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This is otherwise a pretty interesting article. But I'm befuddled by the passage highlighted below.
I honestly can't tell whether this is meant to say that "interest groups" made up a disease entity where none really existed, or whether "interest groups" successfully fought for recognition of a disease in the face of those who denied its existence. And what 'interest groups' are meant - patient advocacy groups?
http://www.nejm.org/doi/full/10.1056/NEJMp1113569
The Burden of Disease and the Changing Task of Medicine
David S. Jones, M.D., Ph.D., Scott H. Podolsky, M.D., and Jeremy A. Greene, M.D., Ph.D.
N Engl J Med 2012; 366:2333-2338 June 21, 2012
[Second graf under "Accounting for the Burden of Disease" heading]
The other mentions of "CFS" in the paper refer to the battles over disease definition in a fairly neutral-seeming way...I think.?
Well, yeah.
And God forbid they should.
I honestly can't tell whether this is meant to say that "interest groups" made up a disease entity where none really existed, or whether "interest groups" successfully fought for recognition of a disease in the face of those who denied its existence. And what 'interest groups' are meant - patient advocacy groups?
http://www.nejm.org/doi/full/10.1056/NEJMp1113569
The Burden of Disease and the Changing Task of Medicine
David S. Jones, M.D., Ph.D., Scott H. Podolsky, M.D., and Jeremy A. Greene, M.D., Ph.D.
N Engl J Med 2012; 366:2333-2338 June 21, 2012
[Second graf under "Accounting for the Burden of Disease" heading]
By examining the many new diseases that have appeared over the past two centuries, historians have categorized the ways in which diseases emerge. New causes (e.g., severe acute respiratory syndrome, motor vehicle accidents, radiation poisoning), new behaviors (cigarette smoking, intravenous drug use), and even the consequences of new therapies (insulin transforming the course and manifestations of diabetes) can produce new diseases. Changing environmental and social conditions can increase the prevalence of once-obscure ailments (myocardial infarction, lung cancer, kuru, and “mad cow” disease). New diagnostic technologies and therapeutic capacity can unmask previously unrecognized conditions (hypertension). New diagnostic criteria can expand a disease's boundaries (hypercholesterolemia, depression). Changing social mores can redefine what is or is not a disease (homosexuality, alcoholism, masturbation). New diseases can emerge as the result of conscious advocacy by interested parties (chronic fatigue syndrome, sick building syndrome). HIV–AIDS alone demonstrates many of these modes of emergence. The emergence, recognition, and impact of disease are never just a bioscientific process; the advent of a new disease always involves social, economic, and political processes that shape its epidemiology and influence our understanding and response.
The other mentions of "CFS" in the paper refer to the battles over disease definition in a fairly neutral-seeming way...I think.?
Disease definitions structure the practice of health care, its reimbursement systems, and our debates about health policies and priorities. These political and economic stakes explain the fierce debates that erupt over the definition of such conditions as chronic fatigue syndrome and Gulf War syndrome.
Well, yeah.
As contemporary disputes over the definitions of alcoholism, chronic fatigue syndrome, and attention-deficit disorder make clear, physicians are never the sole arbiters of disease.
And God forbid they should.