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Thank you, Trish, for looking into the question of where I got the 52% figure. You've found a lot of the central articles, and that's great. I wonder why you chose not to go the source, the paper I published on MUS in the #1 US bioethics journal? You'll find a great many references there...

That's actually extremely rare, because it violates the peer review process.

Many thanks for posting that @Tom Kindlon. It's very direct evidence of denial of medical care, and the kind of reasoning they've used to support it. Chilling.

That's fair enough. It's not good to suggest that people who've had to deal with this injustice are messed up or psychologically harmed. Really that's the idea we're fighting against, so I can see that it's jarring. For myself, it was a moment of truth when I really understood that what my...

I'm not sure there's any tie between being psychologically harmed by an unjust situation and losing your reason. I mean, I don't think that's in any way implied. People who've experienced injustice are definitely not illogical as a rule - if anything, as you say, this kind of thing often makes...

Wow, I think this is so important @rvallee. First, "we can't keep adapting our language for fear it will be twisted and misrepresented". You know I'm with you on that. They don't mince words with each other in research, so there's really no need for us to play that game. Second, I'm sure...

Your concerns about medicine are well-founded, I think, though there's so much substantial medical research on ME now. I'm so encouraged by that change. I'm not sure what I can say to the suggestion that I'm speculating about things I don't know for certain, that I don't tackle these issues...

What a great point, @Esther12. It's true that if the same bad science was used under the "medical" banner, we'd still have the same problem. This is important. The bad science problem cuts across the divide. In medicine science this bad wouldn't pass peer review, though - I do have faith in...

Thanks to all for the discussion on my JME blog today! I just want to say clearly that there is no conceptual problem with the psychosomatic/biomedical divide - not clinically, and not philosophically. I know @Jonathan Edwards keeps insisting there is, but wow, that's really unproductive. Be...

You've got an interesting view worked out, @Jonathan Edwards, and I think you defend it really well. It works. It does rely on a lot of assumptions, though, that I'd take issue with, so we just have a difference of opinion there. You're in good company resisting Chalmers' views on these...

Oh holy cow! Step away from the discussion for a few days and look what happens! It's really tough for me to comment casually on these debates because I teach this stuff all the time - though, geez this is a pretty high level discussion! IMHO the biggest scientific question of our time is...

Thanks for that @Andy. It wouldn't be in my interest, or in the interest of my work to make a public fuss about this, though. It is very good news that a BMJ journal was so very close to publishing a paper that says ME patients must have medical care. That's good progress, and if I become the...

You don't know how useful that is, Andy! The paper of mine that just came out in Bioethics spent a whole year under review at "Journal of Medical Ethics" - which is the ethics arm of the BMJ. All 3 reviewers praised it to the skies. One said it was so important that it needed to be public...

This is really funny, @rvallee! I mean, of course it's absolutely not funny that so many of us have endured what we have based on this thinking. It's an atrocity - and I mean that literally. But I work with these ideas all day, so I don't often step back to say "holy crap!" It's the right...

You are so right about the money @boolybooly. Patients with "MUS" are the most expensive group for insurers and for every national health system, and mental health management has been proven to dramatically cut costs. This worries me when it comes to the new NICE guideline. Is NICE working...

Sorry for the long delay @Snowdrop. Busy week! Yes, I mean "medically unexplained symptoms". Roughly speaking, 50% of outpatients' symptoms fall into that category (or at least this the figure you generally find in practice guidelines). The health system in the UK actually says 52%, so the...

Thanks for that, Sean. There's a strange code of silence around this area of medicine even publicly, even in bioethics. Trying to break that taboo but it's tough!

I'm with you on all of these points @Trish. Very nicely put. The thing is that this is not going to convince anyone who doesn't already agree. To do that, the article starts with the ethical foundations in NICE's own documents. From there it raises an issue well known in ethics called...

I'm so glad you raised the issue of the IAPT. And thanks for mentioning the thing I wrote about BSS. Incidentally, that very serious threat remains. If the WHO does recommend "symptom cluster criteria" in the new ICD for primary care, everyone who uses that manual around the world will...

I appreciate you trying to clarify that @Michelle. For the record, @Jonathan Edwards and I are having a nice email exchange, so all is well on that front. You are absolutely right that in a discussion with patients the Wessely camp would insist that psychiatry is part of medicine, and that ME...