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  May 21, 2012                  

me: ME + DSM-5

"If we believe absurdities,         
  we shall commit atrocities."    

I am around but not very well because I didnīt sleep well for several nights. I donīt quite know why, apart from the fact that lack of sleep is a well-known vicious circle for me. Also, I am still in between 2 computers and 3 OSs and Windows 7 is being troublesome, and again I donīt quite know why.

Anyway... that was the part about ME. Iīve said I would return to the DSM-5 and specifically to discussing

So I am returning to this, that already is over a week old, and to which there were several reactions and comments, of which I will name and link three:

First, there was a reaction to Dr Frances' article, linked above (and commented by me), by Ed Silverman on Pharmalot.com:

       Should A Federal Agency Oversee The DSM?

This was published on May 15, and the question also was made into a poll, in which the answers today are: 63% yes and 35% no, with 128 votes, which suggests 2 to 1 against.

Specifically - and I quote:

(..) Frances proposes that a federal agency ought to assume the job of developing
the DSM, although he believes a new organization would be required, one that could
be housed in the US Department of Health and Human Services, if not the Institute
of Medicine or the World Health Organization. An equivalent of the FDA is needed to
“mind the store,” as he puts it.

This may raise a different set of objections, of course. To what extent, for instance,
should a federal agency delve deeply into determining diagnoses and definitions? On
the other hand, perhaps this would remove the concerns over self-interest and conflict
that have tainted the process. What do you think?

After which followed the question in the last link thatīs also the title of the article, while there are also 15 comments, of which the first two are respectively by Dr Carroll and by 1 Boring Old Man.

These are the other two reactions I had in mind that I wanted to comment on. Their main points, in my brief summaries, come respectively to this:

        • donīt hand it to the government
        • the APA is corrupt (rotten and shilling for pharma)

I agree with both, that is, I think it is, in moral, medical, legal and scientific principle generally a bad idea to hand the practice of medicine to the government, and that includes overseeing medical diagnostic manuals such as the DSM, if indeed these are real science and have been written in a rational, open and honest way - as is not the case with the DSM-5.

I italized ĻprincipleĻ because I agree with it, while also thinking that, as posed, the question misses the real point, which comes to this, also in principle, and indeed in that sense regardless of my relative ignorance of US law, since in principle the same applies in general, also in other countries:

        • There seems to be a real demand and place for some sort of federal
          medical administration that checks the legal correctness of medical
          professional organizations, seeing precisely these are prone to corruption
          in several ways that they cannot be relied upon to properly
          control themselves, such as payments to members to promote specific
          products or policies or plans.

As I said, I do not know much of US law. But the point as I made it seems a reasonable one to me, and can be supported as follows, indeed extending the argument of 1 Boring Old Man:

        • Such a controlling institution also would protect an d help professional medical
          organizations, since in their case there clearly is big money willing to buy
          them so as to do things medical doctors should not do, but that are highly
          profitable, that may be quite dangerous to the public at large, such as is the case
          with prescribing  anti-psychotic drugs to children or systematic overdiagnosing,
          that in many cases a medical professional organization cannot actively control properly,
          since it lacks the legal equipment, and it is not properly medicine but concerns
          possible legal transgressions of medical doctors

In case you need an explanation, here is one, by someone qualified to know:


It is from a site called ĻMedicine in Plain WordsĻ

       Why I donīt waste time on drugs reps (video)

This contains a very interesting and quite courageous video by a former sales rep in the pharmaceutical industry called Gwen Olsen, linked above, whose site

       Gwen Olsen the Rx Reformer

is under the last link, and has more videos.

So here is a third point to support my general point that, in the case of (purported, claimed) medicine, there does seem to be a real demand and place for some sort of federal medical administration that checks the legal correctness of medical professional organizations and their members, and whether they do serve the public's interests as they should, rather than their own or of pharmaceutical corporations:

        • There are strong interests, with great amounts of money, and immoral practices, that are
          trying to corrupt medical people in various ways, that are very dangerous to the public at
          large, and that medical professional organizations just are not capable of controlling, also
          if they were or are honestly willing to do so: This requires legal expertise, independence
          of the professional organizations to be controlled, and legal clout to enforce the rights
          of the public to safely  practiced honest and real medicine. (*)

So I do think there is a strong case that some sort of federal agency should oversee the legal doings and omissions of medical professoonal organizations and their members, and notably of the APA (the American Psychiatric Association), that seems to me to be quite corrupt, for its diagnostic manuals are not based on real science; are not prepared in an open and honest way, but by secret committees with members sworn to secrecy; while the diagnostic manual they are producing is pseudoscience all the way through that seems to be expressly designed to provide psychiatrists with far more power than they have, to make their diagnoses irrefutable, and to allow them access to far more patients to mistreat according to their pseudoscientific manual for the financial interest of the psychiatrists who design the manual and, most dishonestly, pretend it is real science.

Then again, not being a US citizen I do not know how to sensibly implement this. But what is quite clear to me is that if there is no qualified, independent, legally effective control on especially medical professional organizations, the risk is very great - it has happened and is happening: see the video linked above - that these will grow corrupt in ways their own members simply cannot control, for lack of the means, the knowledge, the legal expertise, the objectiveness, and the legal clout to enforce much needed regulation of the practices of some medical professional organizations, and most notably the American Psychiatric Association, whose diagnostic manuals are not science but pseudoscience, and whose practices are not in the legal and health interests of patients but in the financial interests of psychiatrists and pharmaceutical corporations.

Besides, the government is and ought to be involved in protecting the public against quackery, medical pseudoscience, and medical dishonesty. You cannot leave that to their own professional organizations, since these do not have the capacities to do so, even if they tried, and the government also has no right to wait till harm has been done: It must act pro-actively and protect the public against medical corruption, especially in the practicians and professional organization of what is anyway mostly a pseudoscience, viz. psychiatry.


(*) Maybe I should add that in my view and indeed that of many others

(1) the American Psychiatric Association has been doing none of these things - take the appropriate steps to help safeguard the rights of the public to safely  practiced honest and real medicine - and in fact seems to have been doing precisely the contrary with the DSM-5 from its very inception onwards, and also that
(2) it seems not at all unlikely that,
as indeed was the case with the DSM-III, there has been a coup within the leadership of the APA, namely by psychiatrists with very strong ties to pharmaceutical companies.

See e.g. the site
1 Boring Old Man, who is not boring, and is a pensioned psychiatrist who started his medical life as an internist, and who is currently engaged on writing several interesting series on various aspects of the various DSMs and the practice of psychiatry in the US.

Corrections, if any are necessary, have to be made later.


As to ME/CFS (that I prefer to call ME):

1.  Anthony Komaroff Ten discoveries about the biology of CFS (pdf)
3.  Hillary Johnson The Why
4.  Consensus of M.D.s Canadian Consensus Government Report on ME (pdf)
5.  Eleanor Stein Clinical Guidelines for Psychiatrists (pdf)
6.  William Clifford The Ethics of Belief
7.  Paul Lutus

Is Psychology a Science?

8.  Malcolm Hooper Magical Medicine (pdf)
 Maarten Maartensz
ME in Amsterdam - surviving in Amsterdam with ME (Dutch)
 Maarten Maartensz Myalgic Encephalomyelitis

Short descriptions of the above:                

1. Ten reasons why ME/CFS is a real disease by a professor of medicine of Harvard.
2. Long essay by a professor emeritus of medical chemistry about maltreatment of ME.
3. Explanation of what's happening around ME by an investigative journalist.
4. Report to Canadian Government on ME, by many medical experts.
5. Advice to psychiatrist by a psychiatrist who understa, but nds ME is an organic disease
6. English mathematical genius on one's responsibilities in the matter of one's beliefs:

7. A space- and computer-scientist takes a look at psychology.
8. Malcolm Hooper puts things together status 2010.
9. I tell my story of surviving (so far) in Amsterdam/ with ME.
10. The directory on my site about ME.

See also: ME -Documentation and ME - Resources
The last has many files, all on my site to keep them accessible.

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