Advice Malpractice: Good Advice Columnist, Bad Advice Columnist

"Go jump in a lake!"

“Go jump in a lake!”

I cannot imagine being so bereft of wisdom, friends and mentors that I would ever be moved to ask a stranger to advise me regarding an important decision based solely on a letter describing my problem. Nevertheless, a lot of poor souls apparently do, and because they do, many of them probably act on the advice they get from Beth, Abby, The Ethicist and the rest. This means that anyone with the ego and chutzpah to hold themselves out as qualified to give such advice is ethically obligated to be able to do a competent job at it, and at very least to “do no harm.” Yes, unlike the law, advice columnist is one of the professions where the traditional ethical mission of medicine is not just appropriate, but essential.

Most advice columnists in the media are not competent, and some are dangerously reckless. The worst thing an advice columnist can do is to use the trusting and needy stranger as a potential recruit to steer toward the columnist’s ideologically-driven goals. The question being asked by desperate advice seekers, after all, is not “What would you do?” but rather “What should I do?” If the columnist answers the question presuming that the advice-seeker does or should see the world as the advice columnist does, then doing harm is the likely result.

Carolyn Hax ( Washington Post) is a wonderful advice columnist, and Emily Yoffe (“Dear Prudence”) is the other kind. Two recent responses by them illustrate the distinction between competent, skilled and ethical advice, and advice column malpractice. Continue reading

Comment of the Day: “An Unethical Website, Golden Rule Malpractice And The Worst Anti-Bullying Program Ever”

He chose his adversaries well.

He chose his adversaries well.

Debut commenter according2grayson submitted a heartfelt, extensive and thought-provoking reaction to the post about a Lincoln, Nebraska school’s  much-criticized anti-bullying advice and the website that spawned them. I’ll have some comments at the end; in the meantime, here is the Comment of the Day on the post, An Unethical Website, Golden Rule Malpractice And The Worst Anti-Bullying Program Ever:

The rule is “Do not attack” immediately “If I attack you.” You’re being asked to place yourself in the shoes of an attacker. NO ONE attacks without feeling angry, hurt, or victimized. Why do homophobes beat up gay kids? Fear that they might be gay too, or offense at people mocking their God. Fear of what’s different. No, fear isn’t always a rational response to something that might put us on a breathing tube. The word “phobia” by it’s definition means “irrational,” and this pertains to everything from Xenophobia to Homophobia to Genderphobia to Arachnophobia. I guarantee that a garden spider isn’t going to put anyone on a breathing tube, but how many people shriek when they see him anyway?

Now here’s the issue– if you lash out irrationally because you’re afraid of someone, and you punch them in the face– that person now has a very rational reason to punch you in the face. But, being an emotional creature and not understanding why your own initial attack was wrong, you’re not going to say “Well, I punched him…..” You’re going to say “Ow! My nose is bleeding, you little shit!”

 

Until someone does decide to turn the other cheek, it’s only going to keep going back and forth, if not escalating. That’s the entire purpose behind such things as the Golden Rule and Christ’s “Turn the Other Cheek” argument. Read Gandhi. Try to follow the rules of Satyagraha. These rules lead a nation to Freedom without bloodshed. No, it wasn’t a “perfect revolution.” Yes, there were years of hardship that followed. But if you want a perfectly demonized bully (aside from maybe Hitler) British Empire’s your best bet. And these tactics DID take them down.

You can argue that “kids aren’t ready for this.” But I’m sorry, I can only laugh at you for underestimating children. I was 12 years old when my older brother was killed in 9/11. I grew up involved in activism against the wars. I was shoved into lockers, thrown down stairs, beaten up, called a “terrorist” and a “traitor to my nation.” And that was just the latest permutation of bullying I had faced.

I was taught, however, that our duties were to “think globally, act locally” and “become the change we wished to see in the world.” I was told that I wanted to be a voice for a non-violent response to a terrible act– I HAD to learn to respond non-violently to children being children.
And you know what? It didn’t turn me submissive. It didn’t take away a single ounce of pride.

I knew that the assholes picking on me lacked fundamental understandings of most of the reasons -why- they claimed they were picking on me. I knew that if any of these rich kids with their Hallmark Card homes (and, yes, when you go to a private parochial school of 8 kids, you do pretty much know that) had stood so close to national tragedy as any of the family members I was working with– they wouldn’t have handled it. They already couldn’t handle adversity. The gay kids? The black kids? The poor kids? They beat them all up. If other people’s hardships were so terrifying, how would they react to their own?

I laughed at these kids. I went on to graduate third in my class, was the first accepted to college. By which point I’d already worked for 3-4 years with a twice Nobel Prize nominated organization. Already helped organize lobbying campaigns (including one to shut down GITMO with PT & Amnesty International, which Obama recalled the involved groups to respond to in his first press conference) I’d already been a founding member of the World Conference for Peace and shaken hands with one of the last of the habakusha, with a minister who trained under Desmond Tutu, with mothers from Israel and Palestine working side by side (minority though they’ll always be) to end conflict.

In college, when I came out as pansexual, no one batted an eye. Afterwards, when I lost weight and started performing with the NYC Rocky Horror Cast (to an audience of at least 200, weekly. Not factoring special performances at other venues and in NYC cultural events) started performing Off-Broadway, started working with NPR (where a workshop I head-lined along with a few other youths effects by 9/11 won 4 awards including Bronze for “Best Radio Doc of 2011″ from the Society of Professional Journalism) People FLOCKED. Not only was I a hot commodity professionally. But socially as well. I’ll refrain from speaking of my exploits, as this is a mature site– but, when my buddies and I play the “Cassanova” drinking game, I’m usually one of the first to lose, and I always do so in a single scene.

The only argument you can make against any of this is “your life’s not that great” and no, you’re right, it isn’t. I’ve faced many hardships including the death of my brother. Lost my job and apartment in a hurricane last year. But none of that had to do with my response to bullying. And while some of those events may have had me, at times, not in places where I was able to deal to the best of my ability it’s not MY ability in question

ANY child can learn to find personal pride in their own accomplishments, can learn not to take bullies seriously (BECAUSE THEY AREN’T) Can learn not to perpetuate cycles.

And in the end, years down the road, they’ll be getting Facebook requests from their former bullies with notes saying “I’m sorry.” It’s not delusion. I’ve lived it.

Continue reading

Advice Column Ethics: Amy Forgets The Duty To Butt Out

Get out

Newspaper advice column maven Amy Dickinson encountered one of those juicy letters that boosts readership but that should also set off ethics alarms. Her responsible, ethical course was to leave the situation alone. Unfortunately, she took the bait. How unfortunate, we will never know.

“Conflicted” (I have some better names for her ) wrote to “Ask Amy” because, she said, her conscience was bothering her, and no wonder. She had divorced her husband of five years two years ago. “We loved each other, but our marriage was deeply troubled,” she wrote, which is an understatement. He lied to her. He had “inappropriate relationships with other women.” He was profligate with money, and spent the couple into financial trouble. Worst of all, this: “…during a two-year period of our marriage and on five occasions, he was physically abusive. Not a slap or a shove, but full-out rage. I thought he would kill me.”

Naturally, she is still sleeping with him! “We see each other frequently and have a lively sexual relationship,” she says cheerily. The Ex assumed her old hubby had a social life outside of hooking up with his former wife/punching bag, and was fine with that, since the swinging Ex is also sleeping around: Hey, it’s the 21st Century! But now she has learned that he is in a serious relationship with another woman who does not know he never stopped making whoopee with “Conflicted.” They are talking about marriage and babies.

So now, she tells Amy, she is certain he will ruin this “lovely girl’s” life. She thinks she has an obligation to the innocent young thing to tell her about his spending problems and some other more recent details ( “he owes thousands of dollars on credits cards and has not filed his taxes in two years”) and, she says confidently, he “clearly” hasn’t told her about his spouse-bashing episodes, though  “Conflicted”  hasn’t asked him, and hasn’t talked to her. “What obligation do I have to share any of this information with her? I don’t know what to do,” she asks, plaintively.

Amy: This is the Amityville House talking to you now.

GET OUT!!!” Continue reading

Keeping Terrible Secrets

shhhhSomeday I should have an ethics quiz asking which advice columnist is more unethical, Chuck Klosterman, “The Ethicist,” or Emily Yoffe, Slate’s “Dear Prudence.” That horrible exercise is for another day, however. Right now, I am only considering Emily’s latest botch, in which she urged a mother with a guilty conscience to take her terrible secret to her grave.

The secret in question is that the woman asking Emily’s counsel conspired to get pregnant via her gullible, not-ready-to commit boyfriend, who thought she was using birth control. Now it’s 13 years later. She and the double-crossed father are  happily married to other people, in different states, though he “is involved” in his daughter’s life, whom he accepted as his own. Mom never told him what she had done, and he believes that his daughter was an accident, leading him to stay with the family for the child’s first three years.  “Prudence’s” questioner concludes,

“…I had decided that I would go to my grave never telling anyone what I had done. Recently, a friend became pregnant after a one-night stand. Everyone assumes that was an accident, but she confided in me that she had been seeking out sex with the purpose of getting pregnant. I was so relieved to meet someone else who planned an “accidental” pregnancy that it made me wonder if I should open up about my secret. But I’m afraid if I told Ben it might change the way he interacted with Holly. My questions are: Am I some kind of monster for getting pregnant on the sly? And should I come clean, and if so, who should know?”

What? The reply to this should take about 20 seconds of thought to answer:

  • You’re relieved that one of your friends is a lying, betraying fraud? Don’t turn your back on her; I’m warning you.
  • Of course you should tell “Ben,” since he’s the one whose life was turned upside down by your selfish perfidy and deception.
  • “It might change the way he interacted with Holly,” eh? You mean “he might not send quite so much money to you to take care of Holly,” don’t you? Too bad. This is your doing, your lie, and your fault. “I don’t like the potential consequences of telling the truth” is not a justification to keep lying.
  • Yes, indeed you are some kind of monster. What you did was despicable, cowardly, cruel and wrong. Ben might be a prince about it (“Ah, that’s all water under the bridge now! The important thing is that we have our beautiful little girl, and nothing else matters!”), or he might call his lawyer. That’s his choice, and he has an absolute right to have the facts to make it his choice.

Emily, however, reasons otherwise. Don’t tell him, she counsels…

  • “Your act doesn’t make you a monster…” Yes, it really does. Didn’t we establish this in “An Officer and a Gentleman”?
  • “…nor do I think there’s any benefit to enlightening everyone now.”  That’s Ben’s call. The Golden Rule says that he’d want to know that he was tricked, and has been living a lie for over a decade. I sure would. I like to know just how trustworthy the people I associate with really are.
  • “Both you and Ben rose to the occasion and neither of you would express regret that you’re parents to Holly.” Consequentialism! So what? What if she were a rebellious, hateful, crack-addicted thief? The fact that thing turned out all right doesn’t justify the lie or keeping it hidden now.
  • “…At this late date, however, your coming clean would only cast a shadow over your character.” A character that richly deserves such a shadow.
  • “You are deeply remorseful for what sounds like a singular act of substantial deceit.”  What difference does it make that it’s a single act? A single act is enough. And this wasn’t “deceit.” This was a lie.
  • “There’s nothing to be gained by telling your husband and making him uneasy about your essential honesty.” I’d say one’s husband has the right to know the character of who he’s married to. 
  • “You and your friend are also hardly the only women to deliberately get pregnant without letting the man in on your plan, as objectionable as that behavior is.” Oh, that’s terrific, Emily. The old “you’re not the first” rationalization, a particularly dumb variation on “everybody does it.” The conduct is horribly wrong, and the first person to do it is no worse than the 2,342nd.

Gee, I wonder what Chuck would say.

________________________________________

Facts: Slate

“The Ethicist” Gets Lost: Bad Advice, Worse Defense, In The Case Of The Self-Plagiarizing Student

Oh, Chuck, Chuck, Chuck...

Oh, Chuck, Chuck, Chuck…

Chuck Klosterman,The New York Times’ third “Ethicist,” ruffled ethics feathers last week when he decreed that submitting the same paper to multiple college courses was ethical. (You can read his advice to a guilty-feeling student here.) Essentially, his argument in the column came down to three rationalizations, The Compliance Dodge (No rules were broken!), the Trivial Trap (It’s no big deal, and nobody was hurt ) and my least favorite of all, The Comparative Virtue Excuse ( “You’re not betraying the public’s trust,” Klosterman says—in other words, “At least you didn’t kill someone.”),with nods to several more. On the first, which is a close relative of Marion Barry’s Excuse, so you know what I think of it, Klosterman essentially argues that following formal rules constitutes sufficient ethics, which is the hallmark of the unethical. On the second, he himself cheats: he says no one was harmed, yet he ignores the fact that the student intentionally kept the fact that he used one paper for two assignments from the professors involved. Why was that? The student didn’t tell the professors because he knew they wouldn’t approve. Thus the student withheld information that was material, that would have resulted in negative consequences, and that the professors making the assignment had a right to know. That’s a failure of candor and a breach of the duty of honesty in communications. That’s unethical. Continue reading

Comment of the Day: “‘The Ethicist’ and the Doctor”

"Your secret is safe with me, but I have to ask...what that stolen Renoir doing up there?"

“Your secret is safe with me, but I have to ask…what that stolen Renoir doing up there?”

Jeff Long scores his first Comment of the Day with a welcome excursion into the thickets of medical confidentiality. As I expected, many readers were troubled by my support of strict patient-doctor confidentiality as dictates by AMA medical standards. Jeff does an excellent job elaborating on why I (and the professions like law, medicine and the clergy) take the position they do. In professional relationships, trust is essential, and you can trust professions that approve of breaching confidentiality when a damaging secret is involved.

Here is Jeff’s comment, on the post “The Ethicist and the Doctor.”

“First, with regard to Matthew’s example of the cheating spouse who contracts an STD, I think it would probably be difficult to come up with a better example of “the system working as intended.” In the world where doctors respect confidentiality, at least one person gets treated. In the world where the doctor blabs to the world (or at least, to the spouse), there’s a good chance that nobody does. In fact, if the cheater forgoes treatment out of fear of exposure, s/he is putting the spouse at even GREATER risk than in the former scenario, since the STD goes untreated and has a larger window in which to infect the spouse. Certainly, the ideal world is the one where the cheater gets treated AND confesses to the spouse, but the onus for that lies with the cheater. It’s not the doctor’s place. Continue reading

“The Ethicist” and the Doctor

It's all Greek to "The Ethicist"!

It’s all Greek to “The Ethicist”!

The third New York Times writer to take over the mantle of “The Ethicist” column, Chuck Klosterman, may be the most reliable yet, but he ended up wandering into the ethical weeds in his recent advice to an ethically-perplexed doctor, and engaging in advice column malpractice.

A physician asked him what was his ethical course when a patient divulged to him that his persistent headaches may have arisen from the stress of keeping a secret: he was responsible for a crime that had been pinned on an innocent man. Before the consultation, the doctor had promised his patient that “whatever he told me would not leave the room.”  Now the physician was having second doubts, and wondered if he was right to keep the confidence to his patient at the expense of an innocent man’s freedom and reputation.

Klosterman’s answer:

“I would advise the following: Call the patient back into your office. Urge him to confess what happened to the authorities and tell him you will assist him in any way possible (helping him find a lawyer before going to the police, etc.). If he balks, you will have to go a step further; you will have to tell him that you were wrong to promise him confidentiality and that your desire for social justice is greater than your personal integrity as a professional confidant.”

First of all, I don’t understand why a doctor is asking this question to a newspaper ethicist unless he doesn’t like what professional and medical ethicists are telling him. Klosterman, in reaching his reasonable-sounding but flat-out wrong reply, simply discards the concept of professionalism, beginning with the Hippocratic Oath…. Continue reading

More Advice Column Incompetence: The Case of the Jealous Sister

"My wife is behaving irrationally. Is it me, or might she have a teeny problem of her own?"

Once again an advice columnist’s response has me considering whether there needs to be a standard of malpractice for the profession, especially when desperate, trusting people rely on them in times of crisis. I agree that anyone who is prepared to adopt the recommendations of a stranger that are based on a probably inadequate and incomplete description of a dilemma, especially when the columnist could well be a college intern, the janitor or a lunatic, is in desperate straits indeed.  Still,  if you are going to give advice, it had better meet some bare minimum of competence—even if you are just an intern.

A sad and remorseful man wrote “Annie,” the Boston Globe’s advice maven, about whether there was hope for his marriage, which recently and unexpectedly exploded. Continue reading

Ethics Malpractice from “Dear Margo”: The Tale of Witchy, Tubby and Sue

"Well sure---his inner qualities are much more important to me now that he's so hot!"

I read a lot of advice columns, which often involve ethical issues and very often expose the ethical incompetence of the supposed experts who write them. Some advice columnists are ethically spot-on with regularity, like The Washington Post’s Carolyn Hax. Some, like the past and present”Ethicists” of the New York Times, are off-base almost as often as they are on. Then there are the advice mavins like “Margo,” in the Boston Globe. I don’t know how such people get to be advice columnists, but I suspect it either involves picking names out of a hat or the exchange of sexual favors. [Full disclosure: I give out personal ethics advice myself over at AllExperts.com, when a legitimate questioner can find me—ethics isn’t listed as one of the site’s topics—and when the question isn’t a thinly veiled homework question, which it usually is.]

As an example of ethics malpractice, consider this question posed to Margo. “Sue” wrote that she had broken up with her ex-boyfriend over arguments about his weight and eating habits, which “grossed her out.” Eight months later, he’s fit and fabulous, and has a new girlfriend.  “I really would like him back because he’s hot and slim,” Sue writes, plaintively. “How can I step on his witchy new girlfriend so I can get him back?” Continue reading