Oct 2017

Healy 427: 12:30pm–1:30pm (Oct 18)

Why Bioethics Should be Concerned with Medically Unexplained Symptoms

Diagnostic science is a great deal less successful than we’ve been inclined to imagine in bioethics, as research and educational materials routinely suggest that symptoms remain unexplained in half of outpatient cases. I’ll review figures on the prevalence of medically unexplained symptoms (MUS), briefly clarify their challenges with respect to informed consent, autonomy, and truth telling, then explore evidence of an ethical challenge unique to this setting: obstructed access to care based on an erroneous psychogenic diagnosis (i.e. causes in the mind). I suggest this problem is largely caused by the confused idea that it’s a philosophical faux pas to distinguish biological need from psychosocial need in the context of unexplained symptoms. To ensure that patients receive optimal care for MUS, bioethical research is needed, and that research must be built upon foundations that are philosophically sound.

Diane O’Leary, PhD is a Visiting Scholar in Neuroethics at Pellegrino Center for Clinical Bioethics, former director of the Coalition for Diagnostic Rights, and Associate Adjunct Professor in Philosophy at University of Maryland University College. Dr. O’Leary has presented on this topic at the International Congress on Women’s Health Issues, to the UN Special Rapporteur on Health and Human Rights, to a wide range of disease-specific organizations and, in the House of Lords, to the Countess of Mar’s coalition of “chronic fatigue syndrome” organizations.

This presentation is drawn from a paper under final consideration as a target article for American Journal of Bioethics following two rounds of requested revisions. Dr. O’Leary will present on related topics at the 2017 ASBH meeting in Kansas City.