Ah no! I met with my MP this afternoon and he said he hoped to attend this meeting tomorrow. Will all MPs be notified of this, or should I try and contact him again tonight to let him know?
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MUS, PPS services and IAPT integration into NHS primary care - what's happening across the UK?
- Thread starter Dx Revision Watch
- Start date
Ah no! I met with my MP this afternoon and he said he hoped to attend this meeting tomorrow. Will all MPs be notified of this, or should I try and contact him again tonight to let him know?
Dx Revision Watch
Suzy Chapman Owner of Dx Revision Watch
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Via @postersandme
So, a patient is unwilling to collaborate in a management plan and refuses treatment and their mental capacity is questioned?
What happened to informed consent?
What happened to patients' rights to withdraw from treatments/therapies at any point in the process?
So, a patient is unwilling to collaborate in a management plan and refuses treatment and their mental capacity is questioned?
What happened to informed consent?
What happened to patients' rights to withdraw from treatments/therapies at any point in the process?
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Dx Revision Watch
Suzy Chapman Owner of Dx Revision Watch
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I don't know whether only the Officers and members of the APPG on ME would be informed. Maybe safest to contact him.
Okay. I'll email his office.. Thanks
Countrygirl
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...........not co-operating in their management plan? Raises the question of mental capacity???
Dangerous territory.
Is this a veiled threat of potential sectioning if someone with ME refuses to undertake a course of CBT/GET?
Doesn't this contradict the NICE guidelines which makes it clear that the patient must be willing to undergo the suggested treatment?
Edited to say the above poster is the amalgamation of two sections of a document apparently. The original does not suggest that people who refuse treatment for ME could be regarded as lacking mental capacity. The designer of the poster has designed it in such a way to make it appear that way. Rather misleading and not helpful. The situation is bad enough as it is without using misleading material.
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Dx Revision Watch
Suzy Chapman Owner of Dx Revision Watch
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Contradicts NHS patients' right to informed consent.
Contradicts NHS patients' right to withdraw from treatment at any point.
Molly98
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Horrifying
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Unfortunately, This has been building up for years in the Netherlands and in UK
And we are now seeing the horrific results being implemented.
The Wessely-school in Europe has given rise to the biopsychosocial model, which resulted in the non-diagnosis MUS/MUPS and their subsequent rebranding of CFS and ME into functional somatic syndromes / somatic symptom disorder, bodily distress syndrome etc. It remains to be seen how this is categorized in the new ICD II, it is insane to think that psychs can just invent diagnoses or non-diagnosis like MUS/MUPS and categorized existing diagnoses under them ....
Please don't underestimate how big this whole movement is.....and how long they have been working towards this.
Please see that although they will no longer say this disease is (purely) psychosomatic/mental MUS classifications by definition often include categories within the ICD that involve the mental and behavioral chapters....
With their BPS model (hypothesis!), they now claim that even if ME or CFS are not mental/psychosomatic disorders this does not matter in their view, we should let go of the distinction between them, for in their hypothesis ! several factors work together (bio psycho social) (never mind the lack of evidence for this hypothesis, or the interventions based on it; CBT/GET.) CBT/GET of course the treatments that can help in their view, they do admit that perhaps this illness started with an infection, you we ill once, but there are now other perpetuating factors keeping you ill (mental/behavioral), that can be reduced ofcourse by CBT/GET (Pace style/Dutch Nijmegen style)......which they claim are evidence based....when they are not....
Unfortunately governments and insurers don't seem to care about the facts, they indeed want a quick fix, cheap fix, want to keep people out of expensive health care.......
In the Netherlands a 1.5 million Euro MUS project started (funded by health insurers), two of its main project leaders are now in the dutch health council committee writing an adivisory report on ME, have had close working relationships with Wessely school and PACE colleagues for years.
The dutch started this petition to stop this. https://petities.nl/petitions/me-is...e-to-the-advisory-report-assignment?locale=en
Please help, sign, to stop this MUS / BPS influence in care for ME.
MUS involves a whole way/protocol based on the BPS model of GP's talking to patients, not trying to use the words psychosomatic etc, but steering them towards CBT/GET
this study is currently being undertaken in UK https://clinicaltrials.gov/ct2/show/NCT02444520
https://clinicaltrials.gov/ct2/show/NCT02444520
And we are now seeing the horrific results being implemented.
The Wessely-school in Europe has given rise to the biopsychosocial model, which resulted in the non-diagnosis MUS/MUPS and their subsequent rebranding of CFS and ME into functional somatic syndromes / somatic symptom disorder, bodily distress syndrome etc. It remains to be seen how this is categorized in the new ICD II, it is insane to think that psychs can just invent diagnoses or non-diagnosis like MUS/MUPS and categorized existing diagnoses under them ....
Please don't underestimate how big this whole movement is.....and how long they have been working towards this.
Please see that although they will no longer say this disease is (purely) psychosomatic/mental MUS classifications by definition often include categories within the ICD that involve the mental and behavioral chapters....
With their BPS model (hypothesis!), they now claim that even if ME or CFS are not mental/psychosomatic disorders this does not matter in their view, we should let go of the distinction between them, for in their hypothesis ! several factors work together (bio psycho social) (never mind the lack of evidence for this hypothesis, or the interventions based on it; CBT/GET.) CBT/GET of course the treatments that can help in their view, they do admit that perhaps this illness started with an infection, you we ill once, but there are now other perpetuating factors keeping you ill (mental/behavioral), that can be reduced ofcourse by CBT/GET (Pace style/Dutch Nijmegen style)......which they claim are evidence based....when they are not....
Unfortunately governments and insurers don't seem to care about the facts, they indeed want a quick fix, cheap fix, want to keep people out of expensive health care.......
In the Netherlands a 1.5 million Euro MUS project started (funded by health insurers), two of its main project leaders are now in the dutch health council committee writing an adivisory report on ME, have had close working relationships with Wessely school and PACE colleagues for years.
The dutch started this petition to stop this. https://petities.nl/petitions/me-is...e-to-the-advisory-report-assignment?locale=en
Please help, sign, to stop this MUS / BPS influence in care for ME.
MUS involves a whole way/protocol based on the BPS model of GP's talking to patients, not trying to use the words psychosomatic etc, but steering them towards CBT/GET
this study is currently being undertaken in UK https://clinicaltrials.gov/ct2/show/NCT02444520
https://clinicaltrials.gov/ct2/show/NCT02444520
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Countrygirl
Senior Member
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Signed and shared.
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- 77
Thank you.
It is so important to understand that with the rethoric they are now using (based on BPS model), these psychs are creating a role for themselves and their BPS model and subsequent "treatments" in a whole range of diseases that have official diagnoses/names (ME, IBS, Fibro, POTS, Lyme etc) but because they are not fully understood, are now rebranded as MUS.
The implications are enormous. They call it "integrated care"
Yeah right....
Don't underestimate how many GP's physiotherapists etc are being presented with the MUS theory throughout the nation.
Stepped care was invented in the Netherlands....
It is so important to understand that with the rethoric they are now using (based on BPS model), these psychs are creating a role for themselves and their BPS model and subsequent "treatments" in a whole range of diseases that have official diagnoses/names (ME, IBS, Fibro, POTS, Lyme etc) but because they are not fully understood, are now rebranded as MUS.
The implications are enormous. They call it "integrated care"
Yeah right....
Don't underestimate how many GP's physiotherapists etc are being presented with the MUS theory throughout the nation.
Stepped care was invented in the Netherlands....
- Messages
- 77
If you can please sign and share the Dutch Petition. We truely need to raise our voice about this.
(you can sign with your name or anonymous, but don't forget to click on the confirmation link in your email after you sign).
https://petities.nl/petitions/me-is...e-to-the-advisory-report-assignment?locale=en
(you can sign with your name or anonymous, but don't forget to click on the confirmation link in your email after you sign).
https://petities.nl/petitions/me-is...e-to-the-advisory-report-assignment?locale=en
Dx Revision Watch
Suzy Chapman Owner of Dx Revision Watch
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Signed and Tweeted.
Dx Revision Watch
Suzy Chapman Owner of Dx Revision Watch
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http://www.nhs.uk/chq/pages/899.aspx?categoryid=68
Do I have the right to refuse treatment?
Yes. You must give your consent (permission) before you receive any type of medical treatment, from a simple blood test to deciding to donate your organs after your death. If you refuse a treatment, your decision must be respected.
Capacity to consent to treatment
To consent to or refuse treatment, you must have the capacity to make that decision. Capacity means the ability to use and understand information to make a decision.
Under the terms of the Mental Capacity Act 2005, all adults are presumed to have sufficient capacity to decide on their own medical treatment, unless there is significant evidence to suggest otherwise.
Read more about capacity to consent.
Voluntary and informed decisions
For consent to treatment or refusal of treatment to be valid, the decision must be voluntary and you must be appropriately informed:
If you have capacity and make a voluntary and appropriately informed decision to refuse a treatment, your decision must be respected. This applies even if your decision would result in your death, or the death of your unborn child.
http://www.nhs.uk/chq/Pages/900.aspx
Does my child have the right to refuse treatment?
A child (anyone under 16 years old) can consent to treatment as long as they have enough understanding and intelligence to fully appreciate what is involved in their treatment. This is known as being "Gillick competent". Additional consent by a person with parental responsibility is not required.
A young person (anyone aged 16-17) is presumed to be capable of consenting to their own medical treatment. Consent will only be valid if it is given voluntarily by a young person who has received and understood the appropriate information. As with adults, a young person has the right to refuse to consent to treatment.
Where a child under the age of 16 lacks the capacity to consent, consent can be given on their behalf by any one person with parental responsibility or by the court (see below).
In cases where a young person or child deemed "Gillick comptetent" refuses to consent to treatment, a court can overrule their decision if this could lead to death or severe permanent injury. The court used is the Court of Protection, which resolves disagreements about what’s in someone’s best interests.
Consent to treatment
It is a legal and ethical principle that a person must give valid consent before they receive any type of medical treatment. Consent is required from a patient regardless of the treatment, from a blood test to major surgery.
Read more about consent to treatment.
For consent to be valid, it must be given voluntarily by an appropriately informed person who has the capacity to consent. Capacity means the ability to use and understand information to make a decision. The Mental Capacity Act defines a person who lacks capacity and how an assessment is made.
Read more about capacity to consent to treatment.
Children lacking capacity to consent to treatment
If a child under 16 doesn’t have the capacity to consent to treatment, someone with parental responsibility can consent for them. The person with parental responsibility must have the capacity to give consent, be acting voluntarily and be appropriately informed. The child’s welfare or "best interests" must be the first concern.
If a parent refuses to give consent for a particular treatment, the courts can overrule this decision if they think treatment is in the child’s best interests.
If one person with parental responsibility gives consent and another doesn’t, the healthcare professionals can accept the consent and perform the treatment. If the people with parental responsibility disagree about the child’s best interests, the courts can decide.
In an emergency, where treatment is vital and waiting for parental consent would place the child at risk, treatment can proceed without consent.
Parental responsibility
The following people can have parental responsibility for a child under 16:
Do I have the right to refuse treatment?
Yes. You must give your consent (permission) before you receive any type of medical treatment, from a simple blood test to deciding to donate your organs after your death. If you refuse a treatment, your decision must be respected.
Capacity to consent to treatment
To consent to or refuse treatment, you must have the capacity to make that decision. Capacity means the ability to use and understand information to make a decision.
Under the terms of the Mental Capacity Act 2005, all adults are presumed to have sufficient capacity to decide on their own medical treatment, unless there is significant evidence to suggest otherwise.
Read more about capacity to consent.
Voluntary and informed decisions
For consent to treatment or refusal of treatment to be valid, the decision must be voluntary and you must be appropriately informed:
- Voluntary: you must make your decision to consent to or refuse treatment alone, and your decision must not be due to pressure by healthcare professionals, friends or family.
- Appropriately informed: you must be given full information about what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment doesn’t go ahead.
If you have capacity and make a voluntary and appropriately informed decision to refuse a treatment, your decision must be respected. This applies even if your decision would result in your death, or the death of your unborn child.
http://www.nhs.uk/chq/Pages/900.aspx
Does my child have the right to refuse treatment?
A child (anyone under 16 years old) can consent to treatment as long as they have enough understanding and intelligence to fully appreciate what is involved in their treatment. This is known as being "Gillick competent". Additional consent by a person with parental responsibility is not required.
A young person (anyone aged 16-17) is presumed to be capable of consenting to their own medical treatment. Consent will only be valid if it is given voluntarily by a young person who has received and understood the appropriate information. As with adults, a young person has the right to refuse to consent to treatment.
Where a child under the age of 16 lacks the capacity to consent, consent can be given on their behalf by any one person with parental responsibility or by the court (see below).
In cases where a young person or child deemed "Gillick comptetent" refuses to consent to treatment, a court can overrule their decision if this could lead to death or severe permanent injury. The court used is the Court of Protection, which resolves disagreements about what’s in someone’s best interests.
Consent to treatment
It is a legal and ethical principle that a person must give valid consent before they receive any type of medical treatment. Consent is required from a patient regardless of the treatment, from a blood test to major surgery.
Read more about consent to treatment.
For consent to be valid, it must be given voluntarily by an appropriately informed person who has the capacity to consent. Capacity means the ability to use and understand information to make a decision. The Mental Capacity Act defines a person who lacks capacity and how an assessment is made.
Read more about capacity to consent to treatment.
Children lacking capacity to consent to treatment
If a child under 16 doesn’t have the capacity to consent to treatment, someone with parental responsibility can consent for them. The person with parental responsibility must have the capacity to give consent, be acting voluntarily and be appropriately informed. The child’s welfare or "best interests" must be the first concern.
If a parent refuses to give consent for a particular treatment, the courts can overrule this decision if they think treatment is in the child’s best interests.
If one person with parental responsibility gives consent and another doesn’t, the healthcare professionals can accept the consent and perform the treatment. If the people with parental responsibility disagree about the child’s best interests, the courts can decide.
In an emergency, where treatment is vital and waiting for parental consent would place the child at risk, treatment can proceed without consent.
Parental responsibility
The following people can have parental responsibility for a child under 16:
- the child’s mother
- the child’s father, if he was married to the mother when the child was born
- for children born before December 1 2003 – the child’s father, if he marries the mother, obtains a parental responsibility order from the court or registers a parental responsibility agreement with the court
- for children born on or after December 1 2003 – the child’s father, if he registered the child’s birth with the mother at the time of the birth, or if he re-registers the birth (if he is the natural father), marries the mother, obtains a parental responsibility order from the court or registers a parental responsibility agreement with the court
- the child’s legally appointed guardian
- a person with a residence order concerning the child
- a local authority that is designated to care for the child
- a local authority or person with an emergency protection order for the child
A.B.
Senior Member
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Circular logic: that patients decide on their treatment is viewed by the psychobabblers as evidence that the patient does not have the mental capacity to decide on their own treatment.
They are very good at coming up with these (I'm sure there's a name for this). When you say yes, it's yes, but when you say no, it's still yes.
MeSci
ME/CFS since 1995; activity level 6?
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Luckily I fall into the last exclusion category (IBS), and will probably fall outside the age limit (65) by the time it gets here!
Exclusion Criteria:
- active psychosis;
- drug or alcohol addiction as indicated in the patients notes;
- current Benzodiazepine use exceeding the equivalent of 10 mg Diazepam per day;
- the patient is thought to be at imminent risk of self-harm, after psychiatric/ psychological assessment;
- Any psychotherapy treatment within the last year (not inclusive of general visits from community psychiatric teams)
- The patient is taking part in the PRINCE Secondary study
- The patient has irritable bowel syndrome or dissociative seizures.
Dx Revision Watch
Suzy Chapman Owner of Dx Revision Watch
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More on consent to treatment:
http://www.nhs.uk/Conditions/Consent-to-treatment/Pages/introduction.aspx
http://www.nhs.uk/Conditions/Consent-to-treatment/Pages/introduction.aspx
Countrygirl
Senior Member
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Dx Revision Watch
Suzy Chapman Owner of Dx Revision Watch
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If you need a TinyURL for this PR thread, I've created a Custom TinyURL:
http://tinyurl.com/MUSnotforME
#MUSnotforME
http://tinyurl.com/MUSnotforME
#MUSnotforME
Countrygirl
Senior Member
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If you decline treatment, can the GP then strike you off his list? I suspect the answer is 'yes'.
Dx Revision Watch
Suzy Chapman Owner of Dx Revision Watch
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In theory, you have the right to decline. Also supported by statements in NICE CG53.
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