Wikipedia talk:Conflicts of interest (medicine)/Archive 1

Table of Good and Bad Edits
The current tabular form for the examples of good and bad edits is misleading. It suggests, for example, that pharma employees don't need to site sources (note that some pharma employees are accountants, etc.). It also suggests people with medical conditions should refrain from contributing, other than correcting obvious vandalism or libel against people. (Perhaps the more daring of them might even be permitted to take the initiative to correct spelling errors.) Three separate lists (the format just reverted without discussion) is both clearer and more consistent with Wikipedia policy: Everyone can contribute, and everyone should give reliable sources.

The change to three separate lists was reverted, along with all other changes, by the creator back to the creator's exact original, suggesting a sense of ownership. BitterGrey (talk) 23:53, 19 February 2011 (UTC)


 * I'm not even going to attempt to wade in between the two of you, it appears that this has become personal rather than an attempt to improve the encyclopedia (which is, in the end, why we're here). I'd strongly suggest that the two of you either choose to ignore each other for a while, take a break from editing, or have a nice cup of WP:TEA.  If anything is truly that bad, another editor will notice it and fix it.  Just as a random opinion, I prefer the tabular format, though it should be obvious that these are just examples and not specific prescriptions for specific audiences.  I'm not going to write it myself, but I'm curious as to what specific recommendations should go in for me as an employee of a government health and regulatory agency.  SDY (talk) 01:43, 20 February 2011 (UTC)


 * Hi SDY,
 * I hadn't thought about that case. The issues around promoting your employer would be the same:  an editor could spam (say) links to the NIH website just like s/he could spam links to a corporate website.  Such a person might also have a bit of a national focus, e.g., the US's recommendations for mammograms are the only ones worth mentioning.
 * I think it's important to associate specific situations with specific traps that those people are most likely to fall into. I'd thought at one point about having two examples for each type, but that would entail 20 different examples, and my imagination failed before I got very far.  I didn't want to duplicate any items, because I thought that would be interpreted as indicating that only what was listed in 'your' row applied (whereas I think it reasonably clear that single examples apply to everyone), and I didn't want to have noticeably uneven numbers of examples, because it might imply that some groups were worse than others.  WhatamIdoing (talk) 04:27, 20 February 2011 (UTC)


 * SDY, please reconsider. If you and other editors without prejudice don't get involved, Wikipedia content will be determined by the one most willing to edit war, the one most willing to be uncivil, the one who re-reverts instead of discussing.  Changing to a tabular form would make it clear that the examples apply to everyone. BitterGrey (talk) 06:07, 20 February 2011 (UTC)


 * WhatamIdoing, your first change description, "Rv changes by Bittergrey: I think the original is better because it associates specific situations with specific problems" suggests that you intended the examples to apply only to the specific row. Above, you comment "I think it reasonably clear that single examples apply to everyone".  First they don't, and then they do.  Do you at least accept that there is a risk of misinterpretation or confusion? BitterGrey (talk) 06:07, 20 February 2011 (UTC)
 * I don't think this is inconsistent; specific tendencies (illustrated in each row) do not preclude more general relevance (to all editors). I just think this may need to be stated explicitly (i.e. that the table is neither prescriptive nor proscriptive; rather, it's an illustration of tendencies).  BTW, I apologize for forking the discussion (with the section I started below), but I did so because the discussion in this section seems overly personal.  I now see that was not the right approach.  -- Scray (talk) 04:35, 21 February 2011 (UTC)

Categorization of editors
I am not sure that the categorization of editors will consistently have the intended effect. We generally do not encourage editors to use their credentials to justify their edits, yet some may see the categorization in this essay as restrictive. For example, some well-informed advocates make excellent, substantive contributions to disease specific content in articles - it's about the edit (including the primacy of reliable sources), not the editor. That said, editors need to be cognizant of COI, hence I do support the intent (I infer) for this article. I'm just not sure how best to summarize it - I'm not sure the table currently conveys the right message. -- Scray (talk) 19:04, 20 February 2011 (UTC)
 * Switching from a table to separate lists would eliminate this risk of misinterpretation. A table would only be needed if a strong connection along rows was desired: That is, if the definition of good and bad edits depended only the category of editor.  If a table is not needed, it should be replaced with lists, per Wikipedia guidelines:  "Lists are easier to maintain than tables, and are often easier to read."  There might be a middle ground, such as a table with blank columns to weaken the row-connection or some mixture of tables and lists.  These would achieve the same effect as lists, but be more complicated. BitterGrey (talk) 21:37, 20 February 2011 (UTC)


 * While everyone is welcome to make good edits, the bad edits are fairly specific: Physicians don't usually edit articles to get sympathy at home, patients don't usually try to spam their most recent academic publications into articles, and pharmaceutical employees don't usually promote tiny-minority viewpoints.
 * I do expect people with particular experiences and expertise to have particular strengths: I expect activists to be better position to write about the social movement they're in (e.g., Breast cancer awareness or the Women's health movement) than lab workers.  I expect people with a medical condition to be more aware of which celebrity has the same condition than someone in the ivory tower—and perhaps, where stigmatized diseases are concerned, to have a better notion of patient privacy.  I expect a drug company sales rep to know exactly when the drug was approved for sale in his/her country, and exactly when the patents will expire.
 * In short, these categories of people have both strengths and weaknesses, and we want to exploit the strengths while discouraging the weaknesses. WhatamIdoing (talk) 23:23, 20 February 2011 (UTC)
 * I see what you mean. Might it be helpful to footnote one of the column headings, or the table itself, to make a clarifying statement such as: "The 'Good' and 'Unacceptable' edits listed here as examples could be made by any editor; they are used here to illustrate particular strengths and tendencies in the context of conflicts of interest".  I haven't paid enough attention to WP style to know the best place/manner to insert this.  -- Scray (talk) 04:24, 21 February 2011 (UTC)
 * It seems clear that the main objections relate to the association of the "editors" column and the "good edits" column (e.g. implying that people with medical conditions should refrain from contributing to Wikipedia, other than correcting obvious vandalism.). Arguments for the tabular form seem limited to the association of the "editors" column and the "bad edits" column (e.g. "Physicians don't usually edit articles to get sympathy at home.").  Both sides could be satisfied by splitting off the "good edits" column into a separate list.  The remaining table of "editors" and "bad edits" could then be converted to a second list.  This table would need to make it clear that, while certain editor categories might be more associated with certain bad edits, all editors need to observe all Wikipedia policies.  Since these discussions are now over 2,000 words, I'll be bold. BitterGrey (talk) 14:03, 21 February 2011 (UTC)


 * No, these particular types of people have particular strengths. They should be given direct credit for their strengths, not just bashed for their weaknesses.  WhatamIdoing (talk) 17:36, 21 February 2011 (UTC)


 * Editors should be permitted and encouraged to edit anywhere they can support their edits with reliable sources, not based on where their "strengths" lie. As for the abnormally negative examples of weakness, you wrote those, not me. BitterGrey (talk) 18:49, 21 February 2011 (UTC)
 * I agree, which is why I changed the titles and wording of the table to place emphasis on sources. Anyone can edit, but some editors will do a better job than others because of background and specialist knowledge - that is where there strength is.  WLU (t) (c) Wikipedia's rules: simple/complex 20:12, 21 February 2011 (UTC)
 * Great to see a step toward real compromise that wasn't instantly reverted. What would you think to considering a few other wording changes?
 * 1) Replacing "Possible problems" with "Problems to watch for" since there are lots of other possible problems.
 * 2) Replacing "Promoting biased or tiny minority viewpoints" with "Giving undue weight to minority viewpoints" since giving them due weight isn't against policy.
 * 3) Replacing "Reverting obvious vandalism or libel against people" with something specific to people with a condition? ("legwork towards gathering reliable sources and diligence to help maintain articles" was one idea, but there are probably better ones.)
 * 4) Replacing "Possible conflict" with "Editors" or something less negative. BitterGrey (talk) 21:15, 21 February 2011 (UTC)

"Problems to watch for" suggests someone is watching, when this essay is more likely to be presented to an editor as a way of saying "You have a possible conflict of interest". "Possible problems" strikes me as more directive and suggestive to the reader that they should be concerned with these issues. "Undue weight" is a wiki-specific word, "biased" captures the intent in a more meaningful way, and there's a difference between undue weight and fringe theories. Undue weight is bais towards a viewpoint held by a small but identifiable group of stakeholders or experts, fringe theories are essentially nutjob ideas that no actual experts who work in a field support. I see the "patient" category as somewhat redundant to "advocates" and would be more in favour of rolling the two together. Also, I think it might be worth breaking the alternative health professionals out and associating "FRINGE" with them more specifically. "Possible conflict" is important because it identifies that the group in question as having a possible conflict, "editors" is so neutral that it loses the purpose of the table altogether - identifying those with a specific possible conflict of interest. We're not here to ensure no-one's feelings get hurt, we're attempting to identify problems. These groups may think what they're doing is just fine because they have the truth, this page is to suggest that their belief about the truth is what may prevent them from being good editors. Most editors will develop a belief or point of view after some reading. These editors probably already have one and that is what is causing the problem. I'd rather wait to see what other editors think before making any more changes. WLU (t) (c) Wikipedia's rules: simple/complex 21:48, 21 February 2011 (UTC)
 * I think I understand our differences regarding Undue vs. Fringe: Perhaps you were thinking about alternative health advocates while I was thinking about patient's rights advocates. Fringe is clearly more appropriate in the case of alternative health.  Moving the patient's rights advocates into the same group as the patients would be a good idea.  (Should we call this #5?) BitterGrey (talk) 22:37, 21 February 2011 (UTC)
 * I'm content to wait a little while to see what other contributors say. Sometimes my suggestions are good, sometimes they've a massive flaw that I didn't notice.  WLU (t) (c) Wikipedia's rules: simple/complex 02:23, 22 February 2011 (UTC)
 * At now nearly 5,000 words, other editors might be hesitant to go through the discussions, especially now that the driving discussion might have moved to a fourth location. (Third if we don't count the forking.)  This fourth location actually is in user space.  Perhaps the article should be as well. BitterGrey (talk) 02:40, 22 February 2011 (UTC)
 * Please don't move the page into userspace. Convention is that pages move from userspace into WP space.  Moving it back, particularly when you've a history with the editor, consensus hasn't been established and there's no real need, is dickish.  It won't get you blocked, but you will a) create a more acrimonious atmosphere and b) create a totally unnecessary new page.  So just let some time pass to see if the other contributors return or if they've been turned away by a totally unnecessary atmosphere of hostility.  WLU (t) (c) Wikipedia's rules: simple/complex 03:29, 22 February 2011 (UTC)
 * Relax. If I were going to move it into WhatamIdoing's user space myself I would have simply done so (or at least looked into whether I could) instead of discussing it.  I agree that my doing so would have been most unwelcome and completely unproductive.  However, I do think we should consider whether that would be the better place for it - if WhatamIdoing wants ownership.  Since this article is currently not in user space, no one else can create a Conflicts of interest (medicine) essay for Wikipedia.  If it is going to be her essay, perhaps it should be in her space.  If this is going to be Wikipedia's essay, then others should be permitted at least some say in it. BitterGrey (talk) 05:33, 22 February 2011 (UTC)


 * On the substantive points:
 * There are exactly as many "possible problems" as there are "problems to watch for".
 * I am far more concerned with editors pushing bias and fringe-iness than I am with them achieving perfect neutrality, since it is unreasonable to expect any new editor to achieve perfect neutrality, but it is wholly reasonable to expect them to know whether their personal beliefs are mainstream.
 * "Finding sources" suggests that the person isn't welcome to add content, and this type of editor is (on average) less able to do this than the other types listed here. (Quick example:  If you needed a solid source about high cholesterol levels, would you ask the PhD who researches the subject, or would you ask your neighbor who happens to have high cholesterol?)  I have explained elsewhere why I think that libel and invasion of privacy, in particular, is something that a person with a medical condition is likely to be sensitive to.  A false claim that someone has a "loathsome disease" is one of the categories of libel per se in US law.
 * "Possible conflict" is directly on point. I think it appropriate for this page to be direct.
 * Additionally, on the issue of advocates and activists: It's like calling yourself a nutritionist.  These are not regulated terms.  I think that the current combination of names will help the people to whom that row applies find it.  I do not think that they will find themselves under "people with the condition", because a significant proportion of advocates and activists do not have the medical conditions that they have dedicated their lives to.  As an example, Nancy Goodman Brinker is perhaps the single most important breast cancer advocate in the world, and she has never had breast cancer.  WhatamIdoing (talk) 05:44, 22 February 2011 (UTC)
 * To implement the slightly different categories that WLU suggested (and I think are good ideas) the category descriptions would, of course, need to the adjusted. By the way, since I don't know any PhD cholesterol researchers, I actually would ask my neighbor, and then weigh the input based supporting sources. BitterGrey (talk) 06:24, 22 February 2011 (UTC)

Medicine only?
I don't see why the essay would/should restrict itself to medical subjects or editors. Drivers of cars, plant workers, company executives, car repair shops, owners of cars affected by a recent recall, all could be baised in similar ways to patients. Ditto for restaurants, schools, people who take the bus, etc. Medical stuff would probably get the worst of it, but still. WLU (t) (c) Wikipedia's rules: simple/complex 15:32, 21 February 2011 (UTC)


 * I agree that everyone can have COIs. This essay is specific because it was rooted in a pharma-specific question from WikiProject Medicine.  It should be a primer for specific editors, directing them to specific policies that might be particularly relevant to them, while not implying that any editors are exempt from any policies. BitterGrey (talk) 16:20, 21 February 2011 (UTC)
 * It may be worth noting that though medicine and medical COIs are an exemplar of this type of COI, they are not exclusively the domain of this group. But either way, it's just a thought.  WLU (t) (c) Wikipedia's rules: simple/complex 16:48, 21 February 2011 (UTC)


 * It might be possible to combine this idea with Scray's good idea above about a 'clarifying statement' (placed just before or just after the table?). WhatamIdoing (talk) 17:42, 21 February 2011 (UTC)


 * A comment to point out that COIs aren't exclusively problem in medical topics wouldn't be affected by whether the examples were given in tabular format or as lists. There is no reason to discus combing the changes unless someone without a consensus wanted to confound issues to try to 'porkbelly' together a majority. BitterGrey (talk) 19:09, 21 February 2011 (UTC)


 * WLU, why don't you be bold and add the clarification, trusting that other editors will adjust or discuss if needed? That is how things work on Wikipedia (or at least how they should work).  This isn't a policy or even a guideline, so no special restrictions on editing apply. BitterGrey (talk) 19:09, 21 February 2011 (UTC)
 * Being bold doesn't mean trampling a page that is in progress. As an essay, it is more the work of a single editor than most pages, and I'm content to note my comment and wait for others to decide if it has merit in the developing version of the page.  Normally the authors of essays have a vague-to-concrete idea of the purpose of the essay, and I would consider it rude to insert my idea while it is still being developed.  WLU (t) (c) Wikipedia's rules: simple/complex 19:30, 21 February 2011 (UTC)
 * Suit yourself, but please be aware that "essays that the author does not want others to edit ... belong in the user namespace." and that this essay hasn't changed one iota since it was posted days ago. Just as long as your suggestion doesn't end up getting hijacked and used to force something unrelated. BitterGrey (talk) 19:43, 21 February 2011 (UTC)
 * Please be aware that wikipedia is not a battleground and wikihounding is not appreciated by anyone. I have worked with WAID many times in the past and often seen my contributions substantially improved upon by her.  I have the utmost faith in her ability to calmly and civily integrate, respond to or improve my suggestions.  And even if we disagree, it will be civilly and based on substantive points.  Your comment about an essay being in essayspace comes across more like someone trying to pick a fight.  It's an essay, it's not the end of the world.  WLU (t) (c) Wikipedia's rules: simple/complex 19:48, 21 February 2011 (UTC)
 * Wikihounding? I've forgotten how long I've been watching wp:WikiProject_Medicine... and would have appreciated a response to my first attempt at discussion when all this started there. Now, as odd as this might sound, thanks for being the first to do something to start to address my concerns. BitterGrey (talk) 20:15, 21 February 2011 (UTC)

Please stop editing against consensus
Bittergrey,

At this point, I think you need to stop being bold, and start assuming that your edits do not enjoy consensus unless and until you are directly and explicitly told that someone (anyone) agrees with your proposal. There's a point at which "bold" stops being bold and starts being disruptive, and I think you're on that line. WhatamIdoing (talk) 17:38, 21 February 2011 (UTC)


 * I disagree with your assertion that I was editing against a consensus. If it were true, why did you feel the need to revert to your version yourself again?  I've been attempting to initiate discussion and offering alternatives.  Clearly you are the one who is becoming disruptive, if not so already. BitterGrey (talk) 18:36, 21 February 2011 (UTC)
 * Right now this page, which is a user essay, is being edit warred over. This is stupid.  WAID is the primary author, rather than trying to shove a preferred version on to the page, discuss.  Having seen both, I see the value of the table as it more clearly lays out the potential for good or bad edits by specific stakeholders by showing more acutely where expertise-versus-COI may occur.  WAID is not clearly being disruptive.  Both of you have been bold, and reverted.  Let's get to step 3, discuss.  WAID has a lot of experience on wikipedia, and she is worth listening to.  Bittergray, looking into some other pages you have contributed to others have suggested that you may be picking fights or carrying over disputes you've had with WAID in the past.  Please stop.  Wikipedia is not a battleground.  I count four people who have made similar comments, perhaps it is time to bury the hatchet or simply edit elsewhere for a while.  Edit warring over a brand new essay is, as I said above, just plain stupid, particularly when there have only been two editors to the page and it's unrealistic to expect consensus.  WLU (t) (c) Wikipedia's rules: simple/complex 19:43, 21 February 2011 (UTC)
 * Were this a user essay in user space, that would be quite different. Articles in user space have user names in the URL.  This one doesn't.  I'd be OK with it being moved. BitterGrey (talk) 20:02, 21 February 2011 (UTC)
 * Essays in userspace can be edited as well, and the rules would still apply - as does basic civility and politeness. This is an essay, it's not binding, it's not official, it's basically someone's idea.  Mainspace or userspace, basic civilities of wikipedia still apply.  That WAID started it in WP space instead of user space is not an invitation to edit war.  Can we let this go?  Accept that others may not agree with you, and a three day old essay isn't worth edit warring over and really, really makes it look like you're trying to annoy someone rather than improve the essay.  WLU (t) (c) Wikipedia's rules: simple/complex 20:16, 21 February 2011 (UTC)
 * The big difference would be ownership. If it were in WhatamIdoing's user space it would be her essay.  As for edit warring, I have yet to revert once because I decided that this article wasn't worth warring over. BitterGrey (talk) 20:32, 21 February 2011 (UTC)
 * Sure, let's agree that everyone has made mistakes and move on. What do you think of the edit I just made   Do you think it is an improvement or would you suggest another change?  WLU (t) (c) Wikipedia's rules: simple/complex 21:06, 21 February 2011 (UTC)
 * I think it is two steps in the right direction. First, because it involved offering a compromise instead of reverting repeatedly and claiming a consensus where none existed.  (Glad you decided to be bold.)  Second, because it doesn't imply special castes of editors (or at least not as strongly).  One option that we should keep on the table is moving the article into WhatamIdoing's user space.  Discussions there seem to have already started . BitterGrey (talk) 02:54, 22 February 2011 (UTC)

You misunderstand. I made a change to a page I consider to be primarily another editor's work and alerted them to this fact. That isn't the start of a new section on a new page. I don't think it's worth moving it to WAID's userspace, I just don't think you should replace a table with a bulleted list and insist upon it when there is obvious disagreement. WLU (t) (c) Wikipedia's rules: simple/complex 03:26, 22 February 2011 (UTC)


 * Is it just me, or have all the changes to this essay been made boldly, without prior approval in discussion, while all of the changes discussed beforehand (e.g. ) don't seem to be happening?  Anyway, I'm striking out the accusatory part of WhatamIdoing's header.  At the time, there was no consensus: None had been expressed, and time would show that none was present.  Fortunately, since other editors who are being  bold are not being quickly reverted and accused, there is now some progress toward an actual consensus. BitterGrey (talk) 03:47, 23 February 2011 (UTC)
 * Consensus takes time to build and there's no real rush. Plus people get turned off by an acrimonious environment where there's a lot of unnecessary arguing for the sake of arguing.  Not everything needs to be discussed to death and not everyone monitors pages on a minute-by-minute basis.  Relax, the tree's been shaken, now we're waiting for something to fall out.  WLU (t) (c) Wikipedia's rules: simple/complex 16:33, 23 February 2011 (UTC)

I was reviewing the BRD essay, and think it supports my actions strongly enough to try to lay this part of the mess to rest. For simplicity, I'll focus on the "Good edits" table in the play-by-play:

Recommendations for WhatamIdoing:
 * I boldly made a change, consistent with the BRD cycle and the Be bold guideline.
 * WhatamIdoing reverted. The essay advises "Rather than reverting, try to respond with your own BOLD edit if you can." Had this occurred, there might have been movement toward a consensus.
 * I initiated a discussion. "The first person to start a discussion is the person who is best following BRD." The essay recommends "don't get stuck on the discussion ... a new Bold edit as quickly as possible, preferably within 24 hours." After 38 hours, one forking, and 2000 words, no detailed consensus had been reached.
 * I offered a different Bold change based on my best understanding of the viewpoints expressed in the discussion. Ideally, this alternative would have been offered by another editor, but none took the initiative.
 * WhatamIdoing re-reverted, in contrast to the essay: "BRD is not an excuse for reverting any change more than once. If your reversion is met with another bold effort, then you should consider not reverting"
 * WhatamIdoing claimed a consensus and asked me to stop editing against his perceived consensus . No editors echoed this consensus except possibly one discussion about whether the essay was or was not in user space.  (It was not in user space.)  This also is in contrast to the BRD essay: "Do not accept 'Policy', 'consensus', or 'procedure' as valid reasons for a revert."
 * 1) Accept that other editors may want to correct factually inaccurate statements.  Do not take this personally.  They might want to correct such statements no matter who makes them.
 * 2)  Anyone can edit Wikipedia.  Accept that other editors, especially those with differing viewpoints, can and should edit.
 * 3) Engage in discussion and offer compromises. You are an editor like everyone else.
 * 4) If an editor persists in making a change in opposition to a consensus and a second revert is needed,  let another editor make it.  This precludes any risk of a one-on-one edit war.

While buy-in from a number of editors would be great, I'm not expecting it. Since other editors became involved, made changes in the direction of my second proposal, and weren't reverted, the cycle described by the BRD is now occurring. There is interest in putting this behind us.

Thank you for your patience: Given how much policy-editing and essay-editing (including two of BRD quotes above) that WhatamIdoing does, I didn't want the tactic she used here to be mistaken for something to be emulated. BitterGrey (talk) 03:10, 24 February 2011 (UTC)

Well, I'm offended unoffended
I'm a chronic pain patient. I've been editing neuroscience-, emotion-, philosophy- pain- and mental health-related articles for a while. That characterization of patients being good for patrolling vandalism and BLP violations, and problematic when dealing with serious medical content is deeply, deeply offensive. I see this essay adding nothing whatever to this encyclopedia that isn't obvious to a 14-year-old in the basic COI policy. I liked the outline at Wikipedia_talk:WikiProject_Medicine but, that's not what this is. --Anthonyhcole (talk) 12:12, 22 February 2011 (UTC)
 * You're also an experienced editor with nearly 7,000 edits to your account and good ones at that. This I see as more aimed at people who might not understand the difference between a secondary source and a primary source; it's a first step for new editors who think wikipedia is a place to "get the message out" or something else WP:NOT says is a bad idea.  I think it's worth working with it a little more before hitting MFD, but also agree that the "people with a medical condition" line isn't great; it's the least clear, and the most offensive of the lot on both expertise and possible problems.  I've adjusted, what do you think?  I've seen contributors with a condition who make excellent changes and do great work, including on pages about their conditions (CrohnieGal springs to mind, quite high) and others who just managed to annoy people and push a POV (did you ever interact with Guido den Broder?) and I think there's merit to trying to encourage the good and discourage the bad.  WLU (t) (c) Wikipedia's rules: simple/complex 13:05, 22 February 2011 (UTC)
 * Thanks. :) --Anthonyhcole (talk) 13:17, 22 February 2011 (UTC)


 * You aren't alone in offense. I've been dismissed as an "activist" often. Per the version WhatamIdoing edit warred over, "good" edits for me were limited to social movements: Science was to be left to those who could profit from it.  Furthermore, I alone was at risk of "tiny minority viewpoints," and needed to site sources while those with money to gain did not.


 * The table actually is rooted in the wt:med post; the "tiny minority" being the "handful of (minority-view-holding) editors." This was a reference to the time WhatamIdoing persisted as sole defender (eg  ) of a self-promoting "expert" who had come up on COI/N multiple times under different names. ( While not a professional scientist, I think 5 of 6 is not a tiny minority. )  Of course, none of this accountability would have happened if there something that could be mistaken for policy relegating activists, patients, etc. to scientifically inconsequential pages.


 * If Wikipedians in general are permitted to influence this article (not just those with WhatamIdoing's blessing), the problems might eventually get fixed. If not, WhatamIdoing's essay should be removed to WhatamIdoing's user space. BitterGrey (talk) 15:29, 22 February 2011 (UTC)


 * Hi Anthony,
 * In terms of adding content, average patients (i.e., not you) often have trouble differentiating between, e.g, "the side effects I personally experienced" and "the typical side effects". Wikipedia has a history of people either downplaying real risks, or overplaying small risks, and when the whole story comes out, you discover that they were trying to make the article match their (or their loved ones') personal experience.
 * Also, average patients typically don't actually understand the science. One story may illustrate this:  Early in his career, the surgeon went to great lengths to educate his patients.  He spent an hour or more personally explaining every surgery, with diagrams and discussions and outlines of the options.  And then one day, the morning after a routine gall bladder removal, he went to see the patient, who said, "Doctor, I have a question."  Instantly willing to answer anything, he waited for the question:  "Uh, can you tell me what a gall bladder is?"
 * (The surgeon takes a different approach now, and recommends it to his residents. That approach is:  pat them on the shoulder and say, "It's going to be fine.  It's all going to be JUST FINE.")
 * As a result, I'm a little reticent to recommend any area of science as a particular strength for this group. The average patient is far more likely to know which celebrity has the same medical condition than to know how the disease works.  If, however, you'd like to suggest a different strong point that the average patient is likely to have, please let us know.  WhatamIdoing (talk) 16:27, 22 February 2011 (UTC)


 * I object to WhatamIdoing's comment that patients are somehow less intelligent, less experienced, and/or more biased than the average Wikipedia editor. (I've been a patient myself, most recently for arthritis.)  By the way, in the U.S.,  informed consent is not just a courtesy, but the law. BitterGrey (talk) 16:53, 22 February 2011 (UTC)


 * Fortunately, I never said that. I said that the average patient is less knowledgeable about their condition than the other people in the list, e.g., the typical medical professional who specializes in that area.  But if you want to introduce the issue of intelligence, it happens that there's a solid gap of 25–30 IQ points between physicians and patients.  WhatamIdoing (talk) 18:49, 22 February 2011 (UTC)
 * I'm not going to make any comments about what WAID did or did not do. I think it's an unnecessary diversion from the topic of the page and seems like little more than an effort to settle a grudge.  Frankly, I don't care and would appreciate it dropped.
 * The seed idea for this essay was a good one in my mind. It can't, and shouldn't apply to all editors.  All editors have the same requirements, laid out in the policies and guidelines - find sources, summarize them accurately, and make sure to give appropriate weight based on what the relevant experts have published.  If a patient can do that, great.  If a big pharma employee can do that, great.  If they are doing that, they don't need this page.  This page is for the editor who comes in with a biasing background and edits accordingly.  If you find out I'm actually the CEO of GSK editing the viagra page, it's only really an issue if I'm deleting adverse effects.  If I'm adding accurate content from review articles, who cares who I work for?  This is being taken to extremes it was not meant to go, and discussed as if it were absolutes rather than something to watch out for.  If the original wording was less than optimal, let's work with that and try to get it towards the spirit with which it was intended.  WLU (t) (c) Wikipedia's rules: simple/complex 19:00, 22 February 2011 (UTC)
 * A key problem is that there was a divisive and  marginalizing table, which multiple editors have now expressed concerns about.  I agree that this has the potential to be a good essay some day, but only if those concerns and any others are addressed. BitterGrey (talk) 21:00, 22 February 2011 (UTC)
 * Multiple editor have also expressed support for the table, and I strongly feel the "possible problems" table is the most valuable thing on the page - I've run into many an editor who have exhibited these very behaviours. In two cases I can think of, they got blocked - one was a patient who thought the article must reflect their personal experience and beliefs, scientific consensus be damned.  Another was an activist who promoted their fringe point of view until they were banned from editing, then sockpuppeted themselves into a permanent block.  The reason this page exists is to point out there are limitations and problems with some edits.  Though we shouldn't be divisive or marginalize people, we also should point out that single opinions based on their lives, wants and needs are not appropriate perspectives to edit towards.  WLU (t) (c) Wikipedia's rules: simple/complex 12:57, 23 February 2011 (UTC)
 * The tabular format hasn't been discussed much. The current tables are quite different than that initial table, and there seems to be only one editor, at most, interested in going back to it.BitterGrey (talk) 15:08, 23 February 2011 (UTC)

Any page with a half-dozen somewhat redundant new sections is going to discourage some editors and make the discussion harder to follow. At some point I'm probably going to suggest scrubbing the entire previous set of the discussions and starting a "what do people think now" section to re-visit things anew. WLU (t) (c) Wikipedia's rules: simple/complex 16:47, 23 February 2011 (UTC)
 * Second that. You know how to set up an archive, right? --Anthonyhcole (talk) 17:04, 23 February 2011 (UTC)
 * It is getting a bit long, and now that the 'owner' isn't quickly reverting all changes and making personal accusations, it is becoming civil and functional. BitterGrey (talk) 17:21, 23 February 2011 (UTC)
 * Anthony - the page is less than a week old, though I'd love to archive on the basis of volume, I'm reluctant on the basis of age.
 * BG - I realize you feel like an aggrieved party but I'm really not interested in how you've been done wrong. The only person making personal accusations now is you, and it's very easy to address - just stop doing it, stop hinting at it and stop alluding to it, even eliptically.  Please re-read the current page and on the basis of the content, present suggestions.  WLU (t) (c) Wikipedia's rules: simple/complex 17:59, 23 February 2011 (UTC)
 * Can I edit? BitterGrey (talk) 18:49, 23 February 2011 (UTC)
 * It's a wiki, anyone can edit. Whether they will stand or not depends on the edit and editors.  You can always try, but that doesn't mean it will last and you shouldn't take it personally.  If your edit is reversed, it stands a far greater chance of being replaced if you can make a solid case for why it was a good edit on the talk page.  Sometimes consensus is made on the talk page, more often it's made on the actual page.  WLU (t) (c) Wikipedia's rules: simple/complex 19:09, 23 February 2011 (UTC)
 * So can I take that to mean this injunction shouldn't have happened, doesn't have consensus support, and should be put behind us?  The key changes I attempted to make have already been effectively remade by others anyway. BitterGrey (talk) 19:36, 23 February 2011 (UTC)

An experiment
The current table format seems a little, well, accusatory. I've split it into two tables with some introductory language, but am still keeping the specific associations for the various groups of editors. Feel free to revert, just experimenting. SDY (talk) 16:46, 22 February 2011 (UTC)
 * I like how it focuses on common mistakes of new editors, instead of assigning lasting, marginalized categories of editors as "Possible conflicts". We are making progress.  I also like that it now lists strengths that editors can provide, instead of restricting them to a narrow band of "good edits."  I dislike that it uses tables instead of lists, but the content is more important than the formatting. BitterGrey (talk) 17:03, 22 February 2011 (UTC)
 * I actually prefer the old version, I think it nicely illustrates and contrasts the two extremes. One thing I would point out though - the only real expertise that a COI editor might have is knowledge of a specific set of sources.  Theoretically, anyone pointed to those sources would be able to locate and summarize them.  The problem I had with editing the "good" column was finding different ways to say essentially the same thing - this person may have more knowledge of specific sources that other people who haven't worked in the area may not be aware of.  The "bad" column is easier to deal with - there's only one real way to edit properly (find source, summarize accurately) but there's a nearly endless number of ways to eff it up and the real point of the table is to highlight the "direction" we might expect certain groups to eff it up in.  That's where the value of the table lies in my mind - if you're a patient, it's not OK to talk about how it affects you personally, the perspective they're most likely to start from.  It's basically a more concrete and pointed application of WP:NOT.  WLU (t) (c) Wikipedia's rules: simple/complex 19:07, 22 February 2011 (UTC)


 * I'm not at all opposed to re-combining the table, it's just that it's easier to explain what the columns mean when there's a lead-in paragraph. Footnotes could work as well, though from a "flow" standpoint they may be missed (q.v. the offended section above).  One thing that I do want to make sure goes into this essay, though, is a liberal application of WP:AGF and Hanlon's Razor (i.e. the Aristotlean "not evil, just uninformed").  These COI editors have a lot to offer (as the essay acknowledges) and the objective is not to make them feel unwelcome, just to point out things that are likely to lead to headaches.  SDY (talk) 19:24, 22 February 2011 (UTC)


 * It doesn't really matter to me whether it's one table or two, so long as we associate the specific risk factors with the specific risks. I think your (good) introductory text could be copyedited to work for a combined table, if you wanted to do that.
 * I share your concern that footnotes are likely to be ineffective.
 * For the record, I prefer a table over prose (another way to associate the risk factors and risks) because I think it easier to scan and also, as a very minor point, because it is a little easier to keep 'balanced' (not pounding on one group more than another). WhatamIdoing (talk) 21:16, 22 February 2011 (UTC)
 * See my note below, I think we should definitely keep a table, but perhaps the "strengths" table could be eliminated or better dealt with via prose. It's a preliminary idea, and many a time my "great" ideas have flaws (many a time pointed out by WAID with her annoyingly high IQ ).  WLU (t) (c) Wikipedia's rules: simple/complex 12:52, 23 February 2011 (UTC)

Latest and greatest
WLU, the first part of this change isn't working for me. The fact is that patients usually don't know the latest and greatest treatments. A small subset of patients do, but most patients don't. What the average patient knows is only what was said on the television about the condition. (And if that weren't true, Oprah's decision to feature Jenny McCarthy wouldn't bother people.) WhatamIdoing (talk) 19:00, 22 February 2011 (UTC)
 * Yeah, I see your point. As I've said, that's the row I have the most difficulty with.  What advantage does a patient really bring except their direct experience with an illness, an experience they can't include in the page?  How about we collectively do some brainstorming on this one?  I have no real issue with the other rows.  What do patients bring?  Interest, motivation, a desire to learn, a constant attention towards the subject, perhaps an awareness of the gray literature and patients rights organizations?  I take it you think the second part is OK though?  The previous version (BLP and vandalism) did, in my mind, suggest that patients couldn't do anything else, and that's not something I'd like to encourage.  Not to mention, anyone who monitors the page will bring that particular set of tools to the table.  WLU (t) (c) Wikipedia's rules: simple/complex 19:07, 22 February 2011 (UTC)


 * I think that you've got a particular type of patient in mind, and I'm not sure that I do. Your patient seems to be a full-time 'professional patient' who is exceedingly well-versed in the literature.  Mine was cleaning up Common cold earlier this month (and overall doing a fine job of it), because he had a cold; another reported his (her?) personal experience with the involuntary psychiatric commitment in Australia; another spammed advertising about clinical trials into articles because he'd decided to join one.
 * I think the important point to make is that the average patient is the average editor. The average patient does not actually have expertise in a technical/medical area, and we shouldn't pretend that they do.  Their strength, therefore, is in everyday, normal editing, reflecting the fact that they are actually everyday, normal people.  (This suggests that "demanding articles be written so that normal people can read them" might be a related skill set.)  WhatamIdoing (talk) 21:32, 22 February 2011 (UTC)
 * But what we're trying to do here is separate the average editor (which is really anyone who is editing outside their area of expertise) from the patient - so what distinguishes a patient from an editor? In your first case - nothing!  When any editor is cleaning up something and doing a fine job of it, you don't need to point them to this page.  But the second and third are the ones who should have WP:MEDCOI pointed to on their talk page.  It's almost as if we should leave the "Possible expertise" line out for that group, because we don't really expect them to have specialized knowledge.  What if we replaced the "Possible expertise" table with simple prose?  "Any editor can remove BLP violations, revert vandalism and add well-sourced content; though some expert groups might know where to locate certain types of material (company employees might know the history of a product, academics may have access to the most recent review articles, advocates may be aware of news stories and histories of their movements) the actual sources can be summarized and integrated by anyone."  In my opinion that gets at the nub of the issue and rightly points out that anyone can edit.  Once any editor is aware of a source and takes the time to read it, they are free to add it to the page; the ability to parse and summarize is a skill common to many professions or even just hobbies.  WLU (t) (c) Wikipedia's rules: simple/complex 12:47, 23 February 2011 (UTC)


 * If we stick with two tables, I think we can just drop the patients from the 'expertise' table; I think that would be more effective that switching to prose (which isn't as easily scanned, and I do want to encourage people to make these kinds of badly needed improvements). Does that work for you? WhatamIdoing (talk) 16:32, 23 February 2011 (UTC)
 * I've been bold, and added a note that anyone can use a source once identified. I'd argue for a single table again if it didn't leave such a glaringly obvious hole in the "patients" row.  Single table really does juxtapose the two poles (expertise versus issue) in the best way in my opinion, but for that hole... WLU (t) (c) Wikipedia's rules: simple/complex 16:43, 23 February 2011 (UTC)


 * As has been said I do have a COI for IBD. I acknowledge this on my user page.  When I edited these groups of articles I always tried to get someone to look at my edits or suggestions to make sure that I was not abusing COI.  What I think I brought to the Crohn's disease article and other related articles was items missing from the article that would make the article better.  For instance I put in Short bowel syndrome which was missing from the article.  I feel that patients can do things along this nature to add to article either by editing directly by being bold or by suggesting on the article talk page.  I personally tried to stay away from some things that were medically technical and left that to editors more knowledgeable than I am.  Sometimes medical article can also be too medically detailed for the average reader to understand.  When I see something like this I bring it to the talk page and so far I've had no negative responses asking for the article to be clarified better for the normal reader.  We have to remember that our readers will not read an article if it's filled with a lot of things that are just not understood.  So, in my humble opinion, your gaping hole for patients can be that they are qualified to remind editors that there are things missing from the article that are related.  For a newbie, I would suggest that these be done at the talk page of the articles, which is what I did in the beginning.  So adding that patients can add ideas missing to expand articles would fill in your hole you are looking to fill in.  Just an idea I'm throwing out here.  -- Crohnie Gal  Talk  17:52, 23 February 2011 (UTC)
 * Any editor who has done a lot of reading on a topic can spot holes and help fill them and I think that's the issue WAID raised earlier in my assumption that all patients were as well-read on their diagnosis as you. But it takes a "naive" or reader to say "I don't understand what is being said here".  Perhaps that is what we can fill in as a patient strength, making pages readable at the level they're supposed to be, the average person.  IMHO, a brilliant suggestion!  WLU (t) (c) Wikipedia's rules: simple/complex 18:19, 23 February 2011 (UTC)
 * Crap, re-reading the page I see it was a suggestion WAID already made. Great minds think alike?  WLU can't read?  Too much posting on the talk page?  Irrespective I think it a good suggestion.  WLU (t) (c) Wikipedia's rules: simple/complex 19:37, 23 February 2011 (UTC)
 * Implemented. WLU (t) (c) Wikipedia's rules: simple/complex 19:42, 23 February 2011 (UTC)

Wiki Tables Guidelines
Looks like I'm not the only one unfamiliar with Wikipedia's guidelines for tables: A tutorial is here. For example, the column headers (again equating specific types of editors with conflicts) seem to be missing "scope" tags. BitterGrey (talk) 20:33, 22 February 2011 (UTC)
 * Just finished fixing the table in List_of_paraphilias (a list couldn't have become broken in that way) and thought I'd point out the irony. BitterGrey (talk) 15:51, 23 February 2011 (UTC)

Multiple accounts limited to separate topic sets
"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." That the separate accounts shouldn't edit the same topics (or engage in the same discussions) would to be clear to users who have read through the username and the  sockpuppetry policies. However, the target audience for this essay are new users who aren't yet familiar with the relevant policies. I'd make the change myself, but I've been personally asked not to edit. BitterGrey (talk) 15:30, 23 February 2011 (UTC)
 * It's really not about topics. The same person can use two separate accounts to edit the same topic, provided there is an acceptable reason and it's clearly identified that it's the same person.  They aren't allowed to use the second account to votestack or portray a false consensus, but they can make the same point with two different accounts provided the relationship is transparent.  For instance, an editor might use one account at work and another at home because their workplace has a different IT security stance than they do at home.  They're using two different accounts, but everyone knows it.  That would in my mind be not a big deal and perfectly acceptable as long as there's a public disclosure on both accounts.  I read it as a grey area, not a hard and fast line.  The community is normally pretty tolerant of public disclosure of accounts that isn't used to bypass policies or game the system.  WLU (t) (c) Wikipedia's rules: simple/complex 16:31, 23 February 2011 (UTC)
 * WLU, could you point me to where on your talk page your accounts are connected? Per Wikipedia policy,  "Editors who want to use more than one account for some valid reason should provide links between them on the respective user pages..." (The policy goes on to list topical or chronologic separation as exceptions).   Maybe I'm simply overlooking where you have the two accounts associated.  Clearly, not everyone knows you have two accounts.  Also, since you bring up votestacking, one editor specifically inviting a sympathetic editor directly is suspicious . BitterGrey (talk) 17:15, 23 February 2011 (UTC)
 * ...as are off-wiki discussions with editors now suddenly active hereBitterGrey (talk) 18:18, 23 February 2011 (UTC)
 * The user name policy has a link to the  standard template. BitterGrey (talk) 17:40, 23 February 2011 (UTC)
 * I only have one account. You've identified the appropriate template, but you could simply redirect both user and talk pages of one account to the second.  Again, it's not an iron-clad law, it's common-sense policy that has reasonable wiggle-room.  Editors who abuse good faith are normally pretty easy to spot, while those who are consistently transparent shouldn't face any problems.
 * You'll note that I also mentioned Crohnie by name in an above section. Yes, I sent her an e-mail which contained a reference to this page (which is appropriate given she's mentioned by name), but you may also note that we've a long history of corresponding on wiki and off about wiki-related, and unrelated matters and we're pretty transparent about it.  It's only an issue if you are canvassing one side of an argument to votestack, but since we're not voting, and this is a suggested essay rather than mainspace or a policy, it's hardly a big deal.  You could see WAID's comment as a subtle form of votestacking, or you could see it as an invitation to comment given our common interest in this area.  I'm reluctant to see malicious motive anywhere in that note, and obviously I have an active interest in it.  I'm not quite sure my pharmanoia piece could be integrated into this page, but I've been diverted by a large number of tangential posts to date.  Again, picking a fight and in particular holding a grudge isn't helpful.  You're fighting a losing battle by trying to impune the motives of a longstanding and respected contributor, particularly when no-one is agreeing with you.  Appearing paranoid by seeing motive everywhere also won't help your "case" if you're trying to build one, but will definitely go a long way towards alienating people.  I'll say it one more time - just drop it.  We get it, you feel treated unfairly by WAID.  Perhaps you did get bit, but if you are sincerely interested in improving wikipedia, you'll let it go.  WLU (t) (c) Wikipedia's rules: simple/complex 18:30, 23 February 2011 (UTC)
 * So "I use one account at work and another at home because my workplace has a different IT security stance than I do at home. I'm using two different accounts, but everyone knows it" was just a hypothetical example?  Sorry if I misunderstood.  Using the third person would have been more clear.  Again, you brought up votestacking, not me. BitterGrey (talk) 18:42, 23 February 2011 (UTC)
 * Ah, I thought I put in a "for instance I might" but forgot that crucial part. Corrected.
 * I brought up votestacking in the abstract, yes. Feel free to let it drop.  WLU (t) (c) Wikipedia's rules: simple/complex 19:12, 23 February 2011 (UTC)

Seems like some clarification is in order. Would others like to comment on the proposed language, or propose other language that might be more clear and detailed? BitterGrey (talk) 19:39, 23 February 2011 (UTC)