How positivism can get you killed

February 24, 2014 § 5 Comments

Better that patients should die than that medical science cop to ignorance:

The dangers of assigning a psychosomatic diagnosis are shown in a March 2013 article by Alice Philipson in the Telegraph of London. The title is: Professor Dies of Lung Cancer After Doctors Dismiss Illness as ‘Purely Psychological.’ If the DSM-5 SSD category is widely used in its present form, this patient fatality could be joined by many more. Rare disorders and chronic pain patients are already frequently dismissed or marginalized as “head cases.”  DSM-5 will only make this problem worse.

At least when the Aztecs sacrificed you to their gods you got to visit a nice ziggurat.  Modernity’s gods are so much more clinical.

§ 5 Responses to How positivism can get you killed

  • Martin T says:

    There’s a story floating on FB about a family who’s daughter was diagnosed with a rare disease then the Boston Hospital said it was psychosomatic, filed papers with the state, took the daughter and slapped a gag order on dad so he can’t complain publicly.

    I will say there is enormous pressure from my clients to diagnose “a” disease in their pets. Explaining that sometimes I am just treating the symptoms or only have a category of an idea of what is wrong is very difficult.

  • Zippy says:

    Martin T:
    For the most part I think doctors are just giving the people what they demand, under the theory that any answer is better than no answer at all. Unfortunately this is in a context where treatment based on a wrong guess can be much worse than doing nothing at all or doing some harmless crackpot thing.

    There are times that I think going to a veterinarian would be safer than seeing an MD, for all sorts of reasons. The “psychosomatic” catch-all and concomitant dangerous-drug pushing for any symptoms that lack an obvious explanation is just one reason.

  • Martin T says:

    Ah, well. The pressure on veterinarians to run needless tests and do unwarranted treatments and give unfounded diagnoses is perhaps even greater than for MD’s, for me to see a patient and send it home without something is the one unforgivable sin. Our saving grace is that our patients (small animal patients) only live 10-15 years on average so we have less chance to do harm.

  • shell says:

    Zippy,
    can you explain how you see this problem as related to positivism? I may misunderstand the term, because it appears to me that a dismissal of empirical evidence (patient’s symptoms) is contrary to positivism.

    These DSM categories harken back to Dark Ages of medicine (and not only) and are bound to elicit many deserved protests from different corners of society.

    The below is from the blog written by the professor who died of misdiagnosed lung cancer:

    ‘Dr Smirl [the prof] wrote: ‘I can’t prove it, and this is just my opinion, but I have no doubt in my own mind that my misdiagnosis was in large part due to the fact that I was a middle aged female and that my male doctors were preconceived towards a psychological rather than a physiological diagnosis.”‘

    You could post this particular story under “How sexism can get you killed,” since there are very good chances that her symptoms would have been taken seriously and investigated properly if she were a man. The story of her misdiagnosis is a classic, though perhaps more egregious and horrific than most, particularly in this day and age, version of the “It’s all in your head” standard dismissal directed at women who present legitimate medical and other complaints.

    My (unsolicited, but still) advice for anyone suffering from unexplainable symptoms would be:

    Do persist in finding their cause and do not settle for any variant of “It’s all in your head,” because it almost never is (contrary to the current DSM “wisdom”).

  • jf12 says:

    The flappy planes lack handcoats.
    http://www.xkcd.com/1322/

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