Wednesday, October 06, 2004

WebMD explores pro-anorexia websites...

...which are written by anorexics, for anorexics. Their goal is not recovery. They have tips for maintaining an eating disorder, and they denounce treatment. It is entirely possible that they are spreading the illness and providing an online "support system" for continuing life-threatening behaviors.

I was ready with a post, plus link to WebMD's article, when I ran across a statement: "Did you know that linking to our site, except for our home page, is illegal?" Yikes - I've already linked to one of their articles, about patients lying to the doctor. I had no idea that I needed to ask for permission. What to do?

I decided that I would like to be able to link to them in the future, and I would like to stay on their good side (even though they probably have no inkling about my use of their article). I removed the post with the illegal link, and sent them an e-mail, asking them for mercy. Then I filled out their online permission slip. Am I the only one on earth who does this? I did hear back from them via e-mail. They were extremely nice, and they are glad that I am trying to remedy the problem. But...I still don't have permission to link to specific articles from their "My WebMD News" site. I need to be more careful about my links.

Update: Thanks to the anonymous commenter, who says that courts have upheld the right to the kind of linking that I'd like to do. When I review the terms and conditions on the WebMD site, it seems that WebMD has a different take on this. Until I hear from them, I encourage people to link to their home page and read the article (it's easy to find, it's in the "WebMD News Center" part of the site.) How many diseases have their own online advocates that teach people how to be ill, and discourage treatment? The social pressures that affect eating disorders can now be magnified and extended online. There's a risk that, by pointing out these sites, I might be showing anorexics a way to stay sick. I hope that risk is outweighed by physicians' need to know about what patients are reading.


Anonymous Anonymous said...

Curiously, WebMD has another article on the subject of body fat: Can You Be Fat on the Inside? that talks about people who are dangerously obese in the absence of excess body weight, particularly women who are "less preoccupied with restraining or monitoring what foods they ate". I'm evil, but I just don't have the heart to post it to a pro-anorexia website.

On topic: The US courts have said that "deep linking" is OK, and besides it is trivial for a web server to reject direct links.

Apologies if this appears twice—Blogger is being naughty. Bad Blogger! No biscuit!

12:46 AM  
Blogger shrinkette said...

I would like to point out that the above link is directing traffic to the WebMD site, which has a copyright on that material. It must not be opened in a separate frame. Its use is governed by the Terms and Conditions that I have already agreed to uphold.

5:27 PM  
Anonymous Anonymous said...

This is an intersting phenomenon, similar to people who are grossly overweight, but want to be accepted, without reservations, as completely 'normal'. In both of these cases, people are re-orienting their 'self-images' to make it OK for them to continue whatever type of eating disorder they have. Further, they seem to be demanding increased accomodation from the remainder of society.

Now, I think this sort of behavior has always existed, but the advent of the Internet had made it clearly visible to all who are interested. The proper response to this is a complex matter: people are, after all, free to pursue a multitude of 'delusions' without offical interference [UFOs, astrology, telphone psychics, religion, 'wrestling is a sport', 'the Cubs will win the pennant', 'politicians I vote for are honest'] , so why not these as well?

The crux of the matter is where should we stand on the scale of responses from: "compel proper behavior through punishment" to "try to convince them to stop" to "live and let live [or die]" to "support and accommodate". All to often, it seems to hang on one extreme or the other.


5:41 PM  
Blogger Nick said...

Hello, Shrinkette

I look forward to your post on pro-anorexia websites. Some of the medical students were blogging about obesity and capacity rights back in May, when I brought up these websites (I was afraid to link to them!) I applied Appelbaum's 4 criteria for decision-making capacity in an attempt to see where anorexics get tripped up...

Anyway, there were no blogging psychiatrists on line back then, so I'd be curious to hear what you think of this post:

10:04 PM  
Blogger shrinkette said...

Thanks for all the comments. Oh Nick, what a task you have assigned me. Decision-making capacity is a huge issue in psychiatry. Fortunately, I have one of Applebaums' books here...I will try to address your question.

7:42 PM  

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