

The new section is getting better, but it still rambles a bit. I've removed part that seems a bit repetitious. I think the impact will be greater if this is concise. -- Scray (talk) 21:50, 24 February 2011 (UTC)

The new section is, unsurprisingly, pro-Pharma. What are the plans to balance it for NPOV? BitterGrey (talk) 22:02, 24 February 2011 (UTC)

I will admit that I am somewhat cautious about (i.e. prejudiced against) editors with obvious links to pharmaceutical companies, but I think that section is firmly based in WP policy and guideline (e.g. focus on the edits not the editor, rely on sourcing, etc). Do you want to suggest edits or point out non-NPOV wording? -- Scray (talk) 23:51, 24 February 2011 (UTC)

I don't see it as pro pharma, one thought is if it might be worth removing "alleged" since it is well-known that pharmaceutical companies have actively pursued profits at the expense of health (Cohen can be mined for sources in this regard actually, he cites at least two examples explicitly and alludes to two more). It's not "pro pharma" to say "editors who work for pharmaceutical companies can edit too". In many cases they will have considerable expertise, for the very reasons we highlight in this essay. I always find it irksome when someone tries to play the "big pharma" card as if it had any meaning. It paints all employees as evil people solely interested in money with no motivation to improve the world or advance science. Balls to that. I'm OK with reducing it to three sentences at the most if we can, and perhaps we could do so by removing pharmanoia entirely. The crucial nub is that a COI can't be used to disqualify someone a priori. COI is always about caution and oversight, not demonizing and exclusion. WLU (t) (c) Wikipedia's rules:^simple/_complex 00:11, 25 February 2011 (UTC)

Sure Scray. One one hand, there are the "groups such as AIDS den[ia]lists to adopt bizarre, unfounded conspiracy theories to justify dismissing inconvenient facts in favor of a predetermined conclusion" and on the other, the "recognized, published experts in medicine and medical research". Pharma experts and anti-pharma quacks. This was fine for an essay on anti-pharma prejudices, but not for an essay on medical COI. Now, if we had a balancing pair of examples in this section, or another section detailing pharma quacks and anti-pharma experts, that would be neutral. BitterGrey (talk) 00:20, 25 February 2011 (UTC)

I've trimmed so their should be less ramble and less pharmanoia-type material. I'm going to port that AIDS denialism stuff over to the actual pharmanoia page though, that's gold and really gets at the guts of why pharmanoia is not just dumb, but harmful. If you find yourself agreeing with Peter Duesberg about AIDS, it's time to find a different argument. WLU (t) (c) Wikipedia's rules:^simple/_complex 00:23, 25 February 2011 (UTC)

Better. Getting rid of the first expert/quack pair works too. I notice that the section is back to stating "pharmaceutical companies have put profits ahead of patient and research subject's health." While I agree that this has happened, generalizing about off-wiki corruption might not be beneficial. I'll let someone else like to take a turn at it, or suggest weaselling it (...some pharmaceutical companies...). BitterGrey (talk) 00:39, 25 February 2011 (UTC)

(undent) If they're for-profit companies, the bottom line is the... y'know. May be better to state it as an awkward reality than make accusations of what babies they've killed today. SDY (talk) 00:50, 25 February 2011 (UTC)

If we want to talk about profits, then we should talk about the highly profitable dietary supplement industry, and in particular the fact that it is the source of a sizeable chunk of profits in "Big Pharma" companies. (For example, Bayer sells dietary supplements.) The division between "Big Pharma", who only cares about profits, and "Alternative Medicine", who only cares about your health, is a false one. WhatamIdoing (talk) 01:10, 25 February 2011 (UTC)

Though your point speaks deeply and wisely to my heart, like James Earl Jones and Morgan Freeman having a conversation about comic books, that's a whole separate page (if not a separate wiki). It's probably a page worth writing though, because it's almost a trope for people who believe supplements are like drugs without the side effects.

Mentioning that big pharma has been proven to put money ahead of health is not only true, it's relevant - but like all COIs it's a matter of degree rather than absolutes. But on reflection, we've really been over-focusing on big pharma when these points really apply to all these COI editors. I've made another change. I think this is probably closer to what the section should say. Thoughts? WLU (t) (c) Wikipedia's rules:^simple/_complex 02:15, 25 February 2011 (UTC)

Another example of problematic COI

In addition to the examples already offered, I thought I'd mention that employees of device manufacturers might attempt to obscure encyclopedic information about their products that is available in the public domain. For example, this exchange regarding information that I found in a patent and added to the article. While this is just one incident and the person may have been acting autonomously (in fact, they might not have been a device manufacturer employee at all), I think it illustrates what this article is about. I'm not raising this to re-hash but to illustrate a situation not yet covered and quite germane to the encyclopedia. -- Scray (talk) 04:49, 24 February 2011 (UTC)

Sounds like they have either have more than just the equation in their algorithms, perhaps some consistency checks, necessary for the equation to work reliably, or would like us to think so. It is certainly an interesting example, but would we be able to summarize it briefly? BitterGrey (talk) 05:55, 24 February 2011 (UTC)

I wouldn't want to summarize the episode specifically, but the general type of "Potential Problem", e.g.: "Removing encyclopedic information that a company wishes to remain obscure". I'm sure that could be improved. -- Scray (talk) 12:14, 24 February 2011 (UTC)

To broaden the point, a slightly-related problem would be removing information on a competitor's products to make them seem more nebulous. Competitor-demotion has been a problem here too. Perhaps something along these lines should be added to the "researchers" row too.

Scray, if there is no objection, go ahead and make the addition. As reinforced by the above discussion, Bold edits affect this article, while discussion might not. BitterGrey (talk) 15:33, 24 February 2011 (UTC)

A broader phrase might be something like "Suppressing verifiable information to "protect" people from it."

I'm not sure this is specific to medicine or any particular category of COI, though: A public health person might want to suppress information about harms from mammograms. A parent might want to suppress information about sexual behaviors to protect young children. A law enforcement official might want to suppress information about how to build a pipe bomb.

Perhaps a more useful approach might be to point them at NOTCENSORED and NDA, or to explain that articles should contain a wide variety of information, including information that is not relevant or "appropriate" for patients. WhatamIdoing (talk) 19:23, 24 February 2011 (UTC)

Excellent thoughts. I saw these suggestions after making an edit - I'll let others have a go before I edit again. -- Scray (talk) 19:30, 24 February 2011 (UTC)

An idle thought I had - pages are based on reliable sources, what happens if someone wants to cite proprietary documents? Anything that's open source is fair game (although, did anyone follow the debate at Talk:Rorschach test a while back?), but what if someone says "I've got some data at the office that's not publically accessible, but trust me - it supports the fact that St. John's Wort does indeed cure cancer."

On a quasi-personal note as an editor, if the sources support it I'd want to include both the information, the fact that some parties want it censored, and the replies to that attempt at censorship. In my experience that's always been the best way to deal with controversy, by exploring rather than extirpating it.

Idle thoughts, they may not find a home here. WLU (t) (c) Wikipedia's rules:^simple/_complex 21:31, 24 February 2011 (UTC)

I think that "data at the office" would be excluded due to wp:Verifiability, wp:OR, or both. BitterGrey (talk) 21:41, 24 February 2011 (UTC)

None of those exclude hard to find documents, and we aren't bound to use only electronic or easily-accessible references. The line becomes fuzzy once you get into things like grey literature, government reports, internal memos, etc. It's probably not something that'd come up here though, I'd be inclined to kick that sort of question over to WP:RSN. If somebody claimed they had access to special information on a "trust me I'm an expert" basis, I doubt they'd get a good reception after Essjay. WLU (t) (c) Wikipedia's rules:^simple/_complex 00:15, 25 February 2011 (UTC)

Sounds like it would be elegant to stress WP:MEDRS and that "trust me," "I'm an expert" isn't WP:MEDRS. BitterGrey (talk) 00:46, 25 February 2011 (UTC)

"Trust me, I'm an expert" isn't acceptable anywhere - real experts should have ready access to the sources in addition to their already deep understanding of the material, making it relatively trivial to source-up a page or contest, represent or reinforce a particular POV. I would venture that this essay, if anything, stresses more than MEDRS that expertise can be a double-edged sword. I don't know if it's worth noting here, since most people with an admitted COI are going to get less trust almost by default. "Trust me, I'm an expert" is yet another essay that should be written - I've made the point so many times now it'd be simpler just to link to it. For that matter, I've had a big, red box on my user page since March, 2009 saying essentially that.

The "I've got the data at the office" argument is just a hair more nuanced because it appeals to data rather than expertise, but data that's really, really hard to find. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:23, 25 February 2011 (UTC)

Anyone can edit

About "Once sources have been found, any editor can help integrate them into a page":

This isn't technically true. If you don't understand the sources at all, your efforts to use them will be unhelpful.

As an example, I can find sources for Exterior algebra, but I can't really integrate them into that article, because I don't really understand the sources. WhatamIdoing (talk) 20:17, 7 March 2011 (UTC)

I agree that editors should understand the reference enough to integrate it before attempting to integrate it. In practice, those who don't understand exterior algebra should use caution when editing that article anyway. However, they don't have to be expert mathematicians either. Would you like to propose a clarification, or get rid of the sentence since it isn't really specific to medicine or conflicts of interest anymore? BitterGrey (talk) 20:30, 7 March 2011 (UTC)

It bothers me that on a wiki we do not encourage people to integrate sources. Accordingly, I've added a line that I hope accounts for experts' expertise while still allowing any informed individual to add to a page. I've attempted to emphasize that a) it is the source that matters, b) that sources must be understood, and c) that summaries must be accurate (that could be adjusted to neutral which incorporates both accuracy and balance). I hope this captures the objections to the previous wording along with the realities of editor limitations. WLU (t) (c) Wikipedia's rules:^simple/_complex 00:45, 22 March 2011 (UTC)

Section on People with a medical conditon (2nd chart)

First let me say that you all have done a wonderful job writing this essay. I really enjoyed reading it and actually learned a few things. In the second chart you have for People with a medical condition that they can do the Ensuring pages make sense to the average reader. Well I can't find the right words for what I want to say so I'm going to explain how I helped and maybe you can find the words short enough to fit in the chart. My example will be the Crohn's disease article which is obvious I'm sure, though I did this with some other articles too. This article was originally written by a GI who I also spoke with during this time. When I first read the Crohn's article (2007 or 2008) it was filled with too much medical wordings and was so difficult to understand. As a patient who knows a lot about the disease I found that it had to be impossible for readers who never heard of the disease to understand what this disease was. It took some time, but with the help of other editors we made the article reader friendlier. (Disclosure: This is when I first worked with WLU I believe.) We added more in about what the disease did physically to a patient and cut out some of the more medical terminology that are not commonly known. Because I have a COI, I feared editing the article directly so I used the talk page for the most part. If I did edit the article directly, I followed it with asking an editor to check me to make sure I didn't cross any of the boundries of COI. In the chart I don't find Ensuring pages make sense to the average reader what patient's with COI can actually do for an article. I consider what I did for the articles I edited or helped with was I made them reader friendly. Maybe changing it to Ensuring pages are reader friendly and article better balanced would do though I don't like the last part that much. I hope I am saying this clearly. Now what are your thoughts on this? Thank you for listening to me. --CrohnieGal^Talk 11:48, 22 March 2011 (UTC)

The only thing I'm not understanding is what you mean by "balanced" - is that referring to what the diseases do to patients physically? In other words, a more understandable of what the patient's experience of the disease is? Sort of like a wikipedia-acceptable version of "having Crohn's disease feels like this, and does this to your insides"? WLU (t) (c) Wikipedia's rules:^simple/_complex 13:35, 22 March 2011 (UTC)

I mean more balance between the medical information and the common information that is better understood in the writing. --CrohnieGal^Talk 14:33, 22 March 2011 (UTC)

Patients

This shows Doc James removing all mention of patients and healthcare providers, on the grounds that they have no COI. This shows Jytdog adding healthcare providers back into the list. I'm not happy with either of these changes.

Patients and their families can and do put their personal interests ahead of the interests of the encyclopedia, and therefore have a "conflict of interest". For example: Let's re-write the article on this condition to talk about how patients need sympathy and practical assistance, because I'm going to link to it on social media, my friends will read it, and I want them to clean my house! Or, Let's re-write the article to tout the treatment I want my insurance company to pay for! Insurance employees do sometimes read Wikipedia articles, and a favorable impression might benefit me financially. User:SlimVirgin may be better able to say whether that's still considered a problem under the current version of WP:COI. (I haven't followed the guideline closely for a couple of years.) However, it does seem likely that if you are corrupting an encyclopedia article for the actual purpose of personally benefiting from it, then you have a conflict of interest.

As for healthcare providers, I think we should go back to the parallel structure, and I don't object to the issues given. However, the basic "spam" issues now listed (a) apply to a lot more than just healthcare providers and (b) are much easier to spot than adding or removing information because you don't think that patients should have access to certain information or because you want to influence the choices made by a particular patient. User:Davidruben can't be the only doc in the world who has had a copy of a Wikipedia article (that he wrote!) waved under his nose by a patient who was demanding that treatment conform to the recommendations of the Wikipedia article. WhatamIdoing (talk) 01:56, 31 August 2015 (UTC)

Those are examples of bad Wikipedia writing I agree. Yes I guess one could list them as COIs but they are more simply dealt with by WP:MEDRS. And yes I too have had patients bring in articles I have written. Doc James (talk · contribs · email) 02:23, 31 August 2015 (UTC)

MEDRS cannot "deal with" a physician blanking parts of an article because he wants a patient to quit asking him for a test or treatment that he doesn't want to offer, or re-writing a section to introduce happy fluff about the treatment he prefers while reducing the visibility or importance of others. MEDRS is not WP:DUE – and even if it were, trying to manipulate a real-world decision (whether it's the decision of the editor's friends to clean house, or the decision of a patient to accept a particular treatment plan) by editing a Wikipedia article still feels like a COI to me. WhatamIdoing (talk) 02:33, 31 August 2015 (UTC)

I have not seen "physician blanking parts of an article because he wants a patient to quit asking him for a test " I am happy to restore it if you feel it is important. But this is a non problem unlike that of paid promotional editing funded by pharmaceutical and device manufacturers. I just spend the day cleaning up a bunch of our eye articles that have been hit hard by a good dozen paid account over the last 6 years. And not that long ago done the same for our hearing aid articles.

These are WP:DUCK accounts.[1][2]. They are not here to write an encyclopedia in any neutral fashion. They are here only to promote what they have been paid to promote. Doc James (talk · contribs · email) 03:10, 31 August 2015 (UTC)

I agree that healthcare providers don't usually announce that they have blanked parts of an article for the purpose of helping their patients, but I have seen something suspiciously like that. WhatamIdoing (talk) 06:39, 2 September 2015 (UTC)

• WhatamIdoing, re: your question about people with medical conditions, someone with flu writing about flu wouldn't have a COI, though they should avoid adding original research (e.g. adding "honey and lemon soothes the throat better than commercial cough mixture," just because that's what they prefer). But there is no conflicting role or relationship in being someone with an illness. If you could show that someone was pushing a certain treatment to persuade an insurance company to pay for it, that would be a COI, but we would need reason to suspect that was happening. Sarah ^(talk) 21:10, 1 September 2015 (UTC)
  • Right: you wouldn't have a COI if you are merely sick, especially with something so common and boring as influenza. However, you might have a COI if you are trying to re-write the article to get tangible real-world benefits, whether those are "insurance company pays for this treatment" or "I get paid sick leave for a week". This happens on occasion. It is probably more common in the psych area than in articles about common infectious diseases. At the risk of being BEANSy, the insurance company example is probably most effective for rare diseases.
    I don't know how you would classify another case, which is someone re-writing a (usually cancer-related) page to contain information about a diagnosis or treatment for the purpose of manipulating a loved one's medical decisions. Their interest (their family member's choices) and ours (an NPOV-compliant article) are different, and sometimes conflicting. But it's definitely not a financial COI, and I believe that only financial COIs are fashionable these days. WhatamIdoing (talk) 06:39, 2 September 2015 (UTC)

• most problematic patients i have dealt with are running afoul of WP:NOTADVOCACY, of which COI is a subset. The crux is how we want to consider "external relationship", right? A person has some very positive experience with a doctor or institution or drug and becomes a fan and wants to write glowing content about him/her/it, or has some very negative experience and comes here to denigrate. We deal with that sort of positive relationship between people in COI where we have "You should not create or edit articles about yourself, your family or friends"; we deal with negative relationships between people at WP:BLPCOI. But the fan or hater of a doctor/institution/drug/company is definitely here as an advocate. I would be happy to draft something about patient advocacy for this essay, if that sounds reasonable. btw a lot of the problems with alt-med content falls in this too - somebody is a true believer in Vitamin C or yoga or whatever and wants to add content about what it does way beyond what the evidence supports or beyond mainstream practice. Jytdog (talk) 11:48, 2 September 2015 (UTC)

Jytdog, liking something a lot does not give you COI, so be careful not to confuse advocacy with COI. Advocacy often exists in the absence of COI, and COI can exist in the absence of advocacy. Sarah ^(talk) 17:46, 2 September 2015 (UTC)

I don't confuse them and specifically said "patient advocacy". Jytdog (talk) 19:04, 2 September 2015 (UTC)

You wrote that a patient liking a doctor and wanting to add positive content would give them a COI. But that's to confuse COI and POV. A Michael Jackson fan has no COI in regard to Michael Jackson. They have a COI if they're head of his fan club, selling merchandise, a member of his family, etc. Sarah ^(talk) 19:21, 2 September 2015 (UTC)

Moved here

Our general WP:COI guidelines state "Editors with a financial conflict of interest, including paid editors, are advised not to edit affected articles; they may suggest changes on the talk page and must disclose their COI."

To clarify this for medical topics:

• Editors who are professors or research scientists do not generally have a conflict of interest with respect to their area of expertise and are free to edit without disclosure.
• People who work at independent charities or at governmental agencies do not generally have a conflict of interest with respect to the subject matter their charity covers. Editing articles about the charity or government agency itself however would be viewed as a conflict of interest.
• Drug representatives, employees of pharmaceutical companies, and public relation firms of pharmaceutical companies have a conflict of interest with respect to health content. As such they are not to directly edit health care content on Wikipedia. They are welcomed to make suggestions on the talk pages but must disclose their conflict of interest.

Will add more once I have read what is here. Doc James (talk · contribs · email) 04:33, 30 August 2015 (UTC)

That is great! Would be good to broaden that from drug companies to include medical devices, diagnostics, CROs, reagent companies, and health IT companies as well. And also include reference to WP:SELFCITE in the first bullet, so maybe:

• Editors who are medical professionals, professors, or research scientists do not generally have a conflict of interest with respect to their area of expertise and are free to edit without disclosure. However, do not use Wikipedia to promote yourself, your medical practice, your institution, or lines of research you are pursuing, and generally avoid citing your own publications. Please see WP:SELFCITE.
• People who work at universities, hospitals, independent charities, or at governmental agencies do not have a conflict of interest with respect to medical or scientific subjects, but editing articles about your school, hospital, charity or government agency itself would create a conflict of interest, and you should disclose the COI and not edit those topics directly, but instead should propose content on the article's Talk page.
• Employees of pharmaceutical, medical device, diagnostic, research reagent, and health IT companies and CROs, and public relation firms representing them, have a conflict of interest with respect to health content covering products and services they offer, as well as the diseases and conditions they address. You must disclose your COI and you are welcome to make suggestions about content changes on the talk pages of articles, but you should not directly edit.

how is that? Jytdog (talk) 05:45, 30 August 2015 (UTC)

Excellent. How about "generally avoid citing your own publications". I want the authors of Cochrane reviews and USPSTF reviews to add one sentence summaries to appropriate articles. Doc James (talk · contribs · email) 20:36, 30 August 2015 (UTC)

I am good with that. I would rather have it be stronger than weaker - we get so many self-promoting editors, but I will bow on that. Jytdog (talk) 20:40, 30 August 2015 (UTC)

Yes agree just blocked these three here

I would also change "but you should not directly edit" to "are not to direly edit" to make the language stronger. Doc James (talk · contribs · email) 20:49, 30 August 2015 (UTC)

(ec) I support this, but I'd also like to see paid health-content editors (those in the third category) advised not to offer rewrites on draft pages. These are regularly carried over with little or no checking, so that you end up with a company rep having effectively written the article about the company's own product. Talk-page intervention is welcome to correct errors, but not to offer rewrites or take up a lot of volunteer time.

I would suggest something like: "You must disclose your COI and may make suggestions on the talk pages of affected articles, but you should not edit those articles directly, suggest rewrites, or take up a disproportionate amount of volunteer time with inquiries and arguments." Sarah ^(talk) 20:56, 30 August 2015 (UTC)

I like User:SlimVirgin suggestions. Doc James (talk · contribs · email) 21:21, 30 August 2015 (UTC)

While credulous acceptance of suggested edits is a problem, we're much more likely to be effective in modifying the behavior of the volunteers than of the people paid to be obnoxious timesinks. Asking the existing set of credulous volunteers to do the rewriting is more likely to produce a confused muddle of misinformation than an accurate, neutral edit based on information and sources supplied by the COI editor. Opabinia regalis (talk) 21:29, 30 August 2015 (UTC)

User:Opabinia regalis am not sure what you are suggesting? Doc James (talk · contribs · email) 22:43, 30 August 2015 (UTC)

I'm suggesting that SV's suggestion is unlikely to do much good. If the problem is that volunteers are accepting rewrites suggested by COI editors without thorough investigation, those volunteers - however well-meaning - are also not competent to do their own rewrites. Opabinia regalis (talk) 05:07, 31 August 2015 (UTC)

Sigh. Reproducing the substance of my comments on this at WT:MED, as they don't seem to have gotten much attention after the move here.

• Bullet points 1 and 2 are not specific to medical content, are not related to the problem of paid advocacy about branded products, and don't really belong here. Worse, they are basically WP:BEANS warnings to fringey types about how to attack experts editing health-related content.
• It is still strange that you want to add specific commentary about research scientists and government employees but not clinicians or care providers, who are at least as likely to have an interest in health- and health-care-related content. In fact, existing references to possible editing infelicities by clinicians have been removed.
• We already know that marketing employees and PR firms have a COI with respect to their own products. The third bullet adds nothing to this general statement. Opabinia regalis (talk) 21:29, 30 August 2015 (UTC)

added healthcare providers, thx Jytdog (talk) 21:42, 30 August 2015 (UTC)

Yup a lot of what we do is explain WP:BEANS. This is advice how not to attack experts as we are saying it is okay and not a COI. Doc James (talk · contribs · email) 22:45, 30 August 2015 (UTC)

Hoping to head off new trouble, Doc added, "And don't accuse the experts of COI! See, they may edit 'without disclosure' - which definitely doesn't sound like we're letting people get away with something - except under conditions A, B, P, Q, and Z." Sure. And don't stuff beans up your nose. Opabinia regalis (talk) 05:07, 31 August 2015 (UTC)

Sure. To simplify I would like to propose adding

• "Employees of pharmaceutical, medical device, diagnostic, research reagent, and health IT companies and CROs, and public relation firms representing them, have a conflict of interest with respect to health content covering products and services they offer, as well as the diseases and conditions they address. You must disclose your COI and you are welcome to make suggestions about content changes on the talk pages of articles. You are not to directly edit."

Doc James (talk · contribs · email) 22:46, 30 August 2015 (UTC)

Is that proportional? Are we exceeding the rules that are established for the whole community?

Consider this scenario: Alice Expert works for Big Pharma, Inc. Big Pharma, Inc. is developing a drug to treat Common Annoyance. As a direct result of her work, Alice is currently looking at a top-quality, independent source on the prevalence of Common Annoyance. She also notices that Wikipedia article contains zero information about epidemiology.

You propose here that Alice should banned from adding the information to the article, and if she does so much as suggest on the talk page that the WHO has decided that that the prevalence is 239 per 100,000 people, then she has to tell everyone where she works. Is that really the outcome we want? WhatamIdoing (talk) 01:22, 31 August 2015 (UTC)

Yes. So if you work for Medtronic and notice that Wikipedia gives the blinded systematic review and meta analysis of your treatment greater prominence than the unblinded systematic review your 18 billion company paid someone you like to write. You are not allowed to come to Wikipedia and try to remove the unfavorable blinded systematic review. And if you wish to complain endlessly on the talk page you need to disclose. This will save the community time because they can say, oh these two new accounts are simply two of the heads of marketing at medtronic or course they are going to say this.

The same if your marketing department decides to "invent" a new disease and use Wikipedia to introduce said disease. The problem is the number of poor faith COI editors substantially outnumber the number of good faith ones. Doc James (talk · contribs · email) 01:41, 31 August 2015 (UTC)

I believe that we have a remarkable number of good-faith COI editors that cause very few problems, including quite a number of productive WPMED members. We take more notice of the obviously bad-faith ones, but we don't pay any attention to the ones that don't cause us problems.

I share your concerns about someone trying to change content in a way that affects sales. But I don't understand why Alice Expert should be banned from adding epidemiological information: How does that hurt us? How does that help her employer? I note that your proposed language includes everyone, even the janitorial staff. Also, this proposal amounts to a ban, and I believe that the actual guideline is at the "strongly discouraged" level, not a complete ban on editing related articles. We cannot really set a different standard for medical articles than we do for, say, computer articles. WhatamIdoing (talk) 02:29, 31 August 2015 (UTC)

With respect to advertising, much of the world has different laws for medicine than other stuff. So I do not see why we cannot have a slightly different standard here.

I have heard many times from editors with serious COIs that they can still edit the article because we ONLY discourage it we do not disallow it.

Yes it is a ban on directly editing medical content by those with a significant conflict of interest such as PR representatives and heads of marketing of pharmaceutical firms. You say that we have lots of productive good faith editors who are paid by pharmaceutical companies to edit Wikipedia? I know a lot of medical editors and have not meet any of this group you mention. Doc James (talk · contribs · email) 03:12, 31 August 2015 (UTC)

You keep going back to the idea that the target 'audience' here is PR flacks, but that's not what you're writing in your proposed text. Do you actually intend to exclude everyone - the basic science/R&D staff, the IT people, the accountants, and the janitors - from editing anything remotely related to their company's products or product pipeline? Even companies that sell research reagents? All to have a redundant policy basis for stopping the people plopping stuff like "ZYRPLYVYX® (foobarinib) may be the right choice for people suffering from excess nose hair growth" into articles? Opabinia regalis (talk) 05:07, 31 August 2015 (UTC)

Sure how about

• "Employees of pharmaceutical, medical device, diagnostic, research reagent, and health IT companies and CROs, and public relation firms representing them, may have a conflict of interest with respect to health content covering products and services they offer, as well as the diseases and conditions they address. If you receive, or expect to receive, compensation for contributing to a topic you must disclose your COI. While you are welcome to make suggestions about content changes on the talk pages of articles you are not to directly edit the health content in the articles."

It makes it clear that such compensation must be for said edits. This would exclude the janitor unless they decided to hire him to edit Wikipedia. Doc James (talk · contribs · email) 05:38, 31 August 2015 (UTC)

I think this would be more efficient if you started by articulating what, specifically, you're trying to prevent, and why it needs a new guideline, rather than starting with the kitchen sink and then removing bits and pieces.

For example, the list (added by Jytdog above, I believe) includes CROs and companies selling research reagents. These companies may well be sources of spam (there's a notoriously unreliable antibody supplier that always makes an appearance in my spam folder....), but they are very unlikely to be sources of spam about health content. On the other hand, you've said several times that you want PR firms and marketing representatives to be part of the 'audience' here, but now you emphasize that compensation must be directly for the offending edits. Being paid on contract for specific editing tasks is different from being paid a regular salary for a general PR job that may include Wikipedia editing in the course of business.

It seems that you want to say something like "Editors who are paid representatives of a company or its products have a COI; they should not directly edit Wikipedia articles on related topics and must disclose their COI", except that's already policy. The only innovation I see here - outside unnecessary and inconsistent enumeration of who should be covered - is the language "are not to directly edit". Introducing narrower constraints than provided for in the TOU for a specific topic area needs, at minimum, broader community consensus than this backwater talk page. Opabinia regalis (talk) 23:49, 31 August 2015 (UTC)

So "Editors who are paid representatives of a company or its products have a COI; they are not to directly edit health content in Wikipedia articles on related topics and must disclose their COI" Doc James (talk · contribs · email) 23:58, 31 August 2015 (UTC)

That is coming right up to a line in policy. When I interact with conflicted editors, I explain that we have a two-step process for managing COI: disclosure and two kinds of peer review (AfC for article creation, and posting proposals on Talk for review for existing articles), and I ask them to follow that process. People generally do. But I ask them. Currently there is no basis in policy for forbidding conflicted editors from directly editing or creating articles, and WP:MED will be out in front of the community if we say "are not to directly edit". If we go there, it should be intentional, and expecting blowback from the vocal minority of the community that prizes anonymity and focuses on content only. (btw if you want to see how I ask people to follow the two step COI management process and if you have the patience, the conversation flowed perfectly in this thread this thread - i was careful to never forbid them to directly edit and the editor was happy to comply.) Jytdog (talk) 00:54, 1 September 2015 (UTC) (correct link, sorry Jytdog (talk) 11:56, 2 September 2015 (UTC))

Yes and thus this proposal. I am stating that we should "forbid" certain conflicted editors from directly editing medical content.

I am requesting that we give admins permission to block this sort of account User:Arr4 back in Feb of 2015 [3] before they have a chance to try to extort money and made us look bad with their armies of socks per [4]

This will partly deal with this problem. You combine this with reporting their accounts on Elance/Upworks. And you add in higher notability standard and we may have a leg to stand on. Plus you increase the requirements before someone can create a new article. Doc James (talk · contribs · email) 01:24, 1 September 2015 (UTC)

That is indeed a big mess, but it's fraud that has little apparent overlap with "health content" based on the list of articles. If anything, it should be motivating stricter scrutiny of articles about people and businesses. The reasons why the particular topic of health should be special here remain entirely opaque. Opabinia regalis (talk) 05:47, 1 September 2015 (UTC)

Not much health spam shows up because I have deleted most of it. Health spam takes advantage of people who are unwell and looking for accurate knowledge. It is worse than most types. Doc James (talk · contribs · email) 07:07, 1 September 2015 (UTC)

You've skipped the step where you provide evidence that your proposal actually solves your problem. You're already deleting the spam, apparently, so it already violates existing policy. Since you've seen so much of it, I'm sure you'll have extensive evidence available when you start a community-wide RfC on why standards stricter than those applied to BLPs should be used uniquely for a topic area that is much less well-defined than a BLP and that is already often subject to scope creep. Opabinia regalis (talk) 23:54, 1 September 2015 (UTC)

• User had issues here [5]. We would have blocked them sooner.
• Here is the case in detail if you wish to read it [6]

Doc James (talk · contribs · email) 00:21, 2 September 2015 (UTC)

Erm, yes, I've read it. You linked to it above. I responded. It is a very good example of a problem that wouldn't be solved by your proposal.

You don't seem to have read much of this thread, really, or you're responding with the first vaguely related thing that comes to mind instead of engaging with the actual issue, so I'll leave it be. Good luck with the RfC. Opabinia regalis (talk) 02:13, 2 September 2015 (UTC)

No worries I get it. You do not see paid promotional editing as a problems and thus feel we should not do anything about it. Doc James (talk · contribs · email) 07:35, 2 September 2015 (UTC)

You know, it is actually possible to both think it's a problem and disagree with your proposed solution. Opabinia regalis (talk) 15:10, 2 September 2015 (UTC)

Do you have any thoughts on solutions? Doc James (talk · contribs · email) 20:26, 2 September 2015 (UTC)

A couple of thoughts:

• The latest draft is a significant improvement. A person paid to mop the floor at a pharma company should not be prohibited from editing an article about a disease that the pharma company happens to sell treatments for. This draft solves that problem.
• If you want to ban certain people from editing articles, then you really, truly, actually do have to get buy-in from the whole community. It's no good slipping it into an essay. (Also, kudos to Jytdog for staying within the current policies and guidelines, even though those policies make his COI-related work harder.)
• If you want to make the split between the "evil paid PR flacks" and the "innocent employees", then you should deal with those in separate paragraphs. WhatamIdoing (talk) 06:22, 2 September 2015 (UTC)

User:WhatamIdoing if I want to get a ban on PR professionals directly editing medical content I FIRST need to get buy in from WPMED. I have no delusions that this is the end of the process. Doc James (talk · contribs · email) 07:36, 2 September 2015 (UTC)

This sounds like a chicken-or-egg problem. I suspect that many WPMED folks won't support this type of ban unless the whole community agrees to it first. At minimum, my own enthusiasm for this is tempered by my doubts that community-wide support will be forthcoming. WhatamIdoing (talk) 23:54, 2 September 2015 (UTC)