Medical harms poll (Potential for class action law suit regarding CBT/GET)

[Molly98]

My husband did have the idea that now that we have the re-analysis of the PACE study and the AHRQ and also MEA and AFME surveys of patients we should put doctors and health professionals on notice so to speak if they continue to push GET and CBT.

If they recommend GET and GBT, present them with the information to show evidence of harm, get them to sign that they have read and understood the evidence and politely inform them that if you are harmed by undertaking these treatments that they recommend you are prepared to sue because they have evidence of harm caused and have chosen to ignore it and prescribe a harmful treatment regardless. If many patients did it, in surgeries or clinics across the country doctors may become nervous about recommending it and feedback to those higher up the chain that they did not want to end up in a potential legal case being sued and risk their career for the sake of supporting the BPS model. I doubt many would be prepared to risk being affected personally for the sake of continuing to promote a debunked theory. I know the problem with this is that most people on here for instance, wouldn't touch CBT or GET with a barge poll anyway so some how it would mean reaching newly diagnosed which is more difficult and having a standard letter that patients could give to doctors or medical professionals .

But perhaps for those who have had ME long term and struggle to get treatment we need again a standard letter putting doctors on notice that if they dismiss us as having ME, therefore medical complaints are brushed off and treatment not given on the false belief it is psychological we will take legal action if later harm is caused or medical conditions go untreated or undiagnosed as a result. While there is no personal impact on those who continue to prescribe these treatments most will continue to do so because it is easier than to rock the boat or make the effort to look further.

 

[Jan]

Has anyone ever tried a FOI request for harms/adverse events reported to the fatigue clinics, and also of harms/adverse events reported to GP's from folllowing the NICE guidelines? Are we not even attempting to collect this sort of evidence? We often say that if this was a drug causing this harm instead of exercise something would be done. Newly diagnosed patients are going to be harmed, children are going to be harmed, surely we can do something other than waiting and hoping for good results from MEGA one day in the future?

 

[Molly98]

Perhaps legal action would be unsuccessful but no one likes the threat of legal action and no one likes the stress and huge impact on your life and career of having to go through a court case or professional negligence case regardless of the outcome. It may be that warning medical professionals about potential legal proceedings given the current evidence would have more impact and more instantly than looking at claims for harms already done - although I absolutely 100% would like to see this happen and fully support it but it will take a long time. By warning health professionals who are still prepared to push GET and CBT as well as making them sit up and take notice it may also get some doctors and health professionals to look a little further and dig a little deeper than the information they are spoon fed do their own research and realise "Oh fuck these crazy ME patients may have a really illness after all" and I am not prepared to take that risk. I know a lot of doctors mean well and are so stressed and short of time, that's why it needs something pretty drastic which has the potential of affecting them personally to maybe get them to sit up and take notice. I wouldn't wish harm on any of them but if it was a medication they were pushing shown to cause harm or at the least was in affected it would not continue to happen.

 

[Binkie4]

Does Montgomery vs Lanarkshire, March 2015, have a part to play here? I believe it says something to the effect that the medical practitioner, in order to get informed consent, must tell the patient of all possible harms however unlikely. Am unsure that ignorance of possible harms ( there's so much around GET ) would release the doctor from his/ her obligation.

 

[Molly98]

It is interesting, I will have to look up Montgomery vs Lanarkshire, but even if it were the case that ignorance of possible harms would release the doctor from his or her obligation if a patient produced evidence of possible harms and required the doctor to sign that they had read it and the doctor was still prepared to go ahead and recommend then ignorance of harms could not be claimed and would doctors be so willing to take this risk?

 

[Binkie4]

Yep, that's logical. Not sure that doctors would cooperate. We would just be labelled awkward and uncooperative.
Does anyone know if Montgomery v Lanarkshire has been used in ME/CFS? It is a new piece of legislation. Am thinking about magenta. Utterly disastrous if children have GET applied to them.

 

[Binkie4]

Sorry. Feeling particularly exhausted today, bed bound, and not thinking clearly.

 

[Countrygirl]

The Montgomery case was brought up and discussed about a year ago. I think, if I recall, that ignorance on behalf of the doctor is no excuse in law. They have a professional obligation to warn the patients of potential harms. They have no grounds for claiming ignorance.

That is how I remember the essence of the discussion.

 

[RogerBlack]

You're suggesting that they need a motive (not merely intent to mislead, etc), and that is completely untrue. Motive only matters to the media - it's irrelevant in court.

And "intent" doesn't mean that the outcome (harm) was necessarily intended, but just that the action (deception) which led to the outcome was intentional.

Motive is not irrelevant to the court.
In most cases, other than that of strict liability (which are very rare in law, and typically only found in crimes like possession of child porn), motive matters.

The 'hate the disabled' was not quite hyperbole.

The problem is that - without this, someone being harmed is not enough.
The person in question has to know that overall harm is likely, and the patient will not on balance typically benefit from this treatment.

'Deception' is also a problem.
You can't deceive someone if you truly believe that the treatment works.

If you actually believe the treatment works, and are not lying about this, then any prosecution gets a lot harder.
You now have to be proved not just to be providing bad treatment, but knowing you are providing bad treatment below the reasonable standard.

For your average clinician, following national guidelines will almost completely shield them from this.

Action needs to be against particular people or legal entities that have either fallen below their mandated professional standards, or who have broken the criminal or civil law.

BPS is just a nebulous transnational pile of shit, with no central organising person incorporating people on standards bodies, doctors, ...

I would truly like to see someone go to jail for this - but there isn't one person in an evil lair stroking a cat.

 

[RogerBlack]

Why would research from elsewhere not be relevant in a British court?

Who are you suing, or trying to get a criminal/civil prosecution and for what?

If you're trying to sue White et al, harms to patients are essentially irrelevant.

This is not because the harms did not flow from them, but that they had no direct legal responsibility to those patients.

I note for example that Andrew Wakefield published what is now a completely discredited paper (he cooked the numbers, amongst other issues) which has indirectly lead to perhaps 9000 deaths (vaccine preventable deaths due to lower coverage numbers) over the years.

Other than being struck off as a doctor, he has faced no censure.

 

[Binkie4]

Montgomery vs Lanarkshire requires doctors to tell patients of potential harms however unlikely. It is very recent but I cannot see how from a year ago , doctors are not required to tell of the harms of GET, even if not CBT. Ignorance of the harm does not exculpate the doctor nor does the unlikelihood of it happening. So how are doctors able to continue to offer GET? The release of pace data plus other data surely means that the evidence of harm is there.

@Roger- as I understand it, the doctor does not need to know that "overall harm is unlikely": the doctor has a responsibility to tell the patient of harms however unlikely, and his ignorance of those facts is no defence.
I see that doctors think that following the nice guidelines is enough ( that is how my GP treats me), but is it now since M v L?
Any health lawyers around? I think Mv L was a case of a pregnant woman not being given all the info relevant to the birth of her child.

Maybe there is a way forward via the legal route which is why I have offered to contribute to a legal fund?

 

[Valentijn]

Motive is not irrelevant to the court.

You're confusing motive with intent.

 

[Binkie4]

Can anyone advise on the effect of Montgomery vs Lanarkshire 's view of consent on the prescription of GET for ME? Does not the evidence of damage following GET for ME exclude it as a treatment unless fully informed consent has been given.
Informed consent is now the issue not the outcome of treatment.

 

[Binkie4]

How many doctors tell their patients about the potential damage of GET?

 

[Jan]

Who are you suing, or trying to get a criminal/civil prosecution and for what?

.

I would say the NHS, my preference would be if a patient, or pref. patients, could sue (if that's the right word in a case like this) for damages as the treatment offered has caused harm, and they were not warned that it could do so. Even if the GP missed it, the clinic doctor or other medical professional, should have mentioned it to the patient when they recommended GET & CBT .

I am probably being naive, I know nothing about law. I would donate everything I could to support a case such as this though.

 

[PennyIA]

I don't know if there would ever be a way to prove it.

BUT... if the PACE researchers EXPLICITLY and KNOWINGLY excluded adverse effects of GET from their study.

AND then proceeded to claim that it provided benefit for some patients with no risk of harm.

Does that not tend to lend itself to something that would be useful for a lawsuit?

As far as I know they didn't release any details (yet) that would convey harm... so much as that 'patients' dropped from the study.

 

[RogerBlack]

AND then proceeded to claim that it provided benefit for some patients with no risk of harm.

Does that not tend to lend itself to something that would be useful for a lawsuit?

I note again that Andrew Wakefield, whos wrongdoing was very clear, and publication indirectly lead to several thousand deaths, has faced no censure other than being struck off as a doctor.

 

[PennyIA]

I know that in the US that unless you have REALLY REALLY good attorneys, it's nearly impossible to win malpractice lawsuits. Only if they knowingly caused harm. In the past it was a lot easier if harm was caused to get funds... so malpractice insurance pricing climbed sky high. Now, you have to prove that they knew that what they were about to do was unsafe before they did it. So, not knowing how best to treat us doesn't count. Nor would choosing no treatment when they don't know the root cause. And when they think they know the root cause (false illness beliefs) and they think they know the best treatment... well, then that wouldn't qualify under US law either.

But it sure feels like the fact that the study authors knowingly under represented adverse effects kind of falls into the pharmaceutical laws where they can't under represent adverse effects in their own research trials without being held accountable in a lawsuit.

Again, not the doctors advising the treatments... the authors of the study who hid the negative impacts should have a way to be held accountable. Albeit, in the US usually pharmaceutical class action lawsuits usually result from lawyers knowing they can make a ton of money over the fact that people were made ill and/or actually died. And the fact that we are ill and got more ill seems like it's a harder sell.

Agreed that it doesn't seem like much to go on... but it seems like even if the lawsuit was filed (even if it's thrown out) it's a bit of a show of a stand of force of patients who want to make sure EVERYONE knows that enough is enough and bad science isn't going to be ok.