Health Stack Exchange has rules that violate the general rules [closed]

Question

I have been banned for a week there, because some of my answers there violated rules that nowhere else on Stack Exchange are imposed.

The problem is the demand that everything be backed up by peer reviewed articles, even though this site's policy allows answers based on personal experience. Of course, you don't want people to give an answer that is incompatible with what has been scientifically established, but what I've stumbled on has nothing to do with such a problem. Also, it should be clear that no medical advice should be given, questions of that sort will be closed. But you can still answer such questions by addressing some relevant aspects appropriately.

We don't have this demand from hard core scientific topics like physics where I'v made the most contributions, so I wonder how on Earth you could have such a policy for a topic like health where the peer reviewed literature does not cover a lot of what many people want to know or what would be helpful in an adequate way.

E.g. this answer by me addressed a relevant issue with someone experiencing back pain. It was also a request for medical advice, so the question had to be closed by the Mods until that time the OP can reword the question. However, the answer by me that the OP accepted turned out to be very relevant, as the OP wrote in the comments that he wasn't doing any core exercises. My original answer did not mention other aspects relevant to weight lifting, as JohnP wrote in the comments, but I corrected my answer to also include a suggestion about that.

But then the notice

Some of the information contained in this post requires additional references. Please edit to add citations to reliable sources that support the assertions made here. Unsourced material may be disputed or deleted.

is just ridiculous. First, Stack Exchange site policy allows for answers based on personal experience, you don't always need to back up each and every detail using references. Also, it's not really helpful to tag answers without specifically discussing what should be referenced and why.

A big problem with a subject like health is that the peer reviewed literature does not adequately cover the entire subject, many people will ask questions where the peer reviewed literature does not have good answers on. E.g. in case of back pain, if you would base things on secondary review articles you can't recommend core exercises specifically, as no difference is seen between that and general fitness exercises in studies that have examined the results published in primary research articles. But for weight lifting the situation is not clear, if one only looks in the peer reviewed literature.

However, there is of course a great deal of experience in the field and most people who do serious weight lifting also do core exercises. This knowledge then counts for nothing just because the medical professionals have yet to do rigorous studies. The question one should then ask is why, against this site's policy, one cannot give that information here when it is not contested. Obviously, if people were to disagree and say that actually core exercises are bad for your back, on can have a discussion about that.

This is a more serious problem. The OP should obviously have gone to the doctor a long time ago, the question was closed as it should have been. But my answer which was accepted by the OP, simply addresses how to prepare for the appointment with the doctor considering that the problems have been festering for too long. I'm not familiar with any appropriate articles one could cite here, nor do I think it's necessary to give such references in this case. Now the Mod who tagged this and other answer also downvoted all the tagged answers. So, I don't think we're dealing with objective moderating here.

Final example. Here we can see quite well that sticking to what the Mods calls "good references" leads to problems. Two answers are given, one very strictly based on peer reviewed sources, the other one by me based more on the personal experiences that many in the general public will have. The first answer, while technically correct is not all that useful in practice, if you actually take your time to read the articles to find out how big the effect of e.g. frequent hand washing is in practice, you'll find that it has a marginal effect. While significant and one of the few rigorously proven ways to prevent the common cold it isn't actually going to help the OP deal with his problem.

My answer, while inferior from a rigorous scientific point of view (and I do mention in my answer that "although the rigorous proof that it does anything at all is still lacking...") received 5 downvotes and the tag for more references. The discussion shows that the Mod will only be satisfied with a ref that contains the rigorous proof. Another problem with my answer mentioned by another commenter was corrected later by me.

Answer 1

I'm not familiar with Health's specific policy, so I won't weigh in on that. However, I will comment on a few things from a broad, network-wide perspective:

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some of my answers there violated rules that nowhere else on StackExchange are imposed.

So? What does it matter that they're only imposed on one site? That site's community decided that it wanted those rules, and communities are largely free to make whatever rules they want.

We don't have this demand from hard core scientific topics like physics where I'v made the most contributions

Physics is also largely not life-or-death. It's a completely different kind of site.

But then the notice

Some of the information contained in this post requires additional references. Please edit to add citations to reliable sources that support the assertions made here. Unsourced material may be disputed or deleted.

is just ridiculous. First, StackExchange site policy allows for answers based on personal experience,

... except on Health, or on any site that decides it doesn't want answers based on personal experience. Sites are free to make that determination.

There is very, very little override "site policy" that applies equally to all sites. Individual sites, ultimately, can change almost anything they want. You have to respect the rules of the place you decide to participate in.

Just because two sandboxes both have sand in them doesn't mean the rules have to be the same.

Answer 2

Health.SE is a controversial site, no doubt about it. In many ways, it doesn't fit the general SE model of upvotes and downvotes determining the best answer, because many people visiting the site are not health professionals who are 1) very familiar with prevailing medical opinion, or 2) know enough of the background to evaluate the medical literature.

As such, an answer is more apt to get upvotes based on whether it resonates with a user's biases than that it is medically/scientifically correct. Visitors familiar with the SE model might see an upvoted - but completely incorrect - answer as representing accepted medical practice.

Since one's health is possibly at stake, judging a good answer by the number of upvotes alone is not a desirable situation.

Because of that, it was decided early on that the best chance that Health.SE establishes itself as a helpful site (as opposed to popular) was that answers have reputable sources. We've tried to make that easy by listing such sources.

Our model is very similar in this respect to that of Skeptics.

Of course, you don't want people to give an answer that is incompatible with what has been scientifically established, but what I've stumbled on has nothing to do with such a problem.

The first part of that quote is very important; the second is not exactly true. You have received numerous comments asking you to back up your answers. Not only have you largely ignored these requests, but you have given medical advice without backing up your answers.

Most SE sites won't touch medical questions for precisely this reason.

A big problem with a subject like health is that the peer reviewed literature does not adequately cover the entire subject, many people will ask questions where the peer reviewed literature does not have good answers on.

That assumption is incorrect. There is a huge body of reputable literature covering almost every aspect of human health. The Journal of Orthopaedic & Sports Physical Therapy covers many aspects of back pain, as does the Journal of Back and Musculoskeletal Rehabilitation and others too numerous to list. Some of the information is behind a paywall, but we allow answers based on abstracts alone.

Please note that you are still free to answer any question you please, as long as you have a source. If it's not a reputable source, or if the source material has been misinterpreted, it will be commented upon and may be down voted. With downvotes, it may be deleted by the community when enough members have sufficient rep. I have deleted less than a handful of posts as a moderator, preferring to vote/comment and let the community decide on the rest.

Answer 3

I think you might have a bit of a misunderstanding about how Stack Exchange policy and site policy work.

You can think of Stack Exchange as providing some default policies or guidelines that will tend to be a good idea for most sites. However, sites are generally free to define their own policies if the community decides to do so. Thus, sites can establish their own policies that override, modify, or tweak the default policies. There is nothing inappropriate about Health.SE setting their own policies that impose extra requirements (e.g., requirements for references to back up certain statements). If you think about it, this makes sense: each community is different, and there needs to be some flexibility for individual communities to make things work well for their particular topic area.

So, yes, you will find that policies do vary somewhat from site to site. Some SE sites have special policies or rules that might deviate significantly from what you're used to on other SE sites. So, it's important to read the help center, listen to feedback you get from other members of the community, and check out the site's meta in case of doubt.

I realize this might not be entirely obvious, so it's understandable that you were taken by surprise by this -- but that's how things work on Stack Exchange. Now you know.