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The iatrogenic power of labeling MUS: A critical review and meta-analysis of “diagnosis threat” in mild head injury, 2020, Niesten et al
- Thread starter Dolphin
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Dolphin
Senior Member (Voting Rights)
To be exact, the quote I imagine you are thinking of was from the FINE Trial.
rvallee
Senior Member (Voting Rights)
The very premise of medical labels is narcissistic nonsense. Nobody wants a "label". No one ever. Not a thing. When sick people see a medical doctor, they expect the information given to them will be accurate. Because they're experts. And that's the expectation with expertise: they value accuracy backed by credible evidence. At least that's the idea.
If medical doctors randomly give "labels" they know to be BS it completely breaks the entire premise of having a system of expertise built on reliable scientific evidence. In the absence of an explanation, patients expect to be told that it is such and that there are people working on solving it. It may not pan out but that's life, no one has any expectation of perfection. Some may be satisfied with BS platitudes. Most aren't. The very premise that this is acceptable practice is egregious systemic failure, morally bankrupt and one of the biggest obstacles towards progress on chronic diseases.
If you, as a medical doctor, give out "labels" that you know to be BS to your patients I implore you to quit this profession immediately and think about what you've done. You have failed your patients, your training and especially you have failed yourself.
It reminds me of one of the bizarre framing from Wessely, the idea of doe-eyed patients expecting the strong doctor to give a rousingly convincing explanation and when faced with a negative response have to "save face", as if we saw doctors as magical people we have to please and receive their grace. This is incredibly delusional and a caricature of human behavior that frankly invalidates any claim to having expertise in human behavior in the first place.
Medical science ain't complete. Stop pretending this is true while knowing it obviously isn't. The only "secondary motives" at play here are lazy clinicians and dogmatic pseudoscientists. Stop projecting, especially when you make claims to understand human psychology then commit every damn logical fallacy and cognitive bias in the book, twice over.
If medical doctors randomly give "labels" they know to be BS it completely breaks the entire premise of having a system of expertise built on reliable scientific evidence. In the absence of an explanation, patients expect to be told that it is such and that there are people working on solving it. It may not pan out but that's life, no one has any expectation of perfection. Some may be satisfied with BS platitudes. Most aren't. The very premise that this is acceptable practice is egregious systemic failure, morally bankrupt and one of the biggest obstacles towards progress on chronic diseases.
If you, as a medical doctor, give out "labels" that you know to be BS to your patients I implore you to quit this profession immediately and think about what you've done. You have failed your patients, your training and especially you have failed yourself.
It reminds me of one of the bizarre framing from Wessely, the idea of doe-eyed patients expecting the strong doctor to give a rousingly convincing explanation and when faced with a negative response have to "save face", as if we saw doctors as magical people we have to please and receive their grace. This is incredibly delusional and a caricature of human behavior that frankly invalidates any claim to having expertise in human behavior in the first place.
Medical science ain't complete. Stop pretending this is true while knowing it obviously isn't. The only "secondary motives" at play here are lazy clinicians and dogmatic pseudoscientists. Stop projecting, especially when you make claims to understand human psychology then commit every damn logical fallacy and cognitive bias in the book, twice over.
spinoza577
Senior Member (Voting Rights)
The paper writes:
Sad when one already must write "writes" instead of "says".
"iatrogenic" means "generated by a medical practitioner", so that there can be an iatrogenic harm. Normal iatrogenic effects are commonly welcome, I guess.
Sad when one already must write "writes" instead of "says".
fine with me
Dolphin
Senior Member (Voting Rights)
Invisible Woman
Senior Member (Voting Rights)
This is like a flashback to the 90's for me.
The idea around then was that patients were seeking "validation" and that somehow labelling their condition gave them that validation & reinforced their belief that they were ill.
As @rvallee points out, who wants a label?
The problem is the "system" which has evolved via government, medicine, etc. requires these labels.
You start to need adjustments at work - your employer wants to know why and what the diagnosis / label is.
You apply for welfare & they want to know what your diagnosis / label is. In the UK they then tell you that the benefit is granted based on how your condition affects you rather than your diagnosis, but that label sure comes in handy when they want to discriminate against you, or the assessors can't be arsed to write the report and cut and paste from other people who happen to have the same "label".
You go to see another specialist & they'll ask what the diagnosis was, literally the label you were given.
If you disagree with this label, which isn't important until suddenly it is, they'll tell you it cannot be removed from your records. You're stuck with it, even if you're later diagnosed with something else. Yet, some of us here have found that a doctor can, when it suits, change that label without discussing it with you or asking permission.
As for secondary benefits.....
Frankly they can take their label and shove it.
The idea around then was that patients were seeking "validation" and that somehow labelling their condition gave them that validation & reinforced their belief that they were ill.
As @rvallee points out, who wants a label?
The problem is the "system" which has evolved via government, medicine, etc. requires these labels.
You start to need adjustments at work - your employer wants to know why and what the diagnosis / label is.
You apply for welfare & they want to know what your diagnosis / label is. In the UK they then tell you that the benefit is granted based on how your condition affects you rather than your diagnosis, but that label sure comes in handy when they want to discriminate against you, or the assessors can't be arsed to write the report and cut and paste from other people who happen to have the same "label".
You go to see another specialist & they'll ask what the diagnosis was, literally the label you were given.
If you disagree with this label, which isn't important until suddenly it is, they'll tell you it cannot be removed from your records. You're stuck with it, even if you're later diagnosed with something else. Yet, some of us here have found that a doctor can, when it suits, change that label without discussing it with you or asking permission.
As for secondary benefits.....
Frankly they can take their label and shove it.
Hoopoe
Senior Member (Voting Rights)
What about the harmful effects of people who write and believe in this stuff?
How about trying to estimate how much quackery is driven by guidelines that recommend downplaying, ignoring, psychosomatizing unexplained symptoms? With patients then having no choice but to try alternative medicine.
rvallee
Senior Member (Voting Rights)
Oh I did not realize this quote had made it into a paper. Whew, that looks very bad but somehow nothing matters. Amazing that it lead to the conclusion that the response should be to lie better. Really incredible lack of self-awareness. Ethics shmetics.
I guess it was decided not to bother with that.
Hindsight will be appropriately brutal to this barbaric nonsense.
What secondary benefits?
Is it the poverty? The lack of career, social interaction, relationships, achieving your life's goals? The truly shitty physical symptoms? The endless humiliation and degradation and terror (and that is the right word) that society seems almost eager to inflict upon us 'deviants'?
Where is the evidence for secondary benefits? Not working is not a benefit.
Is it the poverty? The lack of career, social interaction, relationships, achieving your life's goals? The truly shitty physical symptoms? The endless humiliation and degradation and terror (and that is the right word) that society seems almost eager to inflict upon us 'deviants'?
Where is the evidence for secondary benefits? Not working is not a benefit.
TiredSam
Committee Member
I am still working. It's just about all I'm doing. My secondary benefits are no sport, music, socialising ...
Surely if I was enjoying the sickness role too much I'd be doing things the other way round?
Invisible Woman
Senior Member (Voting Rights)
Yep. I think many of us, when we first became ill did exactly that. I know I did. Everything else went out the window as I tried to cling on to the ability to work.
One of the things the coronavirus pandemic has demonstrated is that life without going to work, the uncertainty of when normal life will resume etc, far outweighs the benefits of having duvet days. Even for those who have the capacity to keep themselves entertained with books and tv and internet games etc are climbing the walls. They're just mostly imprisoned in their house. We're mostly imprisoned in our bodies, so although the distractions are there we're usually not well enough to enjoy them.
The secondary benefits do not exist. There are only secondary losses.