Wikipedia talk:Mediation Cabal/Cases/2006-02-02 Tourette Syndrome

Experimental treatments section
The current entry, which started on 26 Jan, and became an ad hominem issue about the TSA on 28 Jan, is now in better shape, consolidated under Experimental treatments. I continue to concur with Greg Kuperberg, however, with respect to the Marinol entry. Neither marijuana nor Marinol are currently useful in the treatment of Tourette's, nor are they likely to become useful treatments in the near future. Reference, What Wikipedia is not -- a soapbox. The considerable contributions of Unsigned User can be moved to Marinol and marijuana. Here is my suggested wording to incorporate both Greg's and my concerns over the length and relevance of the Experimental treatments section. Suggested wording Nicotine showed preliminary promise in case reports, but these effects were not reproduced in well-controlled trials several years later. Studies of nicotine derivatives (mecamylamine, inversine) also showed that they were not effective as monotherapy for the symptoms of Tourette's. Deep brain stimulation has been used in treating a few patients with severe Tourette's, but is regarded as an experimental and dangerous procedure that is unlikely to become widespread. Complementary and alternative medicine approaches, such as dietary modification, allergy testing and allergen control, and neurofeedback, have popular appeal, but no role has been proven for any of these in the treatment of Tourette syndrome. Case reports found that marijuana helped reduce tics, but validation of these results requires longer, controlled studies on larger samples. Preliminary research on tetrahydrocannabinol, the main psychoactive substance found in cannabis, in pill form (brand name Marinol®), as a treatment for Tourette's syndrome was promising, but there are concerns about the safety of Marinol, and longer, controlled studies on larger samples are needed. Sandy 03:28, 16 February 2006 (UTC)


 * Quoting AnonUser from the project page: "In fact, neither Sandy nor anybody else has provided a good reason to disagre with the concensus statement in that section!"  Anon, both Greg and I outlined our reasons, and I have outlined them here again.  I didn't respond to your repeated entries on the same topic, as it had already been answered several times.  Both Greg's and my reasoning was given, and I provided it again, above.  Wikipedia is an encyclopedia:  it is not for original research.  According to some of what you have said in this discussion, it is beginning to appear that you want Wiki to advance the cause for further research into Marinol.  It doesn't belong in a TS article because it currently has, and is not likely to have anywhere in the near future, a useful place in the treatment of Tourette's.  The size of the entry belies its lack of relevance to the Tourette entry.  Sandy 18:55, 16 February 2006 (UTC)


 * Also, I suspect that a lot of the confusion over marijuana vs. Marinol in the article is only fallout from your original entries, where you brought in both. In either case, neither of them are current, or likely to become, useful treatments for Tourette's, so a reason for including so much wording about them in the article needs to be established.  Sandy 18:58, 16 February 2006 (UTC)


 * Regarding your statement, "because she just said that she thinks I'm emotionally involved in the "medical marijuana" issue," if you will review my exact words, you will see that I did not say that. I said marijuana/Marinol, as you originally presented both in a combined format. Sandy 19:04, 16 February 2006 (UTC)
 * The statement I responded to (above) was subsequently edited out by Anon. Sandy 21:46, 16 February 2006 (UTC)


 * Regarding your statment, "Many medications' names have been posted to this article, and many of these medications have their own articles in wikipedia that don't mention Tourette's Syndrome at all!"  The use of all of the other named medications is standard in TS, documented in many journal articles, and a routine part of care of Tourette's patients.  Marijuana and Marinol are not. If they were, or if they become standard or useful treatment, they would become of encyclopedic interest and note. Sandy 19:15, 16 February 2006 (UTC)


 * Regarding Anon's statement on the Mediation page about expanding the entire Experimental treatments section: there was consensus (Greg and myself) on 4 Feb to reduce the section.  Here is the statment made by Greg (who has been involved in the TS page almost since its inception), with which I concurred:  "The ... material should be moved to the Marinol page and a medical marijuana page.  The section should be reduced to a short statement that this is a proposed treatment of Tourette's syndrome, with links to the other pages.  I suppose that the whole treatment section simply dwells too much on on-going research and speculation.  It would be a better article if the discussion started with the proven treatments, and then separately and briefly listed the unproven treatments.  User:Greg Kuperberg 18:34, 4 February 2006 (UTC)" Sandy 21:03, 16 February 2006 (UTC)
 * Anon deleted his entire paragraph about expanding the section, after I had already responded.   Sandy 22:05, 16 February 2006 (UTC)

Archives?
Francis, thanks for setting up Archive2 on the Tourette syndrome talk page. I originally set up the first archive, after waiting weeks for an admin to show up, intending to archive the older talk sections (as the talk page was becoming long and unmanageable). I didn't use it, since I don't know if archiving talk pages is an admin function? You may want to delete the first archive, or move archive 2 to archive 1? Not sure how that works ... just wanted to give you the history. Thanks for helping us out. Sandy 13:37, 16 February 2006 (UTC)

Today's example, 16 Feb
AnonUser, we have reviewed several times on the talk page the Wikipedia principles regarding verifiable sources, reliable sources, and what Wikipedia is and is not. I see you've added back in the link to the TSDA (Tourette Spectrum Disorder Association) again. Wiki is not a collection of links, and we talked about the Wiki criteria for reliable sources on the archived talk page. Can you please explain why you continue to add the TSDA link? Because you are in Southern Ca, other editors could interpret this as your insistence on adding a link to your own organization, to publicize it, rightly or not. Additionally, because you've written negatively about the Tourette Syndrome Association on the Wiki TS article, your actions could be misconstrued.

TSDA was founded eight years ago in a dramatic split with the TSA over a funding problem. It does not have national reach or advocacy: in fact, since its founding in about 1998, it has not grown beyond its original boundaries in Southern California, and may have even lost membership over the years. Its Board of Directors and Scientific Advisory Boards feature no persons of note as outlined in the Wikipedia Verifiable Sources I quoted to you on the old talk page. Its website offers no new information, and the organization espouses -- in fact, defines -- a definition of Tourette's for which there is no medical consensus or acceptance. In fact, Tourette Spectrum Disorder is their neologism, and is not defined in medicine. Tourette's is part of the spectrum of tic disorders.

If you add a link to TSDA, we get back into the territory of creating what Wiki is not: a collection of links, and which every website about Tourette's can be added, which is unencyclopedic.

Again, I ask that you talk about these issues before moving forward without consensus.

I also see that you've re-added the Famous People list, which will again encourage everyone who *thinks* they may be famous in Tourette's to add their names to the list. You also titled it in such a way that it discusses OCD, rather than Tourette's. You also deleted my HTML comment reminding other editors that Wiki is not for original research. Could you please explain to me which way you are trying to head with these edits ? Thanks ! Sandy 18:50, 16 February 2006 (UTC)

Copyright
Another issue which keeps coming up is copyright. Anon, I see that you added a picture for GTS, which was a much-needed addition. Thank you for doing that. But, you mentioned that you weren't sure about the copyright on old pictures. Neither am I, which is why I hadn't yet added a picture (I was waiting for guidance from an experienced editor, as to how one determines whether old pictures are in the public domain). My greater concern is that you took the picture from a website/webmaster who does not respect copyright, and has multiple copyright violations on that website and throughout the internet. The particular picture that you added has an identifying stamp in one corner, so on the chance that it is copyrighted, that could be detected. I just thought you might want to check on the picture issue, and be more aware of the problems with that source, in terms of not only copyright, but also reliability and verifiable sources (as he signs his webpage with "PhD" but, according to his own statements, does not hold a PhD from any valid accrediting organization in any field). I encourage you to focus on reliable sources and verifiable information. Sandy 20:20, 16 February 2006 (UTC)

Personal attacks
Regarding Anon's statement: "Sandy is hypocritical when she gets on her soapbox about how I'm violating wiki rules! Yet she had edited my stuff and moved it out of context on the talk page. She also tried to simply erase the entire section on Marinol, until a sysop reverted the page back!"  I have not used the words that "you are violating Wiki rules." I have asked for clarification about how Wiki works and how we might work towards consensus, and better understanding of the pillars and principles of Wikipedia. When you moved duplicate talk entries to the top of the talk page (an entry that was made four times), I moved it back to the bottom to preserve the chronological order that existed on the talk page. I don't recall a sysop reverting any of my entries, except one where I was moving a paragraph to another section, and had failed to include an edit summary, so s/he thought I was deleting an entire portion. Sandy 21:54, 16 February 2006 (UTC)
 * Anon changed the statement quoted (above) after I had responded. Sandy 22:03, 16 February 2006 (UTC)

Multiple edits
Anon, I'm wondering (since we're both fairly new to Wiki), if you have learned to use the Preview button? Since you started your response on the Mediation page 3 1/2 hours ago, you've edited it now 35 times. The changes you have made invalidate all of my responses above. This is the same tangle we get into when editing the Tourette syndrome entry. I have learned to wait, recognizing that when you start editing, you may take multiple edits and several hours to complete your thought, but other editors may not be so patient. This many edits makes it very hard for another editor to get any productive writing done. A technique which many editors use, and you might find helpful, it to edit copy your entire passage, edit paste it into Word or someplace where you can spell check and proofread it, and then bring it back to Wiki when it's ready. Sandy 22:17, 16 February 2006 (UTC)

Impartiality
Thank you for the disclaimer, Francis. I guess I'm a bit troubled about why you took the case, when marijuana/Marinol were involved from the beginning, although that doesn't present a big hangup for me: I'd just like to understand. And, I'd like to get some work done on the article. Since I've been waiting for two weeks, I'm not willing to give up too easily, now that we've actually gotten a mediator :-))

On the bigger picture, I don't think that either Anon or myself sees this as an issue of "illegal" drug use. I believe Greg introduced that theme, when he titled a section "Move Pot elsewhere" (and even Greg expressed his concerns in a broader sense than just "illegal" drug use).

I see this as a much bigger picture of Anon's entire approach to Wikipedia principles and pillars, and encyclopedic content. The Marinol entry is but one example of the problems we're encountering. The issue with Marinol is no different than, for example, including an entire paragraph about deep brain stimulation would be: it's not likely to become a useful treatment for most people with TS, so it should be discussed in that encyclopedic tone, reflecting its current relevance. Neither nicotine, deep brain stimulation, marijuana, Marinol, or standing on your head on Thursday afternoons are currently part of accepted TS treatment. The article gets many "vanity" entries: for example, deep brain stimulation was also originally out of proportion to its likely usefulness as a treatment for TS, and if we include a paragraph about every experimental procedure, and include every "famous" person, and include every personal TS website, and every TV show or movie that makes a passing mention of TS, pretty soon we don't have a Wiki encyclopedic entry.

So, I guess my question to you is, do you see this as a marijuana/Marinol issue, or as I do, which is ... the bigger picture is about how to write a medical article in Wiki? Do you see this as a marijuana issue, and/or will that impact your mediation? TIA. Sandy 22:53, 16 February 2006 (UTC)


 * As far as I'm concerned we're writing an article about Tourette's syndrome for the Wikipedia. The various aspects should be given appropriate weight. I am not a "medical marijuana" campaigner. My opinion is that we should take comparable featured (or good) articles in order to get some idea of the appropriate weight for any disputed section. Regarding your question, I noticed your request on the MEDCAB talk page and took the case before I had read the whole (quite long) request. This was probably a misjudgement on my part.


 * I'd like to make a request that we make discussions either on your respective user pages or on the article talk page and try not to clutter up this page too much. This is only a guideline, but something to bear in mind. - FrancisTyers 23:24, 16 February 2006 (UTC)


 * Thanks, Francis. On that basis, I'm OK with your mediation.  One problem is that Asperger's was a once-featured article, and is the only other DSM condition, so it's hard to find comparable medical articles.  The problem about where to have the discussion is that I'm not sure Anon knows how to find talk pages.  I keep pointing them out, but he never seems to find them, so I put my comments here, and pointed towards them in the main page, but he hasn't found them?  I don't know what else to do.  He hasn't started a talk page, and hasn't responded to numerous requests to come to mine? Sandy 23:32, 16 February 2006 (UTC)
 * PS - is your "mandate" (so to speak) to help us out with all of these issues (above), or just to resolve the Marinol paragraph? I hope we can look at the overall picture, to help us move forward with more effective editing?  Sandy 23:35, 16 February 2006 (UTC)


 * Ok, I will try and introduce him/her to them. Is schizophrenia comparable? - it mentions DSM. Yes, I am mediating a dispute there too, but it isn't related, honest! My mandate is to help resolve disputes and achieve consensus, I am at your disposal :) - FrancisTyers 23:37, 16 February 2006 (UTC)


 * Yes, schizophrenia is a DSM condition, although not at all similar to TS (Asperger's has more similarities than schizophrenia in terms of prognosis, functioning, etc.): I'll go have a look at it. I'm just so glad to have an experienced editor to help guide us.  Sandy 23:42, 16 February 2006 (UTC)