Thanks for the insightful comment. I think you’ve summed up my experience working in psych as well. Because it would be totally wrong to assume patients are lying from the get-go, the provider simply has to do the best they can, providing informed consent and prompting self-reflection where possible, and allow the patient to assume some responsibility for giving the information they give and requesting the treatment they do. There are of course some conditions, such as munchausen’s, in which self-report of symptoms is intentionally deceptive, and in my experience the medical system is still pretty unprepared to detect and diagnose these types of issues, and it was around these types of problems that I designed the thought experiment. I really don’t have a specific clinical course I’m arguing for, because I think we simply need to learn more about the mind before our diagnostic tools will improve to a significant degree.