Wikipedia talk:WikiProject Medicine/Archive 162

The Spectre of WP:MEDHARM and WP:DOCTORSAIDSO : Online harms
This is a bit long. I'm not sure if I should tl;dr it and link to it, hosting it somewhere else

I went along to an online wikimania talk last Sunday which discussed questions of online harm and mental health and suicide prevention on wikipedia. https://wikimania.wikimedia.org/wiki/2022:Submissions/Responsible_community_governance:_Equity_and_access_to_mental_health_information_on_Wikimedia_projects (available to watch here https://www.youtube.com/watch?v=Zasie41p1-U&t=10428s)

This seems interesting / relevant to WP:MED in a few ways:


 * It feels like a bit of a "top down" push of policies on mental health topics to prevent "harm".
 * It feels a bit like medics wanting a privileged position in creating policies that editors then have to adhere to.
 * There is a new concept of "harm" in medical topics. This concept doesn't really comes up in when editing outside of BLP (see WP:HARM) and it appears not to be present in many policies (the word harm is not in WP:MEDRS and has been mentioned a couple of dozens times in its talk pages
 * There was also a push for simplification as well as positivity on suicide and other mental health topics, I think with the aim of using wikipedia as a resource for variously, suicide prevention, mental health destigmatization and advocating for mental health engagement.
 * Tina Butoiu, Wikimedia legal counsel was in attendance.

To understand the policy landscape a bit:


 * COVID was a thing and people seem to have a thing about misinformation.
 * The UK is pushing an Online Safety Bill to address online harms that initially specifically targetted incorrect medical misinformation (the original discussion surrounded facebook groups). This is likely influencing the policy space and will filter into other areas. The idea is that "harmful" material should be remove from the internet.
 * Fact checkers like Full Fact support this bill in the UK
 * There generally seems to be a "thirst" for censorship of "misinformation" from people judging from people I know, politicians, television and social media.
 * I think Suicide methods is a bit of red rag to some doctors and politicians - it gets mentioned specifically in the talk. It's been mentioned in UK parliament with regards to online harms including recently by the chair of suicide prevention panel. Incidentally the chairperson seems woefully ill-informed - she talks about the correlation between self-harm and suicide when their is little - I have heard psychiatrists refer to self-harm as more akin to meditative behaviour than suicide, and seems to completely misunderstand just how common suicidal ideation is.
 * In the UK, there was a desire to group wikipedia in with "social media". ... though this is Matt Hancock speaking and perhaps no one cares what he thinks.

My personal take.


 * Perhaps none of this will actually happen...
 * I do think there should be more material on recovery in some of the pages on suicide and other mental health areas and this would be genuinely WP:DUE rather than simply trying to prevent harm or feeling good. Things like "70% of people who experienced X had no symptoms in Y years after intervention Q" and "what should I do?" is maybe a valid thing to be addressed by pages.
 * Expert involvement is definitely a good thing as is their feedback and unique perspective.
 * Perhaps there is a need to give the "online harm brigade" something, and while poor coverage of the methods of suicide on wikipedia might impair sordid teenagers education in biology and physics, some groups ability to prevent suicide, or lead some people to attempt suicide who might have otherwise found useful, reliable and trusthworthy material through wikipedia's well linked pages; perhaps "censoring" this page is what is necessary to stop people demanding more influence... and maybe we just need to give people their prominent suicide prevention hotline to make them feel happy.


 * I am quite aware of the risk of harm being interpreted broadly and basically allowing anything to be labelled harmful.
 * I am doubtful of magical "expertise" regarding suicide prevention - though I suspect there is research that we should be aware of. Suicide prevention is not necessarily something you can develop "clinical expertise" in, separate from formal study research. I am concerned that the "expertise" that we are talking about here is really just gut feelings and values, dressed up and laundered through claimed expertise. I sort of view this as being a magical way to "win" the arguments that play out on Talk:Suicide methods.
 * While expert contribution is great, I am a little more doubtful of experts being able to limit others contribution, which is kind of what expert created policy is trying to do.
 * Self-harm and suicide are not really related, and I think people are making political use of the fact that self-harm is common and suicide is very bad to push an understandable prevention agenda for both.
 * I'm nervous "niceness" and "censorship" being aims that hide in the clothing of "harm". The argument against both from a harm perspective is one of validation and understanding: that it is more harmful to deny a person the ability to understand a deeply flawed world than it is to try to convince them that is unflawed, and that a sense of being lied to can be more damaging than the truth. This does not necessarily apply to suicide methods.
 * I have my concerns about "simple language" and "user focus". I definitely see access as a valuable thing, and the argument for removing *unnecessary* complexity. But I am quite aware that often the truth lives in the weeds, and simplifying things is a good way of getting rid of the weeds and presenting narrative instead.
 * I suspect that in the face of uncertainty around freedom of speech and the risks of having to fight a legal case, wikimedia will side with censorship... but we will see.
 * I don't really look positively on the notion of wikipedia being turned into an arm of Public health for making interventions for people's well-being. I somehow think being an accurate summary of humanity's best attempt at understanding reality and itself is valuable goal and other people can deal with public health messaging.

Talpedia (talk) 23:33, 21 August 2022 (UTC)
 * puts on medical person hatRe: Self harm and suicide, you are largely right, but there is nuance. Self harm is on a spectrum, and suicide is just one end of that spectrum. A lot of self harm (e.g. cutting) is part of meditative behaviors of some persons, especially in reducing anxiety, depression, obsessions . It's a coping mechanism, albeit a maladaptive one. When a person cuts their skin, some endorphins can be released which may ease some of that mental suffering. But it's important to note that the capacity for self harm is removing a mental "block" which can enable more harmful mechanisms, up to and including suicide . There is so-called "non-suicidal intent self harm" and "suicidal intent self-harm" because some persons who self harm do so with self-destructive thoughts in mind . It is not as though self-harm is entirely "okay" or entirely "bad". It is a multi-faceted thing, but one that we in the medical profession discourage because of the prevalence of accidental suicide, plus the many benefits of other better coping mechanisms (e.g. exercise, social engagement, meditation, therapy) .takes off medical person hatRe: How we, as a project, should feel about the fight against misinformation, "harmful" information, and articles like Suicide methods... that's a doozy. I think, overall, it's important that we keep in mind that Wikipedia is not meant to be an authoritative source on anything, but simply an encyclopedia which links to those authoritative sources. To intend for it to be authoritative would be irresponsible. Similarly, it is not our mandate to pass judgment on our readers. A pertinent thought experiment: in scholarly journal articles about suicide, do you see disclaimers or restrictions on who may view it? No! Because it is implicitly understood that such venues are for researchers and laypersons to understand the phenomenon of suicide. Not as a how-to guide, or as an advocacy essay, or any other such non-scholarly purpose. We, as a project dedicated to the collation and contextualization of information, have a similar mandate, and follow similar lines of formatting. Any government mandate would either have to set aside an exception for such venues (which would likely apply to us as well) or would need to have a sticky "intent to cause harm" clause which would be argued to death and a doornail.I don't think anyone is going to use the government to swing a giant hammer at us for the deletion of suicide methods any time soon. And it's important to note how carefully that article avoids being a how-to guide. There are also good and lawful reasons why a person would want to read about suicide methods (the prevention thereof, the provision thereof to terminally ill persons, planning for a nuclear apocalypse, etc). And if such a government or Wikimedia mandate came down to delete this article, I'll be the first at the front with you, my friend, since Wikipedia is not censored. Re: public health and Wiki, I think you are right that we are not, strictly speaking, an arm of public health. But I do think it behooves us to consider the consequences of our actions. I say that with full knowledge that there is collateral of such consequences in the preceding point, but I believe fully and truly that it is worth it. Overall, it is our job to make sure our information is as accurate as possible, and to follow the consensus of medical experts just as we follow the consensus of any experts. It seems to be working pretty well since multiple studies have been published about how good a job Wikipedia is doing at removing misinformation       . —  Shibboleth ink  (♔ ♕) 16:55, 22 August 2022 (UTC)
 * Thanks for the reply and additional context. Regarding public health, I sort of view the distinction between "public health" and "truth" as whether you are writing to reduce harm, or writing to produce a good summary of the literature. The case of misinformation is kind of simple, because to avoid harm we just need to do what we would do anyway better, potentially prioritising certain things.
 * The issue comes up when public health aims (like encouraging treatment adherence) start to contradict other aims like WP:DUE. A fairly benign case would be reordering topics in articles to nudge people in certain directions - so the article on suicide might start of with "x% of people who attempt suicide are happy they did not succeed. Treatment (wikilink) includes X (wikilink)". The more controversial cases are when you start wanting to hide information (e.g. Suicide methods) or engage in narrative building. A simple case of narrative building would be "such and such a fact while WP:DUE and WP:VERIFIABLE does not support our current vaccination campaign so should be excluded", more complicated cases might engage in WP:Synth to support narratives, potentially in weaker forms. An example that comes to mind is the "famous antivaxxers who died from covid 19" lists that started showing up.
 * In the talk, a statement that I noticed was the WP:UNDUE could be misinformation. I do agree at times, but am a little nervous of "you must say such and such to create a harm reduction narrative otherwise this is misinformation" Talpedia (talk) 17:46, 22 August 2022 (UTC)
 * My general response to that is WP:NOTCENSORED. Not to be callous, but if I wanted to kill myself I don't need an encyclopedic article to do so.
 * There is much to be gained by having encyclopedic articles that are frank about the subject they are discussing. First, it helps you understand other people, and what methods they may choose to end their lives. Making up numbers, what if overdose via pills are used 40% of the time, and succeed only 10% of the time? What happens if your loved one tried and failed to die that way? Are their consequences to overdosing on tylenol? What if guns are used in 10% of attempts, but succeed 90% of the time? There is value in the non-suicidal knowing these things so real prevention can take place that addresses each method and why someone would pick that one over the others (i.e. belief that pills are painless, and don't leave a 'mess' behind vs guns that leave blood and could cause a substantial amount of pain / disfigurement if you fail).
 * This is like anything else out there. Knifes can cut people. We're not going to censor the knife article on account of people possibly wanting to cut themselves looking up the knife article to see if a knife can cut themselves.
 * We aren't writing how-to guides on how to commit suicide, and we shouldn't pretend that this is what we are doing. &#32; Headbomb {t · c · p · b} 09:18, 23 August 2022 (UTC)
 * I think there is a danger in citing WP:NOTCENSORED as though that shortcut answers anyone questioning our content decisions. Wikipedia is not a hate site or right-wing blog or edgy comedian's ramblings or activist propaganda or support group, etc, etc. Simply saying "we are not censored" doesn't explain what we include and why, because I'm sure InfoWars and Jerry Sadowitz, for example, make exactly the same claim about themselves. While we don't remove objectionable material merely because someone asks or insists, we do make editorial decisions about such material. WP:GRATUITOUS explains some considerations. Our various disclaimers (General disclaimer and others) expand more on what we may sometimes choose to include, even if some people (perhaps for very good reasons) would rather we didn't, or that they could chose not to get it. For what it is worth, suicide methods is blocked at my workplace, and could quite easily be blocked by UK ISPs if the government chose. We do remove content that is breaks US law, though I don't know many examples of that outside of CP images and copyright violations (US government leaks of top secret material perhaps?)
 * Back in June, there was a request from Foreign Press Association, Africa, that "mainstream media in the global north" should stop using photos of black patients to depict the lesions of monkeypox in articles discussing the 2022 outbreak. See Talk:2022 monkeypox outbreak/Archive 2. I removed the image they were clearly referring to. I think Wikipedia was somewhat responsible for that image appearing in "mainstream media" because we're a resource for journalists of free-to-use material. Wikipedia is not well resourced for images, as we can't pay for stock photos, so often we do include sub-optimal choices because that's all we have. The image wasn't AFAIK restored and much later, someone added an image of white patients.
 * WikiProject Medicine has for all the time I've been here, chosen not to include drug dose information in our articles. While perhaps some could argue that information could be encyclopaedic, we also know there is a serious risk in an openly editable wiki that the information could be very dangerously wrong. I'm well aware from experience here that even dedicated good-faith editors can be dreadful with their maths and can be careless in their edits. We don't hide behind the Medical disclaimer on that one, and have chosen not to include potentially harmful content.
 * Suicide organisations encourage media to be very careful when documenting the suicide of a famous person, as their method can be copied when details are given. Our WP:MOSBIO discourages noting the cause of death in the lead, unless that cause is itself highly notable.
 * The suicide methods article is not an "anything goes" dumping ground or how-to-guide. I think if politicians and others are questioning why we have that article, or its contents, then we need to explain its encyclopaedia value and note that we are sensitive to gratuitously or carelessly causing harm. A shortcut like WP:NOTCENSORED can be read a bit too much like a teenager telling an adult they don't care about their opinions or concerns at all. -- Colin°Talk 12:55, 23 August 2022 (UTC)
 * @Colin and @Headbomb I totally get what you're saying about WP:NOTCENSORED. Do you think it would be valuable to add an FAQ or similar to the talk page for Suicide methods, or a more general purpose essay/guideline on "dangerous" information? — Shibboleth ink  (♔ ♕) 16:28, 23 August 2022 (UTC)
 * I think the most useful thing to do with that particular article would be to make it a halfway decent article. As SandyGeorgia has proven multiple times over the years (e.g., PANDAS), well-written articles get much less garbage tossed into them.
 * We've made some progress on Suicide methods. For example, last time I checked, the article explains the point that Headbomb presents above:  people who are interested in prevention need to know something about specific methods.  Prevention methods for domestic gas aren't the same as the prevention methods for firearms.
 * If you are willing to put just a few minutes into any of these articles, then they can often be improved merely by removing one or two unsourced statements, shortening/summarizing verbose descriptions (WP:MEDMOS#Cite sources, don't describe them), or adding relevant context (e.g., "In the US" or "Among young people"). A quick glance through MOS:SUICIDE should give you some notion of the kind of problems we have seen and easy solutions for some of them.  WhatamIdoing (talk) 21:00, 23 August 2022 (UTC)
 * Related to this: What do we need, to be able to turn one or more of these into decent articles?  For example:
 * Do we need an outside expert review? WPMED has arranged that for other articles in the past, or perhaps a review of a hundred biographies would make a good paper for some post-doc.
 * Do we need to make a list of good sources? There are med school textbooks that cover this, but I don't know which ones are the best.  We could probably make a list recommendations or find a reference librarian to recommend a few.
 * Do we need help getting some good sources? I believe that WMUK occasionally buys sources for editors, and The Wikipedia Library is another potential method.
 * Do we need an in-person or virtual meeting? Maybe this isn't a pleasant subject to handle alone.
 * Something else?
 * WhatamIdoing (talk) 21:32, 23 August 2022 (UTC)
 * I had a read through it today. It doesn't look too bad. The area suffering from a "One study said..." approach is the section on gun control, which, you know, is a rather-stick-forks-in-eyeballs topic for most people outside of North America. Possibly more of a problem is the specific topic articles on each method. But you are right that this isn't a pleasant subject and I felt rather sad after reading it (not in a self-depressed way, but sad about all those who have attempted or contemplated these things).
 * I guess the motivation of those who would like to see such pages removed or blocked is the idea that hiding information about X makes people less likely to do X. I'm pretty sure there are good stats about how infective that is for unwanted pregnancies and sex education classes at school. Perhaps an expert could help with (or is documented somewhere) whether our descriptions of how messed up you end up if you survive are helpful in discouraging attempts, or descriptions of what it's like for those that find you or your relatives. Some countries, according to the article, think suing your family or refusing life-insurance pay-outs if you jump in front of a train, is preventative. So I suppose an expert could read these topics and advise us if some aspects could be worded differently or some information best left out if it is simply "gory details", say, and not encyclopaedic enough to warrant inclusion. -- Colin°Talk 13:38, 24 August 2022 (UTC)
 * What data is available on what users are doing? I realise Wikipedia collects very little data, but do we know where people come from when they land on Suicide methods and do we know where they go? Maybe some actual data would help inform the debates. Bondegezou (talk) 13:55, 24 August 2022 (UTC)
 * We have that data within wikipedia in the clickstream. There was a tool called WikiNav that parsed this and was searchable but it appears to be broken. I could get some numbers one evening if we wanted them. It doesn't tell us about "off wikipedia" activity however. Talpedia (talk) 14:03, 24 August 2022 (UTC)
 * Check your ad blocker?
 * WikiNav says that 86.2% of last month's traffic to Suicide methods came from "other-search", which I believe basically means "Google". 9.4% came from "other-empty".  My guess is that this category could be things like bookmarks or a link you clicked on in e-mail but is probably mostly "Google, except I have anti-tracking stuff in my web browser".  All other sources of traffic are less than 1% of page views.  The top three articles are Suicide, Suicide by hanging, and Etika.
 * Once people are at the Suicide methods article, they mostly don't read other Wikipedia articles. The two most common links clicked on last month were Pesticide poisoning and Drug overdose.
 * In contrast, most people who read Pesticide poisoning arrived at that article from the Suicide methods article. The pesticide poisoning article's traffic also comes from "other-empty" (12%), "other-search" (11%) and Suicide (10%).  The outbound traffic is similar, or perhaps even more extreme, with readers tending to stop there. WhatamIdoing (talk) 21:02, 24 August 2022 (UTC)
 * Hmm... seems to be working now. Thanks for the stats. If I were to engage in the behaviour that I have sort of criticised - tuning your pages to public health, in this case suicide prevention, rather than WP:DUE], then I would add a third paragraph to the leads along the lines of "blah blah [Suicide prevention] such as [[X, Y, Z. Positive facts about prevention and intervention with a realistic spin". And then track the clicks to these pages. There might be some clever things you could do to work out intent of readers (e.g. suicidal ideation vs curiosity vs related interest) based on looking at the effects of the presence of different links in the lead. I wonder at the ethics of this sort of "click influencing".... Talpedia (talk) 21:31, 24 August 2022 (UTC)
 * Theoretically, we could just ask people who are reading the page why they're there. There are various ways of posting surveys in articles (all of which, AFAIK, would require WMF intervention, but we could ask them).   WhatamIdoing (talk) 03:53, 25 August 2022 (UTC)
 * Thanks for those numbers, (and ). I see them as concerning. If people are mainly coming to the page because they're doing a search for "suicide methods" or similar, then that is concerning, because that's the group you least want having the information! A study asking people reading the page via a survey would be interesting, but (a) need WMF involvement, and (b) need an appropriate IRB/ethics committee approval, and (c) should be designed with input from someone with expertise on suicide. I'd happy to be involved (as a prof of digital health) and know a colleague who's done some work on suicide and online information if people want to pursue that approach. Bondegezou (talk) 14:54, 25 August 2022 (UTC)
 * At least one (and I think two) of the people on the wikimania talk panel linked to above are wikipedians with a medical background and interest in suicide prevention. It might be worth talking to them - with the knowledge that they might have an angle; though perhaps someone with fewer opinions than I should make the approach.
 * Regarding experts, the thing I have taken to saying to myself is: "if I could get an expert to review the literature for me and answer the quesitons I had, they would probably do a better job than I would at understanding they topic, but you normally tend to interact with experts researching what they want to (of have to) or engaged in advocacy". So yeah, if any interested expert were willing to summarize the literature and answer our questions that would be a good thing. I'd have a little less trust in bare recommendations from experts.
 * I do wonder if for some of the people, such as the UK panel for suicide prevention, *any* mention of suicide methods is inappropriate - in which case the opinions of such people is of limited value regarding *improving* the page. Steelmanning this position a little suicidal thoughts and behaviour coincide with depression, and this depression may be a protective factor such that modest frictional costs to suicidal behaviour will be disproportionately effective. This (theoretical?) argument is supported by antidepressants correlation with suicide and blister packs temporal correlation with decreased suicides. Bluntly, if you can't get out of bed, then you may not be able to go to the library to obtain the information equivalent to what can be found on wikipedia. I don't necessarily like this argument... and note that the suicide methods page probably would not provide those in a "protective" depressive state the abilities to act.
 * Perhaps we could directly ask the UK committee, given that they see fit to mention the page in parliament and suggest the need to censor wikipedia in response to the page. I wonder if any wikipedians have one of their MPs on the committee. The members are the MPs for Blaydon, Colne Valley, Blythe Valley, York Central, Bristol South. I note the issues surrounding anonymity for wikipedians making such requests and providing information. Alternatively, perhaps someone from WMF could make the approach. I am aware that the forces of inertia and prioritisation influence parliaments behaviour... and that any interaction with them may increase the chances of their interference, whether we take their concerns into account or not. Talpedia (talk) 20:42, 24 August 2022 (UTC)
 * I don't know how much weight to put on two comments made by one person in a committee. It also isn't clear if they mean the general article we have examined, or more specific method articles. They mention the Samaritans, and to be honest, I'd place a whole lot more weight in their opinions, and value them rather higher than my own, as a random person on the internet. Have they specifically called out some Wikipedia content? It seems the committee is well aware that blocking the top google result will just surface another result, which might be even less regulated or well controlled. Lots of ideas get thrashed about in these committees. I think the Samaritans are likely to know, from speaking to people on their helplines, what Wikipedia's importance is. Rather than trying to change the mind of some random MP, I think it would be more useful if Samaritans could indicate (to us and to that committee) whether Wikipedia is causing harm or perhaps is acting as a buffer, preventing people from reaching the really bad stuff. I think an explicit block on some Wikipedia pages could have that Streisand effect, or some other unintended consequence. But I'm also open to experts saying that we should actually reconsider some of our material. -- Colin°Talk 10:39, 25 August 2022 (UTC)
 * Well the chair did specifically ask that the group for censorship (Online harms) consider forcing wikipedia to censor this content on wikipedia, but perhaps the Committee was already moving there. I guess part of me is just looking for a fight here - getting them to say what they think is wrong and seeing if anything could change their mind.
 * Of course, just improving things rather than seeking out disagreements is often a good approach too!
 * Your suggestions about the Samaritans is a good one. The Samaritans seem to be camapigning on adding materials surrounding suicide to the online safety bill and are encouraging constituents to contact their MP. This looks to be their policy document on the question This report.
 * The report says..
 * It does rather seem that the chair of the committee is just quoting the Samaritan's policy... along with misinformation about self-harm's relationship to suicide unfortunately. Page 14 has a summary of guidelines for websites. They provide some advice for those writing about these topics. They seem to run an advisory service (along with an email address and phone number) that we could contact.
 * Separately. I'm aware that this topic has started addressing the topic of suicide in some detail. I wonder if it would be good to move som of the discussion to a different page to avoid distressing readings who are sensitive to the topic. Talpedia (talk) 12:40, 25 August 2022 (UTC)
 * Or how about "getting them to say what they think is wrong and seeing if anything could change my mind"? So, one of the Samaritans documents mentions Wikipedia, and appears to include it among sites they "know" where "harmful suicide and self-harm content exists". I would very much like to know. They refer to a study of "people who had been in touch with mental health services and who died by suicide were known to have visited websites that encouraged suicide or shared information about methods of harm". That study is here: The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH) (2017), and talks of '“pro-suicide” internet site[s], i.e. providing information on methods or encouraging suicide'.
 * We certainly fail some of their advice. A search on Wikipedia for "suicide methods" autocompletes, and takes me to the page directly, with no "Are you ok. Here's where you can get help" info like Google provides. The suicide methods page contains three artworks where I think there could be a fair argument they glamourise suicide, and could fail their content request to avoid "Graphic images relating to self-harm or suicide".
 * My feeling is the folk at Samaritans are grown-ups with huge experience and not some Daily Mail thoughtless knee-jerk idiocy. There is more material here.
 * I agree we could move this discussion somewhere else. Not sure where? I agree contacting their advisory service could be useful. There may be some things we can do (guidelines) and some things WMF can do (modifying search and providing region-specific help signposting). Has any of that been discussed before? -- Colin°Talk 14:32, 25 August 2022 (UTC)
 * Sure. I guess there's a bit suspicious of bad faith on my part. Perhaps we listen to everything they say, and really they just want to delete the whole page / tell us what to put on it. Obviously, WP:AGF, but on the other hands most editors initial suggestion isn't talking about making WMF legal liable then threatening to take the to court.
 * There's a bit of a question about what we want to talk about here. I suppose the initial topic of this thread was sort of "a bunch of people are talking about harm and top down policies, what do we thinking about that then" with the idea that it's good to be aware of these things. There is still an outstanding question for me here about "who is influencing who" with these discussions. It seems like the samaritan's are influencing policy suggestions by MPs, are they influencing the suggestions of e.g. the medics pushing for top down policy changes? Are there different charities internationally who follow one another in terms of policies and what research is going on.
 * As far as more specific / actionable topics go. I can think of five questions:
 * 1. You can think of criticism regarding suicide coverage as a request for changes by the Samaritans, along with some arguments and evidence. Perhaps we should consider what these requests are and discuss this on the talk page for the appropriate articles, and poke the samaritans for their opinion. I was thinking after having interacted with their advice a little we could draft a set of questions to send them and then get a reply.
 * 2. There's a high-level question of what we think about "Harm". The demands of the Online Safety Bill are effectively that websites (maybe including wikipeida) include considerations of harm (termed online safety) within their editorial policies. Should we be doing so anyway. I guess there is an ethical question about whether we should be preventing "harm" and where harm should sit within our priorities, and if anything can be understood outside of a case-by-case basis.
 * 3. There is a question of whether Wikipedia, individual editors, or the WMF should or want to be engaging in lobbying regarding the UK Online Safety Bill, and this may include addressing incorrect information within policy organizations like samaritans campaigns or "self-regulating" before we get regulated. Attempting to influence policy seems beyond the scope of normal wikipedia activity however and off topic. On the other hand, wikipedia is being actively discussed.
 * 4. Related to all these questions, there is a question of whether we should be collecting data regarding harm - in general - or to address 1 2 or 3. As suggested above we could surveying users of "harmful" about why they are looking at pages. The cost of this means we might like to carry out a bit of a literature review on the topic first.
 * 5. The samaritan's page has advice for those editing on distressing topics, which we might care to consider and write about somewhere in a policy page. I couldn't find this advice on policy pages, but am sure it has come up.
 * I agree that we should see if this has been discussed at length before, but I don't have time to search now! Talpedia (talk) 12:58, 26 August 2022 (UTC)
 * This does threaten to be an existential threat to Wikipedia - at least here in the UK. If the bill requires that Wikipedia is censored to prevent access to details on suicide methods, then either we censor the articles for everybody, or access will be blocked for users in the UK - and based on the vigin Killer affair, even blocking individual pages is likely to heavily disrupt access to the rest of Wikipedia from the UK. WMF needs to engage here.Nigel Ish (talk) 20:48, 27 August 2022 (UTC)
 * 5. The samaritan's page has advice for those editing on distressing topics, which we might care to consider and write about somewhere in a policy page. I couldn't find this advice on policy pages, but am sure it has come up.
 * I agree that we should see if this has been discussed at length before, but I don't have time to search now! Talpedia (talk) 12:58, 26 August 2022 (UTC)
 * This does threaten to be an existential threat to Wikipedia - at least here in the UK. If the bill requires that Wikipedia is censored to prevent access to details on suicide methods, then either we censor the articles for everybody, or access will be blocked for users in the UK - and based on the vigin Killer affair, even blocking individual pages is likely to heavily disrupt access to the rest of Wikipedia from the UK. WMF needs to engage here.Nigel Ish (talk) 20:48, 27 August 2022 (UTC)

I suspect this may be a fascinating discussion that I have not had time to read. For years and years and years we have needed to do something BLP-style to prevent dangerous medical information from proliferating via Wikipedia, and not just only wrt suicide. My proposals were always rejected, with certain WP:MED prominent members leading the opposition, as they were convinced they could hold their solitary fingers in the dike by editing non-stop and maintaining only article leads. The community has failed to act responsibly wrt the dangers of medical info on Wikipedia, is unable to do so in terms of the number of editors needed to keep up, and if this thread means the WMF is now doing something (I find it headache-inducing to even try to read anything that comes out of the WMF, so I say if), we can hardly complain. Meanwhile, on a Featured article, viewed thousands of times daily, information directly relevant to suicidality stood for five days with no one checking it or responding to text proposed on talk before it was added. Re "First do no harm", we should all hang our heads. We can't even maintain highly viewed FAs; why aren't we all pushing for radical change to how medical info on Wikipedia is approached ? Sandy Georgia (Talk)  14:35, 27 August 2022 (UTC)
 * Quick precis. I'm not sure WMF is doing anything, but there were some medic wikipedian's pushing for policies regarding mental health and suicide in a top downdown fashion which WMF people were seemingly open to at a wikimania event. In the UK, the government is drafting a bill called the Online Safety Bill which creates a duty for social-media sites to have policies for "harm" which include those related to suicide, along with legal penalties for a failure to enact these policies. The Samaritans (charity) are pushing for Wikipedia to fall under this policy, with some apparent sympathy from politicians. This might well create a legal duty to implement "harm" related policies similar to what you have suggested before at threat of fines. I suspect that the concept of online media causing harm, and the need for censorship or contextualization has entered into the policy domain more generally. I have my concerns from a Medicalization perspective to more general forms of "harm". Many editors seem open to trying to improve pages. The Samaritan's have a set of guidelines. Talpedia (talk) 15:42, 27 August 2022 (UTC)
 * Thanks for that; if you (anyone?) are able to associate Wikipedia editor names with these "medic Wikipedians", I'd have a better sense of motivations and likely outcomes of any proposals. Also, why only mental health? Sandy Georgia  (Talk)  15:50, 27 August 2022 (UTC)
 * I sort of wanted to avoid being too personal initially and stay more general. The panelists can be found here one panelist is a founder an indian suicide prevention charity - I'm not sure if they are a wikipedian now. User:Netha Hussain is reported as being a radiologist. Talpedia (talk) 16:11, 27 August 2022 (UTC)
 * Something that interests me: The conception of suicide and self-harm (which are overlapping, rather than separate, concepts) that IMO our articles put forward and that the UK bill seems to work from is a very white/Western/modern concept.  I feel that we are missing diversity in perspectives.  I think that involving people from other cultures is going to be important.
 * On a side note, I don't think that "top-down policies" are necessarily a bad thing (sometimes what looks like a "top-down imposition" is just the other side's "terms under which they're willing to participate"), and I don't think that ideas and information put forward by a couple of Wikipedia editors would qualify as "top-down" anyway. WhatamIdoing (talk) 18:58, 27 August 2022 (UTC)
 * I do not disagree; reiterating that community efforts have failed, something top-down might be a very good thing. But as to implementation aspects, I remain interested in the specific editors behind the proposals, and Talpedia has satisfied my curiosity. Sandy Georgia  (Talk)  19:34, 27 August 2022 (UTC)
 * PS, although I still wonder why stop at mental health only. Sandy Georgia (Talk)  19:35, 27 August 2022 (UTC)


 * which are overlapping rather than separate squint hard enough and all concepts start to blur together. I would concede that certain forms of self-harm probably can be considered to be highly overlapping with suicidal behaviour and there is value in trying to construct a concept to capture this, but in the US, "When the definition of self-harm was expanded to include head-banging, scratching oneself, and hitting oneself along with cutting and burning, 32% of the sample said they had done this" from Self-harm. You just can't view the behaviour of 32% of the population engage in as meaningfully the same as suicidal behaviour from the perspective of making interventions... though by all means models of psychology should encompass as much behaviour a possible.
 * I don't think that ideas and information put forward by a couple of Wikipedia would qualify... I'd agree with that. The involvement of the WMF legal departments, the mention of content moderation and comments about the need for expert involvement in policy making all feel a bit top-down to me; but it is just a suggestion the moment. "We need to make sure our editors have access to the best research to make decisions", would be something bottom up.
 * From my perspective the problem with topdown is "someone who I don't trust to properly appreciate the context relevant in specific situations making decisions ahead of time without context". My main concern is really this big split between "expert knowledge and patient information" that seems to exist in medicine, and a failure to properly understand the coercion within medicine and what being lied to does to people, or the need for people to form their own understanding of reality. At times, it feels like all medics see is harms that can be prevented by controlling people, and expert interventions that they do to help people.
 * I feel that we are missing diversity in perspectives. Do I think this is true? I mean diversity tends to be highly valuable once mutually understood, and immediately results in a more nuanced articulation of concepts (more concepts, more moving parts, often better aligned with reality) that can be used to solve things. The harm that exists in other countries is just as relevant as that that exists in western countries, and there are potentially more non-western readers so it's legitimate to specifically consider if there are difference in causes of harm in different countries. In a sense, I feel as if an overlooked form of diversity is between medical expertise and patients or lawyers... having diversity of opinion from professional experts interested in harm and misinformation is perhaps a partial sort of diversity Talpedia (talk) 21:03, 27 August 2022 (UTC)
 * I don't think you have to squint very hard to see suicide as a subset of self-harm. Non-delusional people do not expect to make themselves either happier or healthier by killing themselves.  There may be a problem with saying that self-harm leads to suicide, but I see no difficulty in saying that suicide is the opposite of self-help.
 * As an example of cultural differences, I believe that people in different cultures react differently to Honor suicide. Some cultures glorify it; others condemn it.   WhatamIdoing (talk) 00:41, 28 August 2022 (UTC)
 * I don't disagree (with slight caveats about delusionality versus lack of agency). My issue is groups that seem to want to apply the same rules for self-harm and suicide content because you can view them as part of a spectrum. Talpedia (talk) 12:50, 28 August 2022 (UTC)
 * From reading a few articles, I think that their notion of "harm" might have more to do with teen girls' body images and eating disorders than with deliberate self-injury/cutting. WhatamIdoing (talk) 04:06, 31 August 2022 (UTC)
 * I'm not clear how arguing about self-harm and suicide and their relationship is relevant. Please, I don't want an explanation why. Could we just focus on what as editors we might do about the concerns raised. I think there could be some issues with editors who take NOTCENSORED to mean we have no responsibility for the effect and consequence of the information we choose to include. Related to that is Jimbo's "sum of all human knowledge" nonsense that is still being pushed at About, that needs a whole What Wikipedia is not policy to correct. While there are some extra things Wikipedia could do (like provide links to help for readers who search for suicide material, avoid autocompleting those articles) at the core of the Online Harm bill is the idea that some information/knowledge is "harmful" and therefore best kept from those who may wish to do themselves harm or could be encouraged to do so. I think the artworks at suicide methods would be easy to remove, as they essentially eye-candy. And some text could be worded in a different way if experts felt that helped, while still retaining the information. But if it came to a point where experts and some editors were asking that we don't include some information, or going around removing it, there may be a problem.
 * One solution (related to what WAID notes above about making the article high quality) would be to not signpost that one's edits were removing information because it might be harmful. We've seen similar issues with editors changing individual words or phrases because they felt the current ones were offensive or reinforced stigma or were otherwise felt socially unacceptable to some of the community... they bang up against activist editors who disagree and end up getting topic bans. If the Samaritans or similar groups actually insisted those articles be removed or stubified then we'd have a difficult task, but if the most problematic bits were selective then it may be possible to rewrite sections/paragraphs to be both better and at the same time avoid those bits. I suspect, though, we'd get some watchlister who restores material that "got lost" and if it was reliably sourced, then it is much harder to ask for its removal again. So this might not be easy.
 * Politically, the current UK government lurched to the authoritarian right after Brexit and looks set to lurch further when a new PM is appointed. Even if a cross-party committee develops something sensible, the PM and cabinet ministers can push for their own agendas too. There is some precedent for Wikipedians campaigning about laws being discussed/proposed: when the EU proposed removing Freedom of panorama, there was a campaign (I designed a banner for the campaign).
 * I feel we are currently in the dark about what exactly the Samaritans think is harmful on Wikipedia and thus the extent to which they would like to see changes. Perhaps our first step then would be to find out. -- Colin°Talk 09:07, 28 August 2022 (UTC)
 * Please, I don't want an explanation why alas, this is not a request you can make if the issue is relevant to a debate, but I think I can delay talking about such topics for the moment.
 * the idea that some information/knowledge is harmful I find this concept a little difficult. I'm sure there are some cases that are open an shut like "why do you want to know the security codes for this building" and some of these might apply to the articles in question. To me the premise of freedom of thought and speech is that sometimes you just can't know whether something is harmful, and it's better to allow the thought play out than try to prevent it, which is almost a sociological (and maybe at times "pseudo-religious") viewpoint more than something "individual", though the same things functions at the individual level. I have a lot fewer issues with "contextualization" than I do with removal of material (which incidentally is the angle Full Fact takes) since if your argument is that people should come to an informed decision, they should be informed. If we want to frame "freedom on thought" in the ethics of medicine Autonomy is supported by accurate knowledge for choices to be properly free, and Informed consent requires accurate knowledge of what treatment involves and the alternatives. Incidentally this sort of framing comes up in the concept of patient advocacy by nurses... and perhaps there are philosophical and ethical ideas here.
 * they bang up against activist editors who disagree and end up getting topic bans I guess this might be a problem that can be solved with "top-down" policies. If I wanted to shoehorn the samaritan's into an "informed decision making" and "article improvement" perspective rather than a "harm reduction" perspective it might be that they understand the likely things that people have not considered.
 * I feel we are currently in the dark about what exactly the Samaritans think is harmful on Wikipedia Agreed.
 * Perhaps our first step then would be to find out. seems like a reasonable idea. I was thinking we might try applying their advice first to get a little context (which you are mentally doing here). Perhaps I or someone else should just ring them up and walk through the article with them taking notes. It might be good to get the perspective from similar groups in countries with a large English speaking population as well. Talpedia (talk) 12:50, 28 August 2022 (UTC)
 * I just think you and WAID could debate that topic forever and this is already an off-puttingly over-long section on a difficult subject. And I think we could have a debate about harmful knowledge forever, which doesn't help us with specifics. Because we are an encyclopaedia rather than "the sum of all human knowledge" we don't include instructions about how to do stupidly dangerous things that are best left to the experts, like repairing your gas boiler, or illegal things like where to watch movies for free. We think that the information about what dose of medicine to take is best left to your doctor or the patient information leaflet, rather than Wikipedia. There are probably other examples. Information about how to evade tax is probably legal in itself, and Wikipedia has topics on tax evasion, but likely stops short of enough specifics that anyone could benefit much from reading them in order to evade tax. Whereas information about how to make bombs probably does get covered by some laws. So I imagine there is probably some information we could agree upon that is "harmful" for it to be generally easily available to everyone, and better distributed on a "need to know" basis. The repair manual for my gas boiler is probably accessible online, but only to Gas Safe Engineers, and I'm happy that I and my next door neighbour can't get at it. -- Colin°Talk 16:11, 28 August 2022 (UTC)
 * And I think we could have a debate about harmful knowledge forever, which doesn't help us with specifics. Yeah, I do agree, note WP:FORUM, and that it seems like editors here have been through this before. I think your suggestion for a piece of actual work that can be problem off is a good one, and that a little interaction with people pushing for "regulation" both the Samaritan's and others would be a good one.  Talpedia (talk) 20:04, 28 August 2022 (UTC)
 * I'm trying to put together a list of things that any interested volunteer could do. Here's what I noted in this discussion so far:
 * Talk to Samaritans in the UK to see whether they have specific/actionable concerns ("Suicide bag has a diagram in it" – I believe there was a complaint about that on wiki a few years ago) or general concerns ("If kids can get information online instantly, then they won't have to wait for the library to open to find that diagram in that notorious book, and even a five-minute distraction can prevent a suicide attempt"). Maybe WMUK or WMF Legal could help set up a meeting, if someone was interested in doing this?
 * Study the Suicide methods page to find out why people were reading it. @Bondegezou, if you know people who are interested in this, then I suggest that they consider asking for age information.  I don't imagine that people my age really need to look up ways to kill themselves.  You would probably find older people looking up the method used after the fact in someone else's suicide (see ), or maybe looking for a plot twist for their Great American Novel.
 * Improve articles. I think we have made progress over the years, and I'm sure there is more work to be done.  Not all of this is difficult.  For example, Category:Suicide could probably use some basic clean up work, just to make sure articles are in sensible places.
 * Improve policies/guidelines. At the Wikimania talk, Tina in Legal offered to e-mail information to anyone who wanted it; did anyone ask for that?  SandyGeorgia has suggested a more comprehensive approach (affecting all medical content, not just suicide-related or mental health-related).
 * Anything else? And does anyone want to do/help with any of these? WhatamIdoing (talk) 20:45, 30 August 2022 (UTC)
 * There are discussion in the archives of the suicide bag talk page (e.g., archive 6) where not-a-how-to-guide was raised. There's also discussion at Wikipedia talk:WikiProject Medicine/Archive 82 where User:Chase me ladies, I'm the Cavalry says they have already had extensive discussions with experts and specifically calls-out the diagram showing how to make your own suicide bag from an oven bag, some tape and a cord. There was also a discussion about a hat-note link to crisis helplines at Talk:Suicide/Archive 6 which snowball failed. These discussions were long and I skim read them. In addition to the expected "not-censored" argument was the idea that of all the methods, a suicide bag is best, so if someone is really determined to do it, let's not for goodness sake mislead them into trying one of the inferior choices like paracetamol or CO. It was said that most methods are so straightforward that even the briefest description is sufficient. And also a feeling that discouraging suicide is like discouraging abortion, hence not neutral, and so trying to make readers of our articles less likely to attempt it is advocacy and POV pushing, etc, etc.
 * So while we could perhaps get even more detailed advice on what sort of things are "wrong" with our articles, it seems to me the "here's how to kill yourself with an oven bag" diagram is at the low-hanging-fruit end, and the fact that suicide-prevention groups were upset specifically with it had absolutely zero influence. I imagine that it just provoked an anti-advocacy response in some. If madness is repeating something and expecting a different result, then at the moment I'm not feeling encouraged that it is a good use of time. Is there any evidence that Wikipedia's culture has shifted such that a different outcome would be likely? Have any WP:MED editors shifted their opinion since then? I think if someone created an RFC that said the UK's Tory party was thinking about censoring pages on Wikipedia, then we might even get editors go to war and make those pages even more descriptive and explanatory and add more images and diagrams. -- Colin°Talk 16:16, 31 August 2022 (UTC)
 * That discussion of the suicide bag article that you link to is rather depressing. That sort of stance is highly likely to force legislators to intervene, (and possibly not just on targeted pages) as the discussion definitely reads like Wikipedia is encouraging suicide and encouraging this particular method of suicide.Nigel Ish (talk) 18:37, 31 August 2022 (UTC)
 * I think there are some people (in the world, and therefore on wiki, too) who believe that certain suicides should be encouraged and supported. I remember having a very frustrating experience with someone (another wiki) who thought that once you've decided to kill yourself, no other considerations should apply.  To which the rest of the world says:  Really?  You shouldn't "consider" whether your chosen method is going to result in killing other people?  Or leaving a radioactive crater in the ground for the next several centuries?  But on an "emotional" subject like this, some people aren't necessarily able to think clearly.  It's all lizard brain.
 * I have long wished for a source that evaluated the ethics of suicide methods. For example, most of us would say that suicide by pilot is unethical – the pilot is dumping a huge piece of machinery somewhere, and who knows what it will destroy, not to mention the possibility of other passengers on board – but where's a solid reliable source that says "Suicide by pilot is unethical"? WhatamIdoing (talk) 03:53, 1 September 2022 (UTC)
 * I think most of us, if we are being rational and of sound mind, would be able to come up with reasons why method X is unethical or otherwise suboptimal in terms of impact on others. So how is the Wikipedia providing information if it were to contain sourced text saying so? Perhaps you should be more selective about who you argue with on the internet :-). Anyway, is anyone here less pessimistic than me about this? My worst case scenario is someone is motivated to improve the diagram such that it ends up Featured on the Main Page. Yes, I'm aware of WP:BEANS, but most of the editors I know with that kind of mindset don't lurk on WP:MED. -- Colin°Talk 16:26, 1 September 2022 (UTC)
 * Most of the time, a desire to commit suicide is irrational, a symptom of depression. Providing information on how to commit suicide is very dangerous and and  are right that that past discussion is depressing. In the short term, however, we can improve articles using existing, general guidance. Looking at the Suicide methods article, after a good beginning, it is a poor article in that it's a disorganised list and rarely follows WP:MEDRS. Would some straightforward tidying up help? Bondegezou (talk) 17:34, 1 September 2022 (UTC)
 * I think some tidying up would help quite a lot. I'd also love to have someone find a good book chapter or other overview-type source.  The sources seem pretty scattered and outdated (e.g., statistics from 20 years ago), and I'd like to be able to replace as many as possible with a high-quality source or two. WhatamIdoing (talk) 23:09, 1 September 2022 (UTC)
 * I don't know about irrational. During my sociology study I heard of a research about letters left behind by people who have committed suicide, and the overall conclusion was that the letters were very rational and very well argued. We might say that rational lucidity is what killed them, if they still had illusions about their own life they would not have died so. According to Thomas Szasz, there was a posthumous punishment for men who committed suicide: the state confiscated everything he owned. Wives and kids found a way around this: by claiming that the man was crazy, he could not be held accountable for his own deed. So, they were not dispossessed of their property. Therefore, the idea that only the mentally ill commit suicide is a modern myth. Szasz is using such information to argue that the insanity defense does not hold water, but I'm not arguing that. tgeorgescu (talk) 01:29, 2 September 2022 (UTC)
 * I think there are people who would argue that killing yourself was automatically a sign of irrational thinking, but I believe the claim here was only that it's a majority of the time. I've not looked for any good sources on that point; I wonder whether the rates might vary by country and culture.
 * You've reminded me, though, that I'd like to have some good sources on external/cultural factors. Living in an individualistic culture (e.g., Scandinavia) is an independent risk factor for suicide that is not under the control of the people living in those cultures.  (Scandinavian residents have many protective factors, too.) WhatamIdoing (talk) 03:17, 2 September 2022 (UTC)

Case presentation vs case report
Came across case presentation as an unsourced orphan and added some sources, but in searching for a way to link to it, I came across case report. To me, a case presentation seems to simply be an oral version of a case report, and perhaps could be merged there as a subsection. I don't want to tag for a merge if that's totally ignorant though. Could I get some thoughts? &spades;PMC&spades; (talk) 23:07, 31 August 2022 (UTC)
 * I don't know anything about this. That said, the way we talk about case reports in MEDRS, it sounds like case reports are publications in medical journals, rather than what you confidentially tell (e.g.,) the tumor board at the hospital.  (But perhaps case reports includes unpublished ones?) WhatamIdoing (talk) 03:26, 1 September 2022 (UTC)
 * In my experience, case report generally refers to a published report of a single case as WhatamIdoing says, while case presentation could refer to many different forms of presentation of a patients' case. This presentation could be related to a published report, but more often is done to seek input from other clinicians or for teaching. As such, I think case presentation could exist as a separate short article. |→ Spaully ~talk~ 21:14, 1 September 2022 (UTC)
 * I agree, and that's the way those 2 different terms are interpreted, at least in the UK. Dr. Vogel (talk) 22:20, 1 September 2022 (UTC)

By the way, I'd never heard the term tumor board, but reading the article it sounds a lot like what we call "cancer MDT" in the UK. Except in our MDTs there are more people than the ones listed in that article. I wonder if we should expand it. I'm surprised we don't even have an article for MDTs in general. Dr. Vogel (talk) 22:16, 2 September 2022 (UTC)


 * MDT = Multidisciplinary Tumor Board? It looks like there are plenty of recent review articles available on the subject.  Most of them seem to have been written during the last 10 years. WhatamIdoing (talk) 00:34, 3 September 2022 (UTC)
 * MDT stands for "multi-disciplinary team". But when we say "an MDT" what we typically mean is a meeting of such a team. And it doesn't have to be about cancer, there are MDTs about so many things. If it's about cancer we just call it a "cancer MDT". Dr. Vogel (talk) 00:46, 3 September 2022 (UTC)

WikiProject Medicine Userbox?
Is there a WikiProject Medicine Userbox? If so, where is it? Thanks! Of the universe (talk) 18:44, 4 September 2022 (UTC)


 * Hi . Here is a list of all WP:MED-related templates, including the userbox User WPMed. Ajpolino (talk) 19:18, 4 September 2022 (UTC)
 * Awesome! Thanks :) Of the universe (talk) 19:20, 4 September 2022 (UTC)

Pedophilia vs pedophilic disorder. Request for comment
Hello, I am a psychologist interested in evolutionary psychology, sexology and especially paraphilias.

Recently, i have dispute on the https://en.wikipedia.org/wiki/Talk:Pedophilia regarding distinction between definitions of pedophilia and pedophilic disorder. I discovered a confusion in the terms in the article and decided to highlight the difference. But my edit was labeled as undue weight and reverted. I disagree with that because i think this is a substantial shift from previous to current classification. The discussion seems to be stuck due to the fact that participants became disengaged in answering and suspect my arguments as advocacy. I am somewhat disappointed and confused. Could you comment me or help with the discussion on the talk page please. And perhaps you could suggest a more appropriate form of edit to the article. (I'm not a native speaker and I understand that my wording is far from perfection).

Here is a summary of my edit that I proposed.

1.Incorrect statement in the article:

“Pedophilia (alternatively spelt paedophilia) is a psychiatric disorder in which an adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children”

Proposed edit:

“Pedophilia (alternatively spelt paedophilia) is a paraphilia in which an adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children”

2.Incorrect statement in the article:

“Pedophilia is termed  pedophilic disorder  in the DSM-5…”

Proposed edit:

“In the ICD-11 and in the Diagnostic and Statistical Manual of Mental Disorders DSM-5, there is a distinction between Pedophilia and Pedophilic disorder. Pedophilia is a paraphilia characterized by the sexual preference of children, formerely a disorder, no longer constitutes a disorder 'on its own'. In contrast to that, Pedophilic disorder is a psychiatric disorder which requires both criterion of pedophilia and criterion of negative consequences (act or distress)

3.Incorrect statement in the article:

“The diagnosis can therefore be made based on the presence of fantasies or sexual urges even if they have never been acted upon.”

Proposed edit:

“The diagnosis can be made based on the presence of fantasies or sexual urges even if they have never been acted upon, provided the subject meets the criterion of marked distress due to these urges and fantasies.”

I justify my edit by definitions from DSM 5 and ICD 11 and explanation of APA which highlights the distinction:

"In DSM-5, paraphilias are not ipso facto mental disorders. There is a distinction between paraphilias and paraphilic disorders. A paraphilic disorder is a paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others. A paraphilia is a necessary but not a sufficient condition for having a paraphilic disorder, and a paraphilia by itself does not automatically justify or require clinical intervention.

''The distinction between paraphilias and paraphilic disorders was implemented without making any changes to the basic structure of the diagnostic criteria as they had existed since DSM-III-R. In the diagnostic criteria set for each of the listed paraphilic disorders, Criterion A specifies the qualitative nature of the paraphilia (e.g., an erotic focus on children or on exposing the genitals to strangers), and Criterion B specifies the negative consequences of the paraphilia (distress, impairment, or harm—or risk of harm—to others).''

''The change for DSM-5 is that individuals who meet both Criterion A and Criterion B would now be diagnosed as having a paraphilic disorder. A diagnosis would not be given to individuals whose symptoms meet Criterion A but not Criterion B—that is, to those individuals who have a paraphilia but not a paraphilic disorder."'' [5 ] ~ Azureham (talk) 17:46, 31 August 2022 (UTC)
 * thank you for post--Ozzie10aaaa (talk) 11:49, 3 September 2022 (UTC)
 * could you reply to my commenters? it seems to me that my commenters misunderstand the substantial modern changes that have occurred in the classifications Azureham (talk) 09:48, 4 September 2022 (UTC)
 * Three other editors rejected these arguments, one of whom is a mental health professional . It has been explained to you that pedophilia's satisfaction requires personal harm, or risk of harm, to others, and therefore is a disorder regardless of whether it is acted upon. Your earlier arguments to include reams of text all sourced to a WP:FRINGE 1990 book that claimed pedophilia was evolutionarily adaptive was also rejected by multiple editors. Crossroads -talk- 02:16, 4 September 2022 (UTC)
 * To be precise, only you are trying to maintain a discussion on the content of the arguments. I appreciate this. But, in my opinion, you misunderstand the modern definitions of paraphilia and paraphilic disorder and arbitrarily interpret certain words in support of an outdated point of view. The rest of the commentators did not try to support their judgments with any evidence. I am also a mental health professional and I know that the status does not guarantee the absence of mistakes and biases. As to evolutionary causes, discussion has been stopped, until I provide more up-to-date secondary sources. Azureham (talk) 10:29, 4 September 2022 (UTC)
 * The DSM-5 supports the idea that pedophilia is not always a disorder.
 * Page 698: However, if they report an absence of feelings of guilt, shame, or anxiety about these impulses and are not functionally limited by their paraphilic impulses... and... they have never acted upon their impulses, then these individuals have a pedophilic sexual orientation but not pedophilic disorder.
 * Of the universe (talk) 18:24, 4 September 2022 (UTC) Of the universe (talk) 18:24, 4 September 2022 (UTC)


 * That specific line was the subject of controversy and is a bit misleading, so much so that it led to statements by the APA and was amended in the latest updated version of the DSM-5.
 * The APA stated very plainly: "The American Psychological Association maintains that pedophilia is a mental disorder"
 * The DSM-5-TR now reads "However, if they report an absence of feelings of guilt, shame, or anxiety about these impulses and are not functionally limited by their paraphilic impulses (according to self-report, objective assessment, or both), and their self-reported and legally recorded histories indicate that they have never acted on their impulses, then these individuals have a pedophilic sexual interest but not pedophilic disorder."
 * Clinically, when a patient presents as above, one has to start questioning if they truly have paraphilic impulses, and start consulting differential diagnoses.Legitimus (talk) 20:33, 4 September 2022 (UTC)
 * "The American Psychological Association does not classify mental disorders" so it has no priority over the American Psychiatric Association to discuss diagnoses
 * Paraphilia, spelled as sexual orientation, sexual interest, or arousal pattern, is still distinct from paraphilic disorder. This point is not emphasized in the wiki article. This vagueness entails readers to conclude pedophilic arousal is a psychiatric disorder by itself. Azureham (talk) 07:43, 5 September 2022 (UTC)

Proposed move of Injury
I've opened a discussion on Talk:Injury and any input would be appreciated. Thebiguglyalien (talk) 04:19, 4 September 2022 (UTC)


 * give opinion(gave mine)--Ozzie10aaaa (talk) 22:37, 6 September 2022 (UTC)

Language around migraine


I posted on the talk page to the article prevention of migraines, but it might be more appropriate to post it here since it affects so many articles. In short, I think we should change the word “migraines” to “migraine attacks” or just “migraine” to use the language that patient organisations prefer (I have posted the language guides from CHAMP and Migraine Australia on the talk page), just like we use “people with epilepsy” instead of “epileptic people”, since that's what people with epilepsy prefer. Rogalendingen (talk) 09:51, 27 August 2022 (UTC)


 * @Rogalendingen, thanks for posting these links, which I have read. It sounds like they conceptualize "migraine" as a continuous medical condition that occasionally flares up into attacks and then subsides again.  Even if you have no symptoms, the medical condition of "migraine" is still present.  Essentially, in this model, they declare that migraine is the name of the underlying disease and never the name of that disease's most prominent symptom.  As a result, you can't have "a" migraine, just like you can't have "a" diabetes or "a" lupus (although you certainly can have "a cramp", "a fever", or "a dislocation").  Proponents of this language wouldn't say "I had two migraines and one tension headache this year" because they always have migraine (disorder), even if they only noticed it during two distinct events.  Their preferred description might sound like "I had two migraine attacks and one tension headache this year."
 * My impression is that most people think of this condition as being healthy most of the time and occasionally having an event, rather than always being sick and occasionally having an event. In this respect, it feels to me like the language is intended to elevate the sickest of the affected people, similar to what we see with Chronic fatigue syndrome.  (In ME/CFS, if you say something like "most people can manage this condition", the retort you learn to expect is "well, some people can't even tolerate seeing T-shirts with words written on them!")
 * In the recommended model, the title of Prevention of migraines is wrong because it uses the name to describe symptoms. In this model, Prevention of migraine (in the singular) would be ambiguous, because some people would think that it means how to prevent migraine attacks in a person with pre-existing migraine disorder, and others will think it means how to prevent someone from being susceptible to any migraine attacks in the first place.
 * I don't think this language style is widespread – I would tell you that I had "a classic migraine with aura" last Saturday morning – but it also might be helpful IMO to be more specific. The existing article should probably be moved to Prevention of migraine attacks, and perhaps some day we will even have an article on Prevention of migraine disorder, assuming anyone ever figures out how to do primary prevention ("Try not to be female or to get a head injury" is not a reasonable approach to prevention   ). WhatamIdoing (talk) 23:00, 27 August 2022 (UTC)
 * @WhatamIdoing I agree that Prevention of migraine attacks is more precise here, and yes, fingers crossed that we one day could have an article on Prevention of migraine disorder.
 * On the other hand, can you please provide a reference for your impression? My impression is the opposite, that since migraine is (one of) the most common reason(s) for disability for people under the age of 50, more people wish it was taken more seriously. I have had that discussion with friends that have migraine attacks only a few times a year, and they wish more people understood how severe it can be and how it’s not just a headache. One of them also pointed out that she can’t choose freely what contraception she uses since she has migraine with aura, so it affects her all the time. Rogalendingen (talk) 10:04, 30 August 2022 (UTC)
 * Chiming in with my personal experience, obviously this is entirely anecdotal: I've got migraine disorder (with aura) and bipolar disorder, and I consider myself to be healthy most of the time. Both disorders are potentially very disruptive to my life, so I consider myself to always have a disability (because of the potential for disruption that I need to be constantly cognizant of), but most of the time, I am able to function without pain and without disordered thought---I'm not sick when I'm not having an event, I'm healthy but I have two dormant conditions. Of the universe (talk) 14:31, 30 August 2022 (UTC)
 * I don't think that wanting people to perceive you as healthy most of the time means that you don't want migraine attacks taken seriously. People may not understand the diversity of experience (e.g., that some people have mild migraine attacks, just like others have a severe tension headaches; that you headache isn't the only, or even main, problem; that you can have a migraine attack without any headache), but it doesn't follow that wanting attacks to be taken seriously when they happen means that you also want to be treated like you're sick every day of the year. WhatamIdoing (talk) 15:56, 30 August 2022 (UTC)
 * I guess I could have been clearer in my first reply, but I don’t think people want to pe perceived as sick all the time. Personally, I haven’t had a migraine attack in almost a year, and don’t see myself as sick despite still saying that I have migraine. My experience is similar to the one @Of the universe has.
 * Also, both guides do for example argue against the use of “(migraine) sufferer”, so I don’t see where the assumption that people want to be perceived as sick all the time comes from.
 * I think we should change the direction of the discussion a bit since there has been much focus on personal experiences and opinions. I thought Wikipedia was supposed to reflect the major viewpoint(s), and CHAMP and Migraine Australia represent millions of people. And I have never come across a source arguing for the continued use of “migraines”.
 * Before someone comments that “migraines” is so widely used that we should continue to use it, remember that stomach is widely used for abdomen, people often call all types of dementia for Alzheimer’s, and many don’t know the difference between a heart attack and a cardiac arrest. There are lots of other examples where we in everyday life use non-medical words instead of the ‘correct’ word or medical words wrongly, like in my dialect in Norwegian, where we use foot for leg and the opposite, and if people want to continue to use “migraines” when they talk, that’s fine. I just think we should listen to the majority here on Wikipedia and remove the word “migraines”, unless someone can provide a reference that argue for the continued use of it?
 * Rogalendingen (talk) 19:58, 5 September 2022 (UTC)
 * Sorry, didn't mean to derail, i just got excited about chatting about migraine experiences. :)
 * Yeah, I agree, "migraine" appears to be more correct than "migraines." Informally surveying what's been written about migraine, it seems like plenty of doctors still say "migraines," but all of the the most expert sources are using language similar to the style guides you provided. Of the universe (talk) 21:10, 5 September 2022 (UTC)
 * AFAICT, according to their official reports (e.g., ), Migraine Australia is a fairly new organization with a couple hundred (legal) members – I suspect, but am not certain, that this is their $5 "paid member" count instead of their $50 "voting member" count – and 6,500ish people in their Facebook chat. I would not describe them as "representing millions of people".  "Representing 10,000" might be closer to the mark.
 * @Darcyisverycute (and anyone else who's interested), I think this ties into our conversation above about alcohol, and I wonder whether we should consider the subject a little more broadly. We have patient groups that want us to say "two migraine attacks" instead of "two migraines" or "two migraine headaches".  This seems harmless enough, and it is a bit clearer, but it's unlikely to be the exact terminology used in the source.  If we measure by Ghits, then the quoted phrase "two migraines" outnumbers "two migraine attacks" about 5 to 3 (almost nobody says "two migraine headaches").  Among books published in the last 10 years, the ratio is 3 to 1.  Is this sufficiently similar that we should consider discussing both cases together? WhatamIdoing (talk) 23:44, 6 September 2022 (UTC)

Articles with overlapping/similar scope
Wondering about weight loss, management of obesity, and weight management. The articles cover much the same topics and should be more clearly differentiated imo or perhaps merged. (t &#183; c)  buidhe  05:59, 8 September 2022 (UTC)
 * Also Dieting. Alexbrn (talk) 06:01, 8 September 2022 (UTC)
 * I'd point out that obesity per NIH is not the same as managing one's weight,( hence merging some of the articles mentioned above might not be a good idea, with all due respect)...IMO--Ozzie10aaaa (talk) 15:24, 8 September 2022 (UTC)
 * @Buidhe, I'd suggest that each of those articles needs to have a clear paragraph towards the top about its relationship to the others. For example, off the top of my head:
 * Weight loss can be intentional or unintentional; it can happen in people of any body mass.
 * Management of obesity is always intentional; it happens only in people with BMI ≥30; weight loss may be a goal (but so might weight stabilization, or addressing other/underlying problems first).
 * Weight management can happen in people of any body mass; the goal can be to lose, gain, or keep the same weight.
 * Dieting is always intentional; the goal is frequently weight loss, but can be any type of weight management plus non-weight-related considerations (e.g., Ketogenic diet for epilepsy, gluten-free diet for celiac disease, etc). That article might or might not include non-medical/non-physical diets (e.g., kosher diet for religious reasons, vegetarian diet for ethical reasons, low-carbon diet for anti-pollution reasons, etc.)
 * Once that paragraph is in place, then it should be possible to reduce some of the overlapping content. WhatamIdoing (talk) 15:51, 8 September 2022 (UTC)

Avatar Medicine
I'm fairly certain that this article doesn't comply with WP:MEDRS as it stands. As to whether 'Avatar Medicine' is even a thing, contributors may wish to comment at Articles for deletion/Avatar Medicine. AndyTheGrump (talk) 13:02, 12 September 2022 (UTC)

Human-centric anatomy and disease articles
Please see Village pump (idea lab) and share your thoughts. WhatamIdoing (talk) 18:50, 12 September 2022 (UTC)

Requested move at Talk:Hook effect
There is a requested move discussion at Talk:Hook effect that may be of interest to members of this WikiProject. – robertsky (talk) 05:01, 11 September 2022 (UTC)
 * commented--Ozzie10aaaa (talk) 20:16, 12 September 2022 (UTC)

Reproductive medicine pages
Dear all, Dr. Agnes Stefansdottir is working with 4th year Reproductive Biology Bsc students again this year to see where they can help improve/update/expand content related to reproductive medicine. We just wanted to run their initial ideas by the hive mind to see if there are any thoughts or counter proposals from WikiProject Medicine editors: One tutor has proposed doing a page on the effects of radiation on fertility. There is a reproductive toxicity page where radiation is mentioned but it’s a very short paragraph: Therefore, I wonder if this topic could be made into a new separate page which would then be linked to this page, or whether it would be better for the group to expand the subsection within this page? Other topics sent in so far by the tutors include: Do you have any thoughts, suggestions or feedback on any of these topics? The students are due to begin work on Wed 21st September. Stinglehammer (talk) 11:10, 9 September 2022 (UTC)
 * Neohormones
 * Germ cell nests (cysts)
 * Prolactin / its role in pregnancy recognition in the rodent / role in pseudopregnancy (not mentioned in PRL section; then also pseudopregnancy
 * Nanos genes (no wiki page, as far as I can see, it is mentioned briefly on the drosophila embryogenesis page)
 * PRC2 gene (short wiki page, could do with expanding/updating)
 * INSL3 (short wiki page, could do with expanding/updating )
 * Oocyte abnormalities (for example vacuolated oocytes, spindle displacement, smooth endoplasmic reticulum aggregates) – not sure about this
 * Reproductive toxicology page could probably be expanded to include more detail on other reproductive toxicants (there’s a long list, not many mentioned on this wiki page)
 * Alternatively, an ‘ovarian toxicity’ page or sub-section


 * Ask them to read English Wikipedia rules first and check their knowledge about rules. It's the most important part of activity to any student that will edit Wikipedia. D6194c-1cc (talk) 14:14, 9 September 2022 (UTC)
 * yeah, we induct them first of all and stress writing accessibly (explaining jargon terms), neutrally, in own words and citing what they write using WP:MEDRS and review lit. from last few years. Then organising on page using WP:MEDSECTIONS to structure the page. Anything else worth highlighting here? Stinglehammer (talk) 14:13, 13 September 2022 (UTC)
 * @Stinglehammer, I think that most students will find it easier to add a paragraph to an existing article instead of creating a completely new page, so I suggest starting there.
 * Have you considered asking the students to find something in existing content that is wrong or outdated, and either remove or fix it? Or to add a citation (maybe to a class textbook – recent upper-level textbooks are usually great sources) to something?  This can help them figure out the process of getting citations on the page, and a lot of articles are citing sources from 10+ years ago.
 * You'd think that would be the case but past 6 years have found opposite is true and students often find it easier to focus on creating new pages and co-ordinate their efforts as a group to making it best they can using other high quality medical pages as exemplars. Stinglehammer (talk) 14:13, 13 September 2022 (UTC)
 * @FloNight, if you're around, is there anything you'd suggest to this group? WhatamIdoing (talk) 18:44, 9 September 2022 (UTC)
 * Should also add another tutor has suggested a topic of Embryonic diapause be worked on also. Again if there are any thoughts or comments here, do let us know. Stinglehammer (talk) 14:13, 13 September 2022 (UTC)

Requested move at Talk:Injury
There is a requested move discussion at Talk:Injury that may be of interest to members of this WikiProject. – robertsky (talk) 16:52, 14 September 2022 (UTC)


 * also above at Wikipedia talk:WikiProject Medicine--Ozzie10aaaa (talk) 18:06, 14 September 2022 (UTC)

Four month old draft
Draft:Focused ultrasound for intracranial drug delivery has been waiting to be reviewed at AfC for over four months now. Is there anyone at this WikiProject that would be willing or able to assist in reviewing the draft? TipsyElephant (talk) 16:44, 14 September 2022 (UTC)

Draft:Endogenous Chemically-Responsive Drug Delivery Systems has also been waiting for over four months to be reviewed and assistance would be appreciated. TipsyElephant (talk) 16:45, 14 September 2022 (UTC)


 * @TipsyElephant, both of these need some clean up, but they are notable subjects. The research shows that they'll get more of that clean up if they're in the mainspace instead of hidden in the Draft: space. WhatamIdoing (talk) 20:42, 14 September 2022 (UTC)

List of case reports at Coma blister
Is that really appropriate? Or should that just be nixxed right out? &#32; Headbomb {t · c · p · b} 04:17, 4 August 2022 (UTC)


 * It... depends. A lot.  For a common condition, you wouldn't mention individual cases.  If it's a single patient ever (or especially famous/in pop culture), then you might write a whole article about the one case (see Category:Index cases).  Situations in between those two extremes are occasionally described this way, or (perhaps more often?) the sources for the individual cases are listed in a Further reading section.  I don't know enough about this condition to know where it falls in the spectrum.
 * MLy16 and Ucsfrdu, I think the most important thing you could do to make quick improvements to that article is to add lots of links to other Wikipedia articles. Try to link most "technical" terms.  Two small bits of advice:  First, if there's a string of terms in a row, then we try to skip words:  "One two 3|three." and then find and link "two" somewhere later in the article if possible.  Second, we don't link every occurrence of the same word, but it's good to put links once in the lead and once in the body.  For example, link to blister in the first sentence plus again in either the ==Etiology== or ==Diagnosis== sections.   WhatamIdoing (talk) 18:06, 4 August 2022 (UTC)
 * In this case, none of the case reports are exceptional. Wikipedia is not the place for these non-exceptional case reports. Jaredroach (talk) 23:32, 21 August 2022 (UTC)
 * Removed per folks' thoughts here and Manual_of_Style/Medicine-related_articles. Ajpolino (talk) 03:24, 15 September 2022 (UTC)

History of smallpox - input needed


Your input would be appreciated in the debate on Talk:History of smallpox. The article, the bulk of which was written before 2013, suffers from old age. A lot of new results published in 2016 and later are not reflected at all. Thanks for your help! Renerpho (talk) 02:14, 28 July 2022 (UTC)


 * @Renerpho, the three editors in that section have posted in different years. I suspect that if you decided to WP:Be bold in updating that page, that nobody would object. WhatamIdoing (talk) 18:47, 29 July 2022 (UTC)


 * I'm sure nobody would object. In fact, I am worried about just that. I simply don't feel qualified, hence why I am asking here for someone who is qualified to properly assess the sources, to come over and help with it. Renerpho (talk) 04:20, 28 August 2022 (UTC)
 * Also the history of smallpox vaccine could be moved to a separate article. It's really huge. D6194c-1cc (talk) 10:03, 15 September 2022 (UTC)

Page archiving
Hi all, this page is now regularly pushing thirty sections, and I'll admit I'm having trouble keeping up. In my unscientific survey clicking arbitrarily through past versions of the page, it looks like we've been at around this pace since the summer, while last year we were closer to 20 concurrent threads (results of my lazy survey in two-month increments: 9/21 (15), 11/21 (20), 1/22 (17), 3/22 (13), 5/22 (24), 7/22 (26), and today I believe I'm making the 32nd section).

If I understand the archiving settings correctly, we're currently set to archive threads that have been untouched for 30 days. Any objection to shortening that window? I'd propose a thread untouched for 21 days can be safely archived. If unfinished business starts disappearing, we could always readjust. Any thoughts? Ajpolino (talk) 04:15, 15 September 2022 (UTC)

Oh, I should add that by my count implementing a 21-day archive timer at this moment would result in the archiving of 7 threads. Ajpolino (talk) 04:19, 15 September 2022 (UTC)
 * I would agree--Ozzie10aaaa (talk) 12:08, 15 September 2022 (UTC)
 * Thanks for adjusting this. We change the speed a couple of times a year.  Making it match the needs of the page is a good thing. WhatamIdoing (talk) 23:59, 15 September 2022 (UTC)
 * I think 3 weeks sounds like a fair window. Go for it. Dr. Vogel (talk) 22:13, 16 September 2022 (UTC)

Experimental and Therapeutic Medicine reliability as a source?
NIH profile, eISSN 1792-1015 ISSN 1792-0981, ResearchGate profile.

Can this journal be considered as a reliable source? TIA X-750 List of articles that I have screwed over 01:10, 15 September 2022 (UTC)


 * @X750, looking at https://www.scopus.com/sourceid/19700176236, this is not the best-ever journal, but it's also not the worst-ever. They stopped ranking it a couple of years ago, but 5+ years ago, Experimental and Therapeutic Medicine seems to mostly fall into the second quintile – below average, but maybe (barely?) good enough.  The publisher is Spandidos Publications, which is definitely small-scale.  If I were looking at this journal, I might prefer a stronger reputation if the content is unexpected or an WP:EXTRAORDINARY claim.
 * The journal/publisher is not the only factor to consider. You might want to consider other factors (e.g., the authors' reputations).   WhatamIdoing (talk) 02:58, 15 September 2022 (UTC)
 * More importantly perhaps, it depends on what part of the journal you wish to use, and what you wish to use it for. Experimental and Therapeutic Medicine publishes both reviews, and primary research. Just looking at the journal's most recent issue, if you wanted to use Basal cell carcinoma: Comprehensive clinical and histopathological aspects, novel imaging tools and therapeutic approaches (Review) to update content at basal cell carcinoma, you can probably feel fairly comfortable with the journal as a source. If you're looking to use Cutaneous adverse reactions in a lung cancer patient treated with pembrolizumab: A case report to update lung cancer, less so. You can find some general thoughts on identifying reliable sources for medical content at WP:MEDRS.
 * Also keep in mind, no journal is perfect. Sometimes crappy articles make it into relatively august journals. If you have a particular topic you wish to write about, I'd suggest you find a few decent-looking sources to peruse first to get a sense of the mainstream thinking on the topic, then build the Wikipedia article to reflect that.
 * If you wish to share the particular use you had in mind, I'm sure we could be more helpful. Best, Ajpolino (talk) 03:17, 15 September 2022 (UTC)
 * Hello and, I appreciate the swift replies you both gave. The reason I ask this is because I'm thinking of creating Cyanoamino acid metabolism, and this was one of the articles I was just looking at. I may not end up including it in the article in the end, but I just wanted a ballpark as to where the community stood. I agree with WhatamIdoing's point about author reputations, that specific paper I linked was published under the Department of Orthopedics of Lanzhou University, so I'd be inclined to think its somewhat reliable. I've read WP:MEDRS, and I just wanted a second opinion. Again, thank you both X-750 List of articles that I have screwed over 07:46, 15 September 2022 (UTC)
 * For whatever it's worth, my recommendation would be to consider writing about a different topic instead. Some topics have so few sources available, that it's challenging or impossible to write a decent encyclopedia article on them. With admittedly just a quick Google, GScholar, and Pubmed search, I can't find a single source that discusses cyanoamino acids or cyanoamino acid metabaolism in much detail. All I can find is that it's a KEGG pathway, and so people occasionally note that genes annotated in that pathway appear in their RNA sequencing results. Maybe you found better sources, or have access to a decent offline source(s), in which case power to you. There are lots of articles here that need work, many of which can be more easily sourced, and therefore offer a more pleasant editing experience. That said, certainly we're volunteers and you're welcome to work on whatever interests you. If there's anything else we can do to help, let us know. Otherwise, best of luck! Ajpolino (talk) 15:35, 15 September 2022 (UTC)
 * I agree, the only reason I noticed this was through reading amidase. I might just focus on cleaning up Antimalarial medication, something I've been working on on my own userpage. Cheers X-750 List of articles that I have screwed over 23:31, 15 September 2022 (UTC)
 * It's mentioned in, and a few other papers, but I don't see much substance. Is there a page that could include a simple definition, like "Cyanoamino acids are amino acids with a cyanide group" (or whatever it turns out to be)? WhatamIdoing (talk) 23:56, 15 September 2022 (UTC)
 * This page on ProteinLounge is probably the most comprehensive one I've found detailing the whole process, although unfortunately the content is hidden behind a paywall. YMDB has some nice diagrams too, albeit those are just for the singular molecules. Clicking on the KEGG link gives me an error. I'll have a further rummage when I get home. X-750 List of articles that I have screwed over 00:02, 16 September 2022 (UTC)
 * The KEGG entry cites this article, this article (available through WPLibrary) and this article (ProQuest). So I will probably dig into those later. The AmiGO entry is also interesting, not sure if it will have much value. X-750 List of articles that I have screwed over 00:30, 16 September 2022 (UTC)
 * There's nothing wrong with WP:PAYWALLED sources, assuming that the editor who adds the information has access to them. WhatamIdoing (talk) 15:33, 16 September 2022 (UTC)
 * Of course,, I use ProQuest all the time. The only issue is that I unfortunately do not have access to ProteinLounge. Bummer. I'll put it on the burner for now. X-750 List of articles that I have screwed over 00:07, 17 September 2022 (UTC)
 * You might be able to find someone with ProteinLounge access through WikiProject Resource Exchange/Resource Request. WhatamIdoing (talk) 15:45, 17 September 2022 (UTC)

Dispute at dentistry article
Silvaatan is very adamant that a list of example countries that award certain types of dental degrees should be included in the dentistry article(example edit), whereas I do not think such a list is a good idea because of its potential to become very unwieldy very quickly. See the discussion at User talk:Silvaatan ... any thoughts would be appreciated there, or perhaps there should be discussion on the article's talk page. Graham 87 15:02, 17 September 2022 (UTC)
 * thank you for post--Ozzie10aaaa (talk) 12:12, 21 September 2022 (UTC)

Horses and Zebras: Let's organize some article intros a little differently.


You know how there are many stories about people googling a symptom and getting all the scary results first? I just saw an example of that, in the article Cramps, and think it would be a great help to rearrange the introduction so the common causes (fatigue, electrolyte imbalance) are well before the scary stuff (neurological disorders).

Physicians have a saying, "when you hear hoofbeats, assume horses, not zebras." I think that it would be a great service to write articles on symptoms with this in mind. Does anyone else think that articles like that need a little work? // &#91;NomadicVoxel&#93; &#91; talk \ ctbs &#93; 00:25, 6 September 2022 (UTC)


 * If someone would create an article about Exercise-associated muscle cramps (Exercise-Associated Muscle Cramps) it will be great!
 * Although I think that preamble of that article could describe differences between cramps and spasms . And I can't find any information about crams in context of smooth muscles. -- D6194c-1cc (talk) 21:33, 6 September 2022 (UTC)
 * @NomadicVoxel, I agree with you. In fact, I wonder whether the less-common things should even be mentioned in the first paragraph.  It looks like the Cramp article could use a ==Causes== section.
 * BTW, if you're interested improving multiple articles, then you might be interested in WikiProject Medicine/Popular pages (might as well improve the ones that get read the most...) or looking through Category:Top-importance medicine articles and Category:High-importance medicine articles, or especially this list of high-priority, shorter articles (links like this can be found at WikiProject Medicine/Assessment). WhatamIdoing (talk) 02:01, 7 September 2022 (UTC)
 * I started reorganising some of the facts and it turns out that an article about Exercise-associated muscle cramps already exists, and the preamble even mentioned it, but had no internal link to the page. D6194c-1cc (talk) 12:36, 21 September 2022 (UTC)
 * And the same thing with nocturnal leg cramps, they weren't mentioned. D6194c-1cc (talk) 14:31, 21 September 2022 (UTC)

Foreskin restoration‎


The article on Foreskin restoration has languished for some time with lots of unsourced material, or material that is sourced only to either vendor websites or enthusiast sites and blogs. I've been trying to give it an edit, but an IP editor who apparently rejects the concept of WP:MEDRS is resisting. More eyes would be appeciated. Also - it probably goes without saying given the article title, but expect some NSFW pictures. MrOllie (talk) 21:11, 23 September 2022 (UTC)
 * Page now semi'd. Nice work on the cleanup. Bon courage (talk) 03:12, 24 September 2022 (UTC)

Cramps definition
I've started discussion at Talk:Cramp about the scope of Cramp article, the appropriate name of the article and possible original research with smooth muscles (GI, menstrual). For example, plant milk is not milk. The same things could be with cramps. D6194c-1cc (talk) 14:16, 8 September 2022 (UTC)
 * thanks for posting--Ozzie10aaaa (talk) 12:51, 16 September 2022 (UTC)
 * I removed information about smooth muscles as original research and defined the term more accurately as a "true cramp". D6194c-1cc (talk) 10:46, 25 September 2022 (UTC)

"Template:Medical Warning" listed at Redirects for discussion
An editor has identified a potential problem with the redirect Template:Medical Warning and has thus listed it for discussion. This discussion will occur at Redirects for discussion/Log/2022 September 25 until a consensus is reached, and readers of this page are welcome to contribute to the discussion. Thryduulf (talk) 13:03, 25 September 2022 (UTC)

Multivisceral transplants
I found the term multivisceral transplant in several articles, and linked it, but as you can see, it's currently red. Does it need an article, or a redirect - and if the latter, to what? Andy Mabbett ( Pigsonthewing ); Talk to Andy; Andy's edits 16:02, 25 September 2022 (UTC)


 * I now see that one instance redirects to Intestine transplantation, but that subsection itself has a red link to multivisceral graft. Andy Mabbett ( Pigsonthewing ); Talk to Andy; Andy's edits 16:08, 25 September 2022 (UTC)

Kombucha
I can't tell if this is a good edit or not, if someone interested wants to take a look. Gråbergs Gråa Sång (talk) 05:37, 27 September 2022 (UTC)
 * Not a great source, and didn't mention kombucha. Hence, removed. Bon courage (talk) 05:49, 27 September 2022 (UTC)
 * Thank you. Gråbergs Gråa Sång (talk) 06:00, 27 September 2022 (UTC)
 * I would expect that a better source (i.e., one that's not 9 years old and published by Hindawi) would be pretty easy to find for that. WhatamIdoing (talk) 14:49, 27 September 2022 (UTC)
 * As long as it mentions kombucha. Gråbergs Gråa Sång (talk) 19:06, 27 September 2022 (UTC)
 * I think that https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723656/#sec3-nutrients-11-01806title will be useful for that article.  also warns against consumption by the usual risk groups (under age 4, pregnancy, HIV, kidney failure).  However, with a quick search, I didn't see anything saying that it was "prescribed". WhatamIdoing (talk) 04:10, 28 September 2022 (UTC)

New Talk format - does it apply to this page?


I see that the new format for Talk pages has rolled out. I really like the headers with (e.g.) "Latest comment: 1 year ago 5 comments 3 people in discussion". One of the problems I have with this page is finding the most recent posts (they are not always at the bottom). It would be nice to see this page in the new format. I infer that all Talk pages are now in the new format. But maybe this "Wikipedia_talk" page is not encompassed as a "Talk" page. Or am I missing something? Maybe some preference I need to set?? Jaredroach (talk) 15:42, 28 September 2022 (UTC)


 * You aren't missing anything. It was only enabled for the article   and   namespaces.  In theory, the available options are any or all of the talk namespaces, plus any page that the [reply] tool finds discussions on.
 * The Editing team has a request for everything from the German-language Wikipedia, and they are basically willing to do whatever people want.
 * If you don't know what Jared's talking about, then you don't have Special:Preferences enabled. If you have it, and you don't like it it, you can turn off "discussion activity" at Special:Preferences.
 * Also, @Jaredroach, I suspect you're going to like one of the upcoming bits, which adds a link to the newest comment at the very top of the page. Check out the prototype if you want to see what's in the plans:  Vector 2010, Vector 2022 (scroll down so you can see what happens to the Table of Contents), MonoBook, Timeless.  You can make a new account/new password if you want to see the new Subscribe button.
 * (Also, speaking of prefs, volunteer-me just fixed my prefs at Special:Preferences because I got tired of clicking away the same banner at every site. If you edit multiple wikis, consider doing this at Special:GlobalPreferences instead of just here.) Whatamidoing (WMF) (talk) 01:03, 29 September 2022 (UTC)

Leak syndromes
Is Capillary leak syndrome the same thing as Vascular leak syndrome? WhatamIdoing (talk) 02:20, 29 September 2022 (UTC)


 * Yes. https://www.sciencedirect.com/science/article/abs/pii/S0248866321004616?via%3Dihub
 * "Capillary leak syndrome (CLS) or vascular leak syndrome (VLS) was first described by Clarkson in 1960". Jaredroach (talk) 15:35, 29 September 2022 (UTC)
 * Thanks. I'll redirect the one to the other now. WhatamIdoing (talk) 16:06, 29 September 2022 (UTC)

Input sought on some medical associations
I would appreciate input from editors in this project, about the views of some medical associations, at Talk:Crisis pregnancy center. Thanks. --Tryptofish (talk) 17:01, 30 September 2022 (UTC)

New to Editing: Draft for Consideration
Hello, I'm new to editing Wikipedia and do not know the etiquette and process well enough.

I was frustrated by how this article was basically a badly mangled press release from a company. I think the technology is notable as it is a very active area of research and the current article does not reflect that. I made a draft where I refreshed the entire thing from scratch.

Could someone provide some feedback on it as I am very to new editing?

How long should I wait for feedback?

Should I make the changes all at once or is there a different process?

Is there anywhere else I should post to get more input?

Thank you for your time. DogMcBarkMD (talk) 00:10, 1 October 2022 (UTC)


 * You may be able to find additional citations among the 16 that are currently returned by this search: "https://pubmed.ncbi.nlm.nih.gov/?term=%22Responsive+neurostimulation+device%22". Also, you should be able to use Wikipedia's GUI to just type in the PubMed ID when you insert a reference, and it will be automatically inserted with the proper formatting (occasionally you'll need to further do a minor edit to the date format). The current references are formatted as if they just had a hurricane blow through. Jaredroach (talk) 19:41, 1 October 2022 (UTC)
 * I decided to just go ahead and push the changes. I does not seem to be a heavily watched article so I do not think many people will have a lot to add. Feel free to go through the current page and update as you'd like. DogMcBarkMD (talk) 20:59, 1 October 2022 (UTC)
 * Thanks for this work, @DogMcBarkMD. I'm glad you decided to Be bold.  It looks like a big improvement over the old version.
 * https://pubmed.ncbi.nlm.nih.gov/32936673/ and https://pubmed.ncbi.nlm.nih.gov/34696676/ are both recent review articles on this subject that could be added to the article. It looks like one is WP:PAYWALLED, but perhaps someone will have access already.  The other is free to read. WhatamIdoing (talk) 23:37, 1 October 2022 (UTC)

Splitting discussion for Soft diet


An article that been involved with (Soft diet) has content that is proposed to be removed and moved to another article (Pureed diet). If you are interested, please visit the discussion. Thank you. AngusW🐶🐶F ( bark  •  sniff ) 21:54, 2 October 2022 (UTC)

Post infidelity stress disorder
Do we need an article on Post infidelity stress disorder? There seem to be several references to it, online. Andy Mabbett ( Pigsonthewing ); Talk to Andy; Andy's edits 20:18, 3 October 2022 (UTC)
 * there are 3 for Pubmed--Ozzie10aaaa (talk) 23:21, 3 October 2022 (UTC)
 * It appears that it's another subtype of Interpersonal trauma, which can lead to PTSD. It could probably be included as a section in either article.  I've just barely started this stub; feel free to expand it or to link to it in other articles.  It looks like about 20 mention the term. WhatamIdoing (talk) 01:28, 4 October 2022 (UTC)
 * For now, I've added a (red) link to the list there, with a citation to one of the Pubmed articles linked above. Thanks, both. Andy Mabbett ( Pigsonthewing ); Talk to Andy; Andy's edits 12:31, 6 October 2022 (UTC)

Pseudo scientific practice of Yoga
Our page on Yoga is a GA, yet it does not talk about the Pseudo scientific practice of Yoga. I have started discussion here. Talk:Yoga. Posting this here in hopes that more experienced users can take a look and provide suggestions for improvement of the page Yoga from mainstream scientific perspective. Venkat TL (talk) 16:31, 6 October 2022 (UTC)


 * Needless to say, I am getting strong pushback and frivolous templates for trying to improve that page. Venkat TL (talk) 16:47, 6 October 2022 (UTC)
 * I'm sorry about the template abuse VTL. I slightly disagree with your take on this, but I agree more participants in this dispute would be helpful. Firefangledfeathers (talk / contribs) 16:49, 6 October 2022 (UTC)

Rapid-onset gender dysphoria controversy has an RFC
Rapid-onset gender dysphoria controversy, which is within the scope of this WikiProject, has an RFC for possible consensus. A discussion is taking place. If you would like to participate in the discussion, you are invited to add your comments on the discussion page. Thank you. Nil Einne (talk) 10:58, 8 October 2022 (UTC)

Immune cycle
Any thoughts on Immune cycle? Seems.. well.. not sure what the proper term is. There's a current AfD. Thanks. JMWt (talk) 10:59, 7 October 2022 (UTC)
 * thank you for post--Ozzie10aaaa (talk) 13:01, 8 October 2022 (UTC)

Discussion link
Hello, you suggested to raise the discussion topic Talk:COVID-19_vaccine here. As I think that the problem is more specific to the article COVID-19_vaccine I would suggest to continue a discussion at that talk page but that's only a suggestion.--Myosci (talk) 18:33, 9 October 2022 (UTC)
 * I suggested raising it at WT:MED. That is the talk page for the WikiProject Medicine project. It seems that your requests require a wider audience. --Whywhenwhohow (talk) 02:29, 10 October 2022 (UTC)
 * This is WT:MED. However, in my understanding the OP – who evidently has their own views about the science of myocarditis – has been arguing over several articles that we should be citing certain primary studies instead of review articles. It would probably help if they gave an explicit example of a change they want to make, but in general WP:MEDRS would forbid doing this. Bon courage (talk) 15:50, 10 October 2022 (UTC)
 * I have replied on the talk page. WhatamIdoing (talk) 16:19, 10 October 2022 (UTC)

Mud bath and pseudoscience
A few recent edits to Mud bath appear to make medical claims. The sources appear dubious and appear to be articles by mud bath spas. I undid the edits twice and was reverted twice. Would someone please take a look at it? Thanks Adakiko (talk) 17:49, 9 October 2022 (UTC)


 * @Adakiko, is this the medical claim that you're concerned about?
 * "It has also been used as a method to relieve arthritis, but the practice of mud bathing has been shown to only reduce painful symptoms rather than treat the condition. "
 * " (this keeps the copyright folks happy with us). WhatamIdoing (talk) 18:54, 12 October 2022 (UTC)
 * The reason I asked for help here was not really the mechanics (I can do that) but rather about integration. It is not obvious to me that the article as it stands should be replaced outright and especially not when her draft is so very UK-oriented. It needs someone to make the judgement calls about what is (and is not) WP:DUE and select from her draft accordingly. And of course she can't really post it herself due to wp:COI given that she is joint author of a number of the papers cited. I'm sorry that I evidently failed to make that clear up front. --𝕁𝕄𝔽 (talk) 19:03, 12 October 2022 (UTC)
 * Well I see that and you have already done just that. Thank you. --𝕁𝕄𝔽 (talk) 19:08, 12 October 2022 (UTC)
 * I have reorganized the draft a bit and split out the UK specific guidelines into a UK section. In terms of guidelines, it appears that the UK is the only country that has made this ratio a formal guideline. In the US for example, the CDC emphasizes BMI, and mentions waste diameter without refering to the weight-height ratio. One remaining issue is that draft relies to heavily on primary sources.  Per WP:MEDRS, secondary sources are required to support medical claims.  I have marked all the sources as either primary (33) or secondary (11). The draft will need to be edited a bit more replacing where possible, primary with secondary sources. Boghog (talk) 03:55, 13 October 2022 (UTC)
 * Thanks. This is better than what we had in the mainspace, so I've merged it there.  I've cleaned up a few problems.  Please feel free to continue improving the article directly in the mainspace.  @Boghog, there's a ref error showing on the page.   WhatamIdoing (talk) 16:11, 13 October 2022 (UTC)

Good posture vs bad posture
It's a bit odd that good posture and poor posture are separate articles. Especially since there is no agreement about what good posture is or whether "bad" posture even causes back pain or other ailments. Overdue for a merge to spinal posture or something? (t &#183; c)  buidhe  03:34, 13 October 2022 (UTC)


 * Or even just posture, judging by the content of the dabpage. Dr. Vogel (talk) 07:16, 13 October 2022 (UTC)
 * Both pages should be merged into posture or something similar. No reason to differentiate. S EMMENDINGER  ( talk ) 13:20, 14 October 2022 (UTC)

Potentially good articles
Here's a list of articles that have been nominated for Good articles. Please consider reviewing one or more of these.


 * 07 Oct 2022 &#x2013; Coronary artery bypass surgery (talk · [//en.wikipedia.org/w/index.php?title=Coronary_artery_bypass_surgery&action=edit edit] · [//en.wikipedia.org/w/index.php?title=Coronary_artery_bypass_surgery&action=history hist]) was GA nominated by Cinadon36 (t · c) ;
 * 17 Sep 2022 &#x2013; COVID-19 pandemic (talk · [//en.wikipedia.org/w/index.php?title=COVID-19_pandemic&action=edit edit] · [//en.wikipedia.org/w/index.php?title=COVID-19_pandemic&action=history hist]) was GA nominated by Ozzie10aaaa (t · c) ;
 * 10 Sep 2022 &#x2013; Blood donation in India (talk · [//en.wikipedia.org/w/index.php?title=Blood_donation_in_India&action=edit edit] · [//en.wikipedia.org/w/index.php?title=Blood_donation_in_India&action=history hist]) was GA nominated by Mark the train (t · c) ;
 * 16 Jul 2022 &#x2013; Thiamine (talk · [//en.wikipedia.org/w/index.php?title=Thiamine&action=edit edit] · [//en.wikipedia.org/w/index.php?title=Thiamine&action=history hist]) was GA nominated by David notMD (t · c) ;

WhatamIdoing (talk) 01:43, 15 October 2022 (UTC)

Requested move at Talk:Auschwitz trial
There is a requested move discussion at Talk:Auschwitz trial that may be of interest to members of this WikiProject. — Shibboleth ink  (♔ ♕) 20:55, 3 November 2022 (UTC)

Medical–industrial complex Page


Hi all, I am a student at Rice University editing the Medical-Industrial Complex article. I have details about my plans on my user page, as well as a draft of my proposed plans in my sandbox. This article fits into the WikiProject Medicine category and is currently rated mid-importance. CatherineGCC (talk) 13:28, 18 October 2022 (UTC)
 * commented--Ozzie10aaaa (talk) 13:05, 20 October 2022 (UTC)

Anti–vascular endothelial growth factor therapy
This is really quite a mouthful, when in reality it's simply called anti-VEGF. Does WP:COMMONNAME apply here, or is it superseded by a different policy? Dr. Vogel (talk) 23:43, 14 October 2022 (UTC)


 * As long as both of them are mentioned prominently in the article, I don't think it's hugely important which one is in the title. WhatamIdoing (talk) 01:46, 15 October 2022 (UTC)
 * Yes, I agree it's all good as long as both are mentioned prominently. What I'm trying to find out is whether there is something specific about titles in our wikiproject that supersedes WP:COMMONNAME, in the same way that for example our reliable sources policies supersede Wikipedia's more general ones. Because otherwise it feels much more natural (to me) to move this the far simpler and more common title Anti-VEGF. It's not a hugely important issue, I just wanted to see what more experienced editors and med-editors thought about this. That's why I'm asking here rather than start an RM. Dr. Vogel (talk) 21:01, 18 October 2022 (UTC)
 * Well, WikiProjects don't actually make rules, but Manual of Style/Medicine-related articles says to prefer the INN for drugs, but doesn't say anything about abbreviations. This article is kind of about "use of" rather than the compounds themselves anyway.  I'd say there's no rule against having a shorter name.  Would you like to start a Requested moves discussion on the article's talk page? WhatamIdoing (talk) 15:31, 20 October 2022 (UTC)
 * Thank you for explaining. I think it would be nicer to have the shorter name, so I'll start an RM as you're saying and see how it goes. I think it's fine either way, really. Dr. Vogel (talk) 22:38, 20 October 2022 (UTC)
 * RM here. Dr. Vogel (talk) 22:43, 20 October 2022 (UTC)

Merging Cup-to-disc ratio into Optic cup (anatomical)
Hi guys, I feel like we can't really justify 2 separate articles for this. So I want to take the content from the CDR article, place everything at the cup article, do some copy editing to make the single article make sense, and redirect the CDR to the cup article, leaving some signposting for attribution. If there are any objections, please feel free to disagree. Otherwise if nobody objects after a few days I'll just do it. Thanks! Dr. Vogel (talk) 22:45, 12 October 2022 (UTC)


 * I agree with the merging and redirect. PatrickOConnor (talk) 23:52, 13 October 2022 (UTC)

Forgot to mark this as ✅ Dr. Vogel (talk) 12:13, 21 October 2022 (UTC)