Dr David Tuller: Updated Medical Textbook Still Promotes Biopsychosocial Ideology

[Countrygirl]

https://virology.ws/2025/07/04/tria...book-still-promotes-biopsychosocial-ideology/

Trial By Error: Updated Medical Textbook Still Promotes Biopsychosocial Ideology​

7 Comments / By David Tuller / 4 July 2025

By David Tuller, DrPH

For decades, Kumar & Clark’s Clinical Medicine has been a standard textbook for medical education around the world. Last month, Elsevier pubished the 11th edition. The miniscule section on what it calls “chronic fatigue syndrome/myalgic encephalopathy” is pathetic. This section is in a chapter called “General Hospital Psychiatry,” promotes “psychological symptoms” as a core component of the illness, and recommends the fraudulent PACE trial as “further reading.”
(The authors offer no explanation for their decision to use “encephalopathy” rather than the much more widely accepted term “encephalomyelitis.”)

Patient advocates have had concerns about this matter for a while. A petition “to request updating of the description of ME/CFS in Kumar and Clark’s Clinical Medicine textbook,” based on the 10th edition, was posted on change.org more than a year ago. It has racked up more than 10,000 signers. (An article on the ME Association website provides more details.)
Elsevier responded last February, noting that “the book’s editors are aware of the petition, and of the strength of feeling held by many ME/CFS patients and their friends and family members about the way the condition has traditionally been approached within the medical profession.”

In its response, Elsevier further noted that, for the upcoming version, “the editors have worked with the specialist chapter authors to produce content which addresses the concerns of patient groups, whilst being based on the range of published literature and contemporary treatment approaches within the field.”

Yeah, right.

The 11th edition does feature some modest changes corresponding to some of the requested changes. It now includes a mention of “ME”–albeit the wrong ME. It drops graded exercise therapy (GET) as a recommendation—yet it highlights the PACE trial as a reliable source of information, even though that piece of crap purported to prove that GET was effective. Etc.
In the new edition, the discussion of CFS/ME appears in a section of the General Hospital Psychiatry chapter headed “Medically Unexplained Symptoms and Functional Neurological Disorder.” In the text, these two groups are lumped together as MUS/FND, with general observations intended to apply to any clinical entity falling within the parameters of these categories. (In reality, FND is a subset of MUS.)

 

[Rufous McKinney]

A good Lawsuit is whats needed about now.

 

[southwestforests]

(The authors offer no explanation for their decision to use “encephalopathy” rather than the much more widely accepted term “encephalomyelitis.”)

While I generally avoid undocumented speculation and stay away from putting thoughts in unknown people's minds,
(that being said, I will very happily put thoughts in imaginary people's heads as I write my stories)

my brain being the brain it is, can not help but notice the pattern similarity between
"encephalopathy"
and
"pathology"

Therefore, my speculation is that it is a subtle dig at ME/CFS patients,
as in,
"You people have a pathology in the head."

 

[Rufous McKinney]

No sym- pathy....

Pathology

reading about that term, how did it become such an invalidation? the study of the nature of disease becomes a curse word.

 

[southwestforests]

how did it become such an invalidation?

Believe it or not, I have an answer for that,

And I'll give it this way,
First,

Then,
it would not be odd for the word pathology to follow a parallel path to the word pathological,
whose path began some time back,
https://www.etymonline.com/search?q=pathological

pathological(adj.)​

1680s, "pertaining to disease," formed in English from pathologic + -al (1). Sense of "worthy to be a subject of pathology, morbid, excessive" (as in pathological liar) is attested from 1845. Related: Pathologically.