{"id":36,"date":"2022-09-16T19:25:03","date_gmt":"2022-09-16T19:25:03","guid":{"rendered":"https:\/\/pressbooks.palni.org\/prindlepost\/?post_type=chapter&p=36"},"modified":"2022-11-02T16:55:54","modified_gmt":"2022-11-02T16:55:54","slug":"informed-consent-and-the-joe-rogan-experience","status":"publish","type":"chapter","link":"https:\/\/pressbooks.palni.org\/prindlepost\/chapter\/informed-consent-and-the-joe-rogan-experience\/","title":{"raw":"Informed Consent and the Joe Rogan Experience","rendered":"Informed Consent and the Joe Rogan Experience"},"content":{"raw":"
\r\n
\r\n

Can providing too much information undermine a doctor\u2019s duty to let patients\u2019 choose?<\/p>\r\n\r\n<\/header>\r\n

\r\n
\r\n
Before reading: Should doctors be allowed to make choices about what information is most relevant and what information might be best left out or should they be required to deliver all information without guiding patients\u2019 decision-making? Draw and label the scale below in your notes. Place yourself more toward the left side of the scale if you think doctors need to help patients reason through their options. Place yourself more toward the right side of the scale if you think doctors should only relay facts and leave everything else up to patients.<\/h5>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n\"\"\r\n\r\n<\/header><\/div>\r\nThe Joe Rogan Experience (JRE) podcast was again the subject of controversy<\/a> when a recent episode was criticized by scientific experts for spreading misinformation about COVID-19 vaccinations. It was not the first time this has happened: Rogan has frequently been on the hot seat<\/a> for espousing views on COVID-19 that contradict the advice of scientific experts, and for entertaining guests who provided similar views. The most recent incident involved Dr. Robert Malone, who relied on his medical credentials to make views that have been widely rejected seem more reliable. Malone has himself recently been at the center of a few controversies: he was recently kicked off of YouTube and Twitter<\/a> for violating their respective policies regarding the spread of misinformation, and his appearance on the JRE podcast has prompted some to call for Spotify (where the podcast is hosted) to employ a more rigorous misinformation policy.\r\n\r\nWhile Malone made many dubious claims during his talk with Rogan \u2013 including that the public has been \u201chypnotized,\u201d and that policies that have been enforced by governments are comparable to policies enforced during the Holocaust \u2013 there was a specific, ethical argument that perhaps passed under the radar. Malone made the case that it was, in fact, the moral duty of himself (and presumably other doctors and healthcare workers) to tell those considering the COVID-19 vaccine about a wide range of potential detrimental effects. For instance, in the podcast he stated:\r\n\r\nSo, you know my position all the way through this comes off of the platform of bioethics and the importance of informed consent, so my position is that people should have the freedom of choice particularly for their children\u2026 so I\u2019ve tried really hard to make sure that people have access to the information about those risks and potential benefits, the true unfiltered academic papers and raw data, etc., \u2026 People like me that do clinical research for a living, we get drummed into our head bioethics on a regular basis, it\u2019s obligatory training, and we have to be retrained all the time\u2026 because there\u2019s a long history of physicians doing bad stuff.\r\n\r\nHere, then, is an argument that someone like Malone may be making, and that you\u2019ve potentially heard at some point over the past two years: Doctors and healthcare workers have a moral obligation to provide patients who are receiving any kind of healthcare with adequate information in order for them to make an informed decision. Failing to provide the full extent of information about possible side-effects of the COVID-19 vaccine represents a failure to provide the full extent of information needed for patients to make informed decisions. It is therefore morally impermissible to refrain from informing patients about the full extent of possible consequences of receiving the COVID-19 vaccine.\r\n\r\nIs this a good argument? Let\u2019s think about how it might work.\r\n\r\nThe first thing to consider is the notion of informed consent<\/a>. The general idea is that providing patients with adequate information is required for them to have agency in their decisions: patients should understand the nature of a procedure and its potential risks so that the decision they make really is their decision. Withholding relevant information would thus constitute a failure to respect the agency of the patient.\r\n\r\nThe extent and nature of information that patients need to be informed of, however, is open for debate. Of course, there\u2019s no obligation for doctors and healthcare workers to provide false or misleading information to patients: being adequately informed means receiving the best possible information at the doctor\u2019s disposal. Many of the worries surrounding the advice given by Malone, and others like him, pertain to just this worry: the concerns that they have are overblown, or have been debunked, or are generally not accepted by the scientific community, and thus there is no obligation to provide information that falls under those categories to patients.\r\n\r\nRegardless, one might still think that in order to have fully informed consent, one should be presented with the widest range of possible information, after which the patient can make up their own mind. Of course, Malone\u2019s thinking is much closer to the realm of the conspiratorial \u2013 for example, he stated during his interview with Rogan that scientists manipulate data in order to appease drug companies, as well as his aforementioned claims to mass hypnosis. Even so, if these views are genuinely held by a healthcare practitioner, should they present them to their patients?\r\n\r\nWhile informed consent is important, there is also debate about how fully informed, exactly, one ought to be, or can be. For instance, while an ideal situation would be one in which patients had a complete, comprehensive understanding of the nature of a relevant procedure, treatment, etc., there is reason to think that many patients fail to achieve that degree of understanding even after being informed. This isn\u2019t really surprising: most patients aren\u2019t doctors, and so will be at a disadvantage when it comes to having a complete medical understanding, especially if the issue is complex. A consequence, then, may be that patients who are not experts could end up in a worse position when it comes to understanding the nature of a medical procedure when presented with too much information, or else information that could lead them astray.\r\n\r\nMalone\u2019s charge that doctors are failing to adhere to their moral duties by not fully informing patients of a full range of all possible consequences of the COVID-19 vaccination therefore seems misplaced. While people may disagree about what constitutes relevant information, a failure to disclose all possible information is not a violation of a patient\u2019s right to be informed.\r\n
\r\n
Respond to the following questions in your notes and through classroom discussion.<\/h5>\r\n
    \r\n \t
  1. How should we describe the role nurses and doctors play in assisting patients with medical decision-making? What does providing too little information look like? Is there a similar problem of providing too much information? If it does exist, can you describe what it might look like?<\/li>\r\n \t
  2. Surely different patients will require different kinds of assistance in order to understand the relevant medical facts and make an informed choice. Some patients might not need a lot of help to get to this point, but some might require a great deal more. If we start punishing doctors for providing too much information, won\u2019t we be discouraging them from assisting those who most need assistance?<\/li>\r\n \t
  3. Should we hold the Joe Rogan Experience podcast responsible for what Dr. Robert Malone said? Why not think that it\u2019s the responsibility of podcast listeners to decide for themselves whether the views they hear are accurate or valuable?<\/li>\r\n<\/ol>\r\n<\/div>\r\n ","rendered":"
    \n
    \n
    <\/div>\n<\/header>\n
    \n

    Can providing too much information undermine a doctor\u2019s duty to let patients\u2019 choose?<\/p>\n<\/header>\n

    \n
    \n
    Before reading: Should doctors be allowed to make choices about what information is most relevant and what information might be best left out or should they be required to deliver all information without guiding patients\u2019 decision-making? Draw and label the scale below in your notes. Place yourself more toward the left side of the scale if you think doctors need to help patients reason through their options. Place yourself more toward the right side of the scale if you think doctors should only relay facts and leave everything else up to patients.<\/h5>\n<\/div>\n<\/div>\n<\/div>\n
    \"\"<\/div>\n

    The Joe Rogan Experience (JRE) podcast was again the subject of controversy<\/a> when a recent episode was criticized by scientific experts for spreading misinformation about COVID-19 vaccinations. It was not the first time this has happened: Rogan has frequently been on the hot seat<\/a> for espousing views on COVID-19 that contradict the advice of scientific experts, and for entertaining guests who provided similar views. The most recent incident involved Dr. Robert Malone, who relied on his medical credentials to make views that have been widely rejected seem more reliable. Malone has himself recently been at the center of a few controversies: he was recently kicked off of YouTube and Twitter<\/a> for violating their respective policies regarding the spread of misinformation, and his appearance on the JRE podcast has prompted some to call for Spotify (where the podcast is hosted) to employ a more rigorous misinformation policy.<\/p>\n

    While Malone made many dubious claims during his talk with Rogan \u2013 including that the public has been \u201chypnotized,\u201d and that policies that have been enforced by governments are comparable to policies enforced during the Holocaust \u2013 there was a specific, ethical argument that perhaps passed under the radar. Malone made the case that it was, in fact, the moral duty of himself (and presumably other doctors and healthcare workers) to tell those considering the COVID-19 vaccine about a wide range of potential detrimental effects. For instance, in the podcast he stated:<\/p>\n

    So, you know my position all the way through this comes off of the platform of bioethics and the importance of informed consent, so my position is that people should have the freedom of choice particularly for their children\u2026 so I\u2019ve tried really hard to make sure that people have access to the information about those risks and potential benefits, the true unfiltered academic papers and raw data, etc., \u2026 People like me that do clinical research for a living, we get drummed into our head bioethics on a regular basis, it\u2019s obligatory training, and we have to be retrained all the time\u2026 because there\u2019s a long history of physicians doing bad stuff.<\/p>\n

    Here, then, is an argument that someone like Malone may be making, and that you\u2019ve potentially heard at some point over the past two years: Doctors and healthcare workers have a moral obligation to provide patients who are receiving any kind of healthcare with adequate information in order for them to make an informed decision. Failing to provide the full extent of information about possible side-effects of the COVID-19 vaccine represents a failure to provide the full extent of information needed for patients to make informed decisions. It is therefore morally impermissible to refrain from informing patients about the full extent of possible consequences of receiving the COVID-19 vaccine.<\/p>\n

    Is this a good argument? Let\u2019s think about how it might work.<\/p>\n

    The first thing to consider is the notion of informed consent<\/a>. The general idea is that providing patients with adequate information is required for them to have agency in their decisions: patients should understand the nature of a procedure and its potential risks so that the decision they make really is their decision. Withholding relevant information would thus constitute a failure to respect the agency of the patient.<\/p>\n

    The extent and nature of information that patients need to be informed of, however, is open for debate. Of course, there\u2019s no obligation for doctors and healthcare workers to provide false or misleading information to patients: being adequately informed means receiving the best possible information at the doctor\u2019s disposal. Many of the worries surrounding the advice given by Malone, and others like him, pertain to just this worry: the concerns that they have are overblown, or have been debunked, or are generally not accepted by the scientific community, and thus there is no obligation to provide information that falls under those categories to patients.<\/p>\n

    Regardless, one might still think that in order to have fully informed consent, one should be presented with the widest range of possible information, after which the patient can make up their own mind. Of course, Malone\u2019s thinking is much closer to the realm of the conspiratorial \u2013 for example, he stated during his interview with Rogan that scientists manipulate data in order to appease drug companies, as well as his aforementioned claims to mass hypnosis. Even so, if these views are genuinely held by a healthcare practitioner, should they present them to their patients?<\/p>\n

    While informed consent is important, there is also debate about how fully informed, exactly, one ought to be, or can be. For instance, while an ideal situation would be one in which patients had a complete, comprehensive understanding of the nature of a relevant procedure, treatment, etc., there is reason to think that many patients fail to achieve that degree of understanding even after being informed. This isn\u2019t really surprising: most patients aren\u2019t doctors, and so will be at a disadvantage when it comes to having a complete medical understanding, especially if the issue is complex. A consequence, then, may be that patients who are not experts could end up in a worse position when it comes to understanding the nature of a medical procedure when presented with too much information, or else information that could lead them astray.<\/p>\n

    Malone\u2019s charge that doctors are failing to adhere to their moral duties by not fully informing patients of a full range of all possible consequences of the COVID-19 vaccination therefore seems misplaced. While people may disagree about what constitutes relevant information, a failure to disclose all possible information is not a violation of a patient\u2019s right to be informed.<\/p>\n

    \n
    Respond to the following questions in your notes and through classroom discussion.<\/h5>\n
      \n
    1. How should we describe the role nurses and doctors play in assisting patients with medical decision-making? What does providing too little information look like? Is there a similar problem of providing too much information? If it does exist, can you describe what it might look like?<\/li>\n
    2. Surely different patients will require different kinds of assistance in order to understand the relevant medical facts and make an informed choice. Some patients might not need a lot of help to get to this point, but some might require a great deal more. If we start punishing doctors for providing too much information, won\u2019t we be discouraging them from assisting those who most need assistance?<\/li>\n
    3. Should we hold the Joe Rogan Experience podcast responsible for what Dr. Robert Malone said? Why not think that it\u2019s the responsibility of podcast listeners to decide for themselves whether the views they hear are accurate or valuable?<\/li>\n<\/ol>\n<\/div>\n

       <\/p>\n","protected":false},"author":28,"menu_order":3,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["kenboyd"],"pb_section_license":""},"chapter-type":[],"contributor":[67],"license":[],"part":3,"_links":{"self":[{"href":"https:\/\/pressbooks.palni.org\/prindlepost\/wp-json\/pressbooks\/v2\/chapters\/36"}],"collection":[{"href":"https:\/\/pressbooks.palni.org\/prindlepost\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.palni.org\/prindlepost\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.palni.org\/prindlepost\/wp-json\/wp\/v2\/users\/28"}],"version-history":[{"count":4,"href":"https:\/\/pressbooks.palni.org\/prindlepost\/wp-json\/pressbooks\/v2\/chapters\/36\/revisions"}],"predecessor-version":[{"id":67,"href":"https:\/\/pressbooks.palni.org\/prindlepost\/wp-json\/pressbooks\/v2\/chapters\/36\/revisions\/67"}],"part":[{"href":"https:\/\/pressbooks.palni.org\/prindlepost\/wp-json\/pressbooks\/v2\/parts\/3"}],"metadata":[{"href":"https:\/\/pressbooks.palni.org\/prindlepost\/wp-json\/pressbooks\/v2\/chapters\/36\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.palni.org\/prindlepost\/wp-json\/wp\/v2\/media?parent=36"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.palni.org\/prindlepost\/wp-json\/pressbooks\/v2\/chapter-type?post=36"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.palni.org\/prindlepost\/wp-json\/wp\/v2\/contributor?post=36"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.palni.org\/prindlepost\/wp-json\/wp\/v2\/license?post=36"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}