Here at Medical Humanities, we have published a few pieces–mostly under the heading Current Controversy–regarding chronic fatigue syndrome. Today we present a preview of our final published piece on the subject, which appeared in June online. While the theme is now closed (we are not accepting new articles on CFS), today’s article presents the work of Diane O’Leary, a philosopher and bioethicist, whose work sits in the overlap between philosophy of mind, philosophy of medicine, and bioethics: A concerning display of medical indifference: reply to ‘Chronic fatigue syndrome and an illness-focused approach to care: controversy, morality and paradox’
What should clinicians do in cases where patients suffer from ongoing symptoms that have not been definitively explained? In practice recommendations that question is generally answered based on research in psychiatry that’s driven by the quest to eliminate mind-body dualism. Michael Sharpe and Monica Greco give us a vivid example of that approach in their article, “Chronic fatigue syndrome and an illness-focused approach to care” – where, purely on the basis of musings about dualism, they recommend that clinicians should ignore the possibility of disease in patients with ME/CFS. What’s striking about this recommendation is, first, that it contradicts conclusions from the National Academy of Sciences, the WHO, NIH and CDC. Second, Sharpe and Greco see no need to address, or even acknowledge, that formidable professional opposition. In fact, authors feel so secure about the force of their philosophical thoughts that they see no need to mention safety or risk avoidance for ME/CFS patients as they’ve been emphasized by health leaders across the globe in the last five years. Every patient, and every medical professional, should feel concern about the implications of this example. We can, and should, do better when it comes to the role for philosophy in clinical decision-making.
Diane O’Leary is a philosopher and bioethicist whose work sits in the overlap between philosophy of mind, philosophy of medicine, and bioethics. She is currently a Visiting Fellow at the Center for Philosophy of Science at University of Pittsburgh. Dr. O’Leary has published widely on uses and misuses of dualism in medicine, including “Medicine’s metaphysical morass: How confusion about dualism threatens public health”, in the current issue of Synthese. She clarified bioethical concerns about management of medically unexplained symptoms with a target article in American Journal of Bioethics, and her chapter with Keith Geraghty, “Ethical Psychotherapeutic Management of Patients with Medically Unexplained Symptoms”, is forthcoming in Oxford Handbook of Psychotherapy Ethics. Dr. O’Leary is a frequent public speaker on issues related to mind and body in medicine. Her work has been supported through fellowships from the Rotman Institute of Philosophy in Canada, and the Brocher Foundation in Geneva, Switzerland.