HIPAA Blog

More Bornstein: OK, let's not get out over our skis, particularly if we are medical ethicists!  Forbes quotes "Dr. Arthur Caplan, the founding director of the Division of Medical Ethics at the NYU Langone Medical Center in New York and one of the nation’s most prominent bioethicists." as saying Bornstein "absolutely should lose his license" for saying he's written a letter that he now says Trump dictated.

First of all, letting someone else do the initial draft is not unethical.  If the party requesting the letter wants it to say something specific, there's no harm (ethical, legal, or otherwise) letting them make those suggestions, even if it's providing the actual words.  Now, the doctor is morally, legally and ethically obligated at that point to closely review the wording and change anything that is not 100% in alignment with the doctor's own opinions.  He can't sign it sight unseen, he can't skim and sign, and he can't let anyone sign under his name (or stamp his signature for him); that would be at least unethical if not outright illegal.  But simply letting someone else draft the wording that you agree with 100% before you sign is just not problematic.

The doctor disclosing Trump's medical information is problematic: whether it's the Propecia leak, or the letter itself, it needs to have Trump's authorization (or be directed by Trump) before it can be released.  I would assume the letter was authorized or directed by Trump, but not the Propecia.  However, I can't make that determination without more facts, which I don't have.  Likewise, Dr. Caplan shouldn't be making such "absolute" judgments without all the fact.  In hindsight, I suspect he'd agree that he overstated the case, at least based on the facts he had in hand at the time.

Ultimately the problem is that where Trump in concerned, the press, the pundits, and the chattering classes, as well as many institutional leaders (such as prominent bioethicists), seem to have no problem abandoning all pretext of objectivity or sobriety.  Look, I get it that you think Trump is a clown and a buffoon (frankly, I couldn't agree more, and often speak -- and have spoken -- much more harshly of the man); personally, I don't like the man.  But I try not to let my personal feelings direct my professional interpretations, and the press (and Dr. Caplan) should try to do the same.

OK, I'm going off topic (if you're looking for HIPAA stuff, you can stop here):

"WANT MORE TRUMP?  THIS IS HOW YOU GET MORE TRUMP."

Trump is President.  Get over it.  Governing-wise, he's going to do some things that are good and some things that are bad (IMHO, tax cuts and Gorsuch fall into the former category, tariffs in the latter).  He's also going to say outrageous things just to get folks agitated and distracted -- it gins up his supporters as much as it infuriates his opponents.  Much of this will be outright lies, almost always about stupid and inconsequential things (such as how many people were at his inauguration, or whether he's the healthiest man ever to be President).  This is intentional.  Why?

Trump is President.  Think about it.  How did that happen?  How did he get that much support?  I would posit that a large portion of that support is not support of Trump, but an active and energized low-to-middle class cohort substantially energized by furious opposition to what they view as an arrogant ruling class of elites.  They believe that the elites hate them.  Why do they feel that way?  Largely by the unhinged reaction of this elite class to everything and anything Trump says or does, no matter how trivial.  Particularly when compared to the actions of others similarly situated (this entire Bornstein incident stems from the press' overreaction to Trump's braggadaccio about his health, while Hillary's health issues were not only not reported, but actively covered up by the mainstream press).  And even more particularly when the ultimate results end up substantially different from what actually happened ("thousands" didn't "die" from the tax cuts, in fact, people got more money and the economy improved; Trump's juvenile rhetoric didn't get us into a nuclear war with North Korea, in fact, the opposite has occurred).

Trumps antics, particularly his Twitter account, are distractions, and when Trump's opponents jump on them, it only helps Trump.  Trump's twitter is a laser pointer, and the press and pundits are a bunch of cats chasing around a red dot on the floor.

More importantly, the elites and the press have spent all the powder they should've been saving.  They've cried "wolf" (or perhaps "Michael Wolff") so many times, if and when Trump does something really outrageous, their reaction won't have any effect on the public who just might have otherwise turned against Trump. 

Now, personally, I greatly enjoy watching the press and the elites beclown themselves, so this entire post is an "argument against interest."  Jon Stewart, whoever replaced him, John Oliver, Seth Meyers, Steven Colbert, that Carrot-Top lookalike chick at the WHCD, all those people who "DESTROYED" Trump or Sarah Huckabee Sanders or whomever for stupid and trivial matters like how they look, all toil in totally un-self-aware service of the Trump 2020 campaign. 

Look, I thought the "my nuclear button is bigger" Tweetstorm was a stupid provocation of a reckless lunatic.  But I also recognize that it may well have worked.  Then again, I thought Reaganomics was "voodoo economics" and the Laffer curve was a joke.  I'm not always right, but I do try to learn from my mistakes and not double down on them. 

And look, I wish it weren't Trump.  I wish there were someone classy and erudite who was nominating Gorsuch and passing tax cuts.  I wish we didn't live in such boorish and stupid times.  But we do.  And unless a lot of other folks start figuring out WHY things are this way, we're just going to keep getting more of things this way.