Scott Alexander (host, Astral Codex Ten)

You could get collateral history in quotes from friends and family.

Is Fido really a good boy?

Does your cousin seem happier when Fido is around?

At some point this becomes insane and humiliating.

Good luck figuring out which point that is.

Or you could do the ultra-responsible thing and deny the letter.

You could say, as your psychiatrist, I inherently have a conflict of interest.

I know you.

I like you.

I can't be objective in this determination.

Now your patient will hate you forever.

Every other doctor gives their patients emotional support animal letters.

The only other psychiatrist in town charges $500 per appointment and demands at least 10 appointments before they'll write an ESA letter.

They'll never be able to make it work.

They'll lose Fido.

They'll lose Fido and it will be your fault and they'll hate you forever and they'll never take any of the medication you recommend ever again even if they're suicidally depressed and you're the last psychiatrist in the world.

Or you could wash your hands of it.

You could say, I'm going to be ultra responsible and demand you see a third party.

But just between you and me, that third party could be, Pettable, get your ESA letter in 24 hours.

Link in post.