MAGICAL MEDICINE: HOW TO MAKE AN ILLNESS ... - Invest in ME

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ill‐health and disability is directly caused by diseases and their pathological processes” and White posits that
behaviour and the “social context” are an alternative approach to the biomedical model of disease
(Biopsychosocial Medicine, OUP 2005).
In his section “Moral commentary on the manipulation of care”, Reich says:
“Understanding the betrayal of care: we can see that physicians and political leaders in National Socialist Germany
accomplished a betrayal of care in three senses. First, they radically altered the very idea of care that constitutes the
goal of medicine… subverting the moral standards of care in medicine. Second, they betrayed the actual care of tens of
thousands of individual patients by violating the patients’ trust in caregivers……And third, they betrayed the moral
integrity of many physicians…by violating their sense of commitment to the interests, lives and health of their patients.
“In so doing, they deeply altered the ethos and ethics of medicine, simply by manipulating what it meant to care.
“The moral problem was that the deepest of medical sentiments in the service of the sick was distorted
toward ideological goals to the total disregard of the individual.
“We see how vulnerable care is to societal and cultural forces: care itself can be perverted.
“The relative ease with which sentiments of care were manipulated to a global level of insufficient regard for the
individual…could lead us to reflect on the extent to which we too easily overlook medicine’s commitment to care for
sick people and the apparent ease with which that commitment is betrayed.
“In the United States at present there is a gargantuan manipulation of the idea and commitment of care in the
healthcare delivery system. ‘Managed care’ has subjected care for the individual patient to the demands of
commercial medical enterprises that take great care lest costs increase while profits decrease. The major
moral conflict of doctors in the United States today is this conflict between their responsibility to care for the best
interests of the patient and their responsibility to take care of the system whose prime interest is in managing finances
for corporate purposes.
“We need to give more attention to care as the originary element of all ethics….For without care, all the patients’ rights
and all the professional rules and ethics codes imaginable will accomplish very little” (see also Section 3 below).
The socio‐cultural factors that shaped the manipulation of medical care at that time seem to be re‐
emerging at the hands of UNUMProvident and the Wessely School in both the US and the UK.
For example, the PACE Trial seems to have no science behind it (the Wessely School studies that provide the
alleged evidence‐base for CBT and GET use the Wessely School’s own Oxford criteria which exclude those
with ME and rely on subjective questionnaires) and seems to be an exercise to remove people with the
targeted disorder “CFS/ME” from State and insurance benefits, thereby subjugating the needs of the sick
individual to the ideological goals of State and commercial interests.
With apparent contempt for the large body of evidence showing that ME/CFS is a devastating organic
disorder, Waddell and Aylward assert:
“Diagnosis is often non‐specific…These conditions are ‘characterised more by symptoms and distress than by
consistently demonstrable tissue abnormality’ and have been described as ‘medically unexplained symptoms’ to
emphasise the limited nature of objective disease or impairment (Page & Wessely 2003)”.
Waddell and Aylward argue that the classic formulation of the sick role which entitles people to State
benefits has “major limitations” because it is “firmly rooted in a medical model of illness”.