As an example of a gross breach of medical ethics

Sometimes the revoltingness of the Official Opposition is surprising. Oh what am I talking about, it’s almost always surprising. But still, one contribution to the genre by “Skep tickle” is pretty damn amazing. PZ posted a screen grab, because the contribution is about him. Scroll down to the end of the post.

I’ve been pointed to the comment by Skep tickle, aka Eliza Sutton, MD, and I post it here as an example of a gross breach of medical ethics. She should be ashamed.

(click for larger image, if you can stomach it)

She’s suggesting he had a “disseminated gonococcal infection.” Tee hee.

Note that she’s diagnosing me with “septic arthritis” in the complete absence of any facts. If she had the information that my doctor had, she’d know that they tapped and cultured the synovial fluid, and found no sign of any infection at all. And then she leaps from her completely bogus diagnosis of an infection to suggest that it is a “disseminated gonococcal infection”, and then counts back from the incubation period to surmise, while denying that she was surmising, that I acquired it while associating with the Skepchicks!

To say I’m disgusted is an understatement. I think the UW hospital should know what one of their doctors does in her spare time, so I’m not going to shy away from mentioning her name.

Remember that time she came here to tell me I’m mentally ill? What a fine doctor.


  1. themann1086 says

    Who was it that diagnosed Terri schiavo via video from the floor of congress? I want to say bill frist. August company to be in right there…

  2. screechymonkey says

    Remember, folks, it’s not rape unless you have the entire thing on videotape (and maybe not even then), but speculative half-assed medical diagnoses by internet are A-OK!

  3. jenniferphillips says

    I am truly flabbergasted. I mean, I have zero expectations of decency from this contingent, but still–WHAT THE FUCK CAN SHE POSSIBLY BE THINKING. Using ones professional status to lend credence to libelous allegations like this is just beyond the pale. I don’t even know how to process the fact that I clearly have not underestimated members of the pit *enough*. Poor PZ. I’m so sorry for everyone who has to endure this cascade of abuse.

  4. quixote says

    Compare and contrast with the black doctor in the Midwest (St. Louis?) who was fired almost immediately for tweeting sympathetically about the demonstrations in Ferguson.

  5. leftwingfox says

    Congratulations Doc. You have the ethics and logical deduction skills of Bill Frist. Aren’t you proud?

  6. Al Dente says

    The official Slymepit explanation is that it’s a “joke.” The ‘pitter making this excuse has yet to explain how it’s funny.

  7. John Morales says

    I don’t see how medical ethics comes into it; more plain old ethics, for mine.

    Sure, it’s malicious innuendo — but it’s clearly made in a personal rather than a professional (i.e. medical) capacity.

  8. Funny Diva says

    Oh! Silly us, Ophelia!
    She was “off duty” and using a pseudonym, so, you know, we can’t expect her to actually apply her professional standards as an MD in any sort of consistent, let alone responsible, manner! Just because she knows better in her professional life doesn’t mean she has to know (let alone behave) better On Teh Internetz! It’s not real life, you know!

    (as far as I can tell, the Slymepitters know full well she’s a practicing “respected/important” MD”…that’s not a secret from them…one of her own “supporters” outed her in her professional capacity over a year ago. On this very blog, iirc!)

  9. Silentbob says

    From the screenshot dated July 16:

    – The incubation period [for disseminated gonococcal infection] (the time from exposure to 2-10 days [sic]

    In what could be a complete non sequitur or at least a coincidence, Skepchickon was held July 3-6. Not that I’m implying anything by that.

    Oh, no *nudge, nudge*! Not implying anything at all. Just thought I’d randomly mention it *wink, wink*.

    Jeez. No wonder it’s called the slimepit.

    … Meanwhile, Mick “even-handed” Nugent remains very, very concerned about PZ Myers irresponsible smears.

  10. Silentbob says

    And in my link @ 12, Mick helpfully suggests that if PZ knows of any rapists he should forthwith report them to the police, along with his accumulated evidence.

    As the kids would say, “The stupid! It burns!!!”.

  11. Kevin Kehres says

    It’s libel per se to accuse someone of having a venereal disease. This is as open-and-shut a case as you could possibly have. Actionable.

    Report her to the medical board.

  12. screechymonkey says

    Kevin Kehres @14:

    It’s libel per se to accuse someone of having a venereal disease. This is as open-and-shut a case as you could possibly have. Actionable.

    No, it’s really not.

    Look, what Skep Tickle did is gross and pathetic and not funny even if it was intended as a joke. It’s just plain shitty behavior. But that doesn’t make it legally actionable.

    Even if PZ were the type of person who was fond of bringing defamation lawsuits — and he’s stated repeatedly on his blog that he has no intention of doing so — it would be a dead loser. It’s only an “open-and-shut” case in the sense that it would lose on a motion to dismiss.

    Her post is speculative. It takes “known” facts that PZ blogged or tweeted, adds some references to medical texts, and then says well, hey, it could be this…..

    Even if she had come out and flatly said “PZ has an STD” — which she didn’t, and expressly denied saying — it wouldn’t necessarily be defamatory. There’s a well-established principle in defamation law that something that otherwise looks like an actionable factual assertion can be treated as mere opinion when it’s clear from the context that the author isn’t implying any factual knowledge and is just drawing a conclusion based on truthful premises.

    Report her to the medical board.

    For what, exactly? I’ve seen lots of people suggest this on Pharyngula, and everyone is just asserting that it’s an “obvious” breach of medical ethics. Which it could be — it’s not a subject I have any knowledge about — but I notice nobody is quoting from any relevant professional rules. If there is such a rule, I doubt its legal validity.

    So she used her medical knowledge to engage in some speculation about someone. So what? She has no doctor-patient relationship with him, she didn’t access or leak any confidential information. She didn’t issue a prescription or exercise any state-granted authority or power. She didn’t do anything that a non-doctor couldn’t have done with some futzing around on Wikipedia or WebMD. (And from what some are saying, her speculation was of about the same quality.)

    I’m not seeing how this is a breach of professional ethics. Doctors are allowed to be jerks without getting disciplined. Maybe there’s some special rule that doctors aren’t allowed to express opinions on medical matters of non-patients. That’s certainly not the case for lawyers, or else legal bloggers like Ken White at Popehat would be in a lot of trouble.

  13. Donnie says

    Per Adam Lee at Daylight Atheism quoting from Wikipedia, Skep Tickle with or without her MD made:
    “Allegations or imputations “of loathsome disease….”

    and continuing the ….

    “….(historically leprosy and sexually transmitted disease, now also including mental illness)


    “Allegations or imputations of “unchastity” (usually only in unmarried people and sometimes only in women)”

    Skep Tickle made three allegations and imputations about PZ (STD, unchastity), Ophelia (mental illness), and unnamed Skepchicks (STD, unchastity)

    All states except Arizona, Arkansas, Missouri, and Tennessee recognize that some categories of false statements are so innately harmful that they are considered to be defamatory per se. In the common law tradition, damages for such false statements are presumed and do not have to be proven.

    Statements are defamatory per se where they falsely impute to the plaintiff one or more of the following things:[2]

    Allegations or imputations “injurious to another in their trade, business, or profession”
    Allegations or imputations “of loathsome disease” (historically leprosy and sexually transmitted disease, now also including mental illness)
    Allegations or imputations of “unchastity” (usually only in unmarried people and sometimes only in women)
    Allegations or imputations of criminal activity (sometimes only crimes of moral turpitude)[12][13]

    The cites for the above are from:
    12] “Libel, and Slander Per Se”. Retrieved 2009-07-09.
    13] Larson, Aaron (August 2003). “Defamation, Libel and Slander Law”. ExpertLaw. Retrieved 2009-07-09.

  14. screechymonkey says


    It wasn’t an allegation. It was speculation.

    “Per se” libel doesn’t mean “yay, plaintiff wins automatically” as you seem to think. It only means that the plaintiff doesn’t have to prove one of the elements of the tort — damages — as part of his prima facie case, because harm is presumed. It doesn’t relieve a plaintiff of the burden of showing the other elements of the tort. Since my argument had nothing to do with the element of damages, your invocation of “per se” libel is a nonsequitur.

    Your post doesn’t address the fact/opinion distinction that I was making.
    “Joe has HIV” is defamatory (assuming Joe does not, in fact, have HIV)
    “Joe wrote in his memoir that he slept with a different partner every night. He probably has HIV by this point” is not.

    Need some cites? Here you go:

    When the defendant’s statements, read in context, are readily understood as conjecture, hypothesis, or speculation, this signals the reader that what is said is opinion, and not fact.
    Though some statements may be characterized as hypothesis or conjecture, they may yet be actionable if they imply that the speaker’s opinion is based on the speaker’s knowledge of facts that are not disclosed to the reader. Id. at 154, 603 N.Y.S.2d at 818, 623 N.E.2d at 1168 (citing Restatement (Second) of Torts § 566 (1977)). On the other hand, if a statement of opinion either discloses the facts on which it is based or does not imply the existence of undisclosed facts, the opinion is not actionable. Id. at 154, 603 N.Y.S.2d at 818, 623 N.E.2d at 1168.

    Levin v. McPhee, 119 F.3d 189, 197 (2nd Cir. 1997)

    (Note, by the way, that Levin involved speculation that the plaintiff was involved in a murder, which would be another type of “per se” defamation.)

    a proffered hypothesis that is offered after a full recitation of the facts on which it is based is readily understood by the audience as conjecture.

    Gross v. New York Times 623 N.E.2d 1163 (N.Y. Ct. App. 1993)

    And here’s a good explanation of the rule from Ken White at Popehat:

    Statements of opinion enjoy broad First Amendment protection. Now couching something as an opinion isn’t an automatic or complete defense — I might be sued for saying “In my opinion Joe Blow robbed a bank last week,” because that implies undisclosed facts that may be false. But my statement is protected by the First Amendment when I disclose the facts underlying it, or when those facts are generally known. So if Joe Blow is arrested for bank robbery and it’s on the front page of the paper, my statement “Joe Blow is a bank robber” is almost certainly protected opinion based on generally known facts. If I say “the newspaper says that Joe Blow was seen putting on a ski mask in the street, and bank tellers say someone with a ski mask robbed them, and I saw Joe Blow running down the street from the bank afterwards. Joe Blow is a bank robber,” I have disclosed the facts that form the basis for my opinion, making it protected (unless, for instance, I lie about seeing Joe Blow run down the street.) This doctrine protects the right to opine about news stories and court proceedings.

  15. leni says

    I don’t see the point of even arguing that it’s libel. PZ isn’t going to sue anyone, and in this case that’s a good thing.

    Not just because I don’t think people should be sued for being assholes with creepy internet handles*, but because it’s pretty clearly a speculative joke. A stupid one that took way more effort than the punchline warranted, but still pretty clearly a joke. Screechymonkey provided details, but even without that it seems pretty silly to suggest a lawsuit.

    *Skep Tickle? That might just be the skeeviest internet handle for a doctor I’ve ever seen in my life.

  16. says

    Clearly a joke?

    That’s not my idea of what a joke is. A bunch of people gathering together to share their hatred of a small group of other people is the wrong context for “jokes.” Those are at best a special subset of jokes – hate-“jokes” or some such.

  17. John Morales says

    It’s a deliberate malevolent smear.

    (The only sense in which it is jocular is that everyone knows it’s not a serious claim)

  18. ema says

    It’s not a joke. It’s a person known to be an MD engaging in conduct unbecoming. Not a breach of medical ethics (as far as HIPAA is concerned) but still unacceptable behavior*.

    * “Are you a patient of Dr. So&So’s? This is how your doctor jokes about strangers. With unfettered access to your medical records just imagine how much funnier she could get.”

  19. says

    It’s slightly tangential, but my initial reaction was surprise at this sort of callousness from a physician. She was informed that someone was in excruciating pain and hospitalized, and her first impulse was this sort of sneering speculation.

    As little patience as I have for Orac these days, I’ve always respected the fact that he shows compassion for sick people (and those with sick relatives) regardless of his opinions of them, even when they’re promoting quackery. That’s what I expect from a doctor. It’s shocking to see a physician this glib in the face of suffering.

  20. says

    Moreover, there’s a vast difference between an internet “diagnosis” – however (ir)responsible that might be in any given case – genuinely intended to help someone and a “diagnosis” meant to smear people.

  21. leni says

    That’s not my idea of what a joke is. A bunch of people gathering together to share their hatred of a small group of other people is the wrong context for “jokes.” Those are at best a special subset of jokes – hate-“jokes” or some such.


    But shitty, speculative jokes are not libel. And I was responding to the assertion that this was actionable libel as suggested by Donnie, not that it was good humor.

  22. says

    I just want to say (and I’m doubting my post will go through) – I’m tired of this crap between people who should be coming together on the same issues and problems. For the most part, I stopped reading things here on FreeThoughBlogs as well as the Slymepit and many other areas because everyone I *used* to admire has de-evolved into the very sort of people I took great pains to get away from (read theistic manics). I want so very much to like and enjoy reading the likes of you, PZ, and many more but I can’t any more. I want to cry when I read the kind of stuff you all put out now. You used to be people I admired and looked up to.

    Not so much any more.

  23. Jackie says

    How does that read as a joke to anyone? She’s suggesting he has VD. One of her friends believed her enough to repeat her speculation as serious. These are people who make ridiculous claims frequently, maliciously and in earnest.

    Even if it were a joke, doctors do not get to make “jokes” about people having VD. It is a violation of ethics.

  24. Anthony K says

    If it makes you feel better Renee, after having read through the link in your ‘nym, you’re not someone I’d ever have admired, nor are you working on the same issues as me.

    But go ahead and cry if that helps you cope with those mean ol’ SJWs.

  25. Anthony K says

    Note that Renee’s link lists the Slyme Pit under ‘Sites we love’. There’s a link to the ‘Glass Houses’ post, though nothing criticizing Skep Tickle.

    Her White Tears are all real though, I’m sure.

  26. carlie says

    Libel isn’t the only thing to consider. I’ll link to this comment by toska on the same subject. Here’s an excerpt:

    Look, here’s what the American Medical Association has to say about it. I’ll give you a hint; it says she’s responsible for what she posts online.
    physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate.
    To maintain appropriate professional boundaries physicians should consider separating personal and professional content online.
    Physicians must recognize that actions online and content posted may negatively affect their reputations among patients and colleagues, may have consequences for their medical careers (particularly for physicians-in-training and medical students), and can undermine public trust in the medical profession.

  27. leni says

    How does that read as a joke to anyone?

    For me it was the part where she said “Not that I’m implying anything by that.”

    The whole stupid thing was a set up for a crack at Skepchick with a bonus insult to PZ. The entire point of the comment was to imply something, so I read this statement as sarcasm.

    I could certainly be wrong, I have been many times before and will be many times again, but I have a hard time understanding how anyone could read that as an attempt at a serious medical diagnosis.

    I definitely agree about sleazy, mean, petty, and unethical, though. If she were my doctor I’d drop her in a minute and make a point of telling her employer exactly why. But she’s not my doctor (Thankfully. I spent some time in a different Seattle hospital and even being that close gave me the creeps.)

    Even if it were a joke, doctors do not get to make “jokes” about people having VD. It is a violation of ethics.

    Maybe, maybe not. I’m not really sure where you’re going with this.

  28. screechymonkey says


    Well, at least that’s an attempt to substantiate the “breach of medical ethics” claim, but it’s pretty weak.

    1. It comes from the American Medical Association. Which might sound impressive, but it’s a voluntary association — according to its own site, a majority of U.S. doctors aren’t even members. It has no authority to revoke anyone’s license or impose other professional discipline.

    2. The quoted material is from an ethics opinion, not a rule. (Again, the AMA isn’t really in a position to pass rules anyway, other than rules for its own members.)

    3. Even as an opinion, it’s pretty watered down. It basically says “yeah, you should bear in mind that what you say online may affect your reputation and could have consequences.” Which is either empty advice or circular: if you say something people don’t like, then they won’t like it, and they might not like you.


    I read the original comments as a joke, and the subsequent tweets along the lines of “gosh, I have a DUTY to try to HELP people” as disingenuous bullshit.

    Again — just because I don’t think it constitutes libel or grounds for professional discipline doesn’t mean I don’t think it’s shitty behavior.

  29. Silentbob says

    @ 28 Anthony K

    I had a look at the site linked by Renee’s handle. Currently featured on the front page is a post calling for signatures for an anti-Rebecca Watson petition. I also note, listed as one of their bloggers is the charming personality* known as Mykeru.

    Why can’t we all just get along?

    * read: “obsessive anti-feminist slimepit troll”

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