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I really do not know what you are referring to here, Diane.

Are you actually familiar with the UK system, Diane? It is broken throughout by shortage of money, but the 2007 NICE guidelines say nothing about not having appointments. It seems entirely reasonable to say that if there is no reason to think a test will be of help it should not be paid for by a...

I am very familiar with the approach, Diane. A lot of UK advocates have been following this approach for a decade and more recently others in the US. But if the debate has no bearing on the right to have medical care why raise it and spend most of the paper on it? As far as I can see nobody in...

A bg problem with focusing on the dichotomy of mental and physical for ME is that the BPS enthusiasts have been extremely successful in persuading the media that all the complaints about PACE etc are simply because PWME do not like the idea of being put under mental illness. We have discussed...

I am not sure that helps. The distinction of interest, as indicated above, is not between one branch of medicine and another but between people who are practicing outside what ought to be the framework of any medical speciality and those within. The BPS approach to ME seems to me to be neither...

That I would entirely agree with, but it is not a matter of a distinction between psychiatry and internal medicine or between mental and physical health. Physicians are just as likely to use the 'biopsychosocial' term. Physicians and GPs regularly think problems are all in your head. What I...

Another quick point. Have you read the 2007 NICE guidelines, Diane? I don't have them to hand but I don't think there is any suggestion of denying medical care of the sort you are interested in. There is a recommendation to do certain tests and not others, which I see as about as well judged as...

OK, one more point. My reference to poor logic was along these lines, Diane ( @Diane O'Leary ) What I read was: It is unethical for NICE to follow the UK BPS consensus because it is not based on good evidence. Therefore, NICE should follow the US IOM consensus, despite it not being based on...

There is going to be a lot to discuss here and my contribution is going to be a bit piecemeal as I am trying to get from Switzerland to England today. Welcome to Diane to the discussion here. I was expecting to send some emails and maybe I will, but maybe we should just exchange ideas here in...

Not really. I sent a rude email to Diane and she has replied with great tolerance and hopefully we will have a constructive dialogue. The point is that having a silly belief about something is not mental illness. It is something 'mentally normal' people have all the time. Mental, or...

I agree with that, but it is pretty clear that the article is intending to give the impression that something else is being denied - some treatment where the evidence is not cast iron but suggestive. The problem is that that opens the door to all sorts of nonsense. And of course the BPS crowd...

Or maybe psychoneuroimmuno$$$$$$$babble

Many thanks for doing that. As an immunologist I fear I have to conclude this is drivel. (Maybe nobody is surprised.)

This strikes me as dishonest and probably against the law on informed consent. I don't think the UK BPS people have been foolish enough to make quite such unfounded claims in public.

Oh, really? How come nobody in ME research knows about this knowledge? From his comments it sounds as if he is providing people with fabrications. I think there is a serious issue of informed consent here if the information is bullshit.

No, I just think this is wrong. Evidence-based medicine, in its true wide-angled form, requires that you have sufficiently reliable evidence of benefit outweighing risk before you use a treatment. It is not some asymptotic goal, it is basic policy. There are no treatments for ME in this category...

I think the view she holds is very likely to hinder things, but I would agree that her article will probably make little difference. The view is likely to hinder because it is the basis of the idea that 'every patient responds to something different so we should have a range of treatments' -...

I see a big problem here. She is arguing for evidence-based guidelines but her argument is that treatment of PWME should not need to be evidence-based. Her heart seems to be in the right pace but her logic looks to be hopeless, with the result that this is only likely to hinder the process of...

She really doesn't get it poor dear, does she. It's a bit like the girl who went into a bar and ordered a Perrier and water.

No, it is another back-scratching club.