CFS – an illness without disease?

In a recent paper psychologist Prof Michael Sharpe and sociologist Monica Greco discuss CFS as an ‘illness without disease’ in comparison to cancer, a known disease, and argued that, while illness-focused treatments like CBT and GET can ameliorate the symptom of fatigue, there is also a need to address the paradoxical predicament of illness-without-disease that patients find themselves in.

Chronic fatigue syndrome and an illness-focused approach to care: Controversy, morality and paradox, by Michael Sharpe and Monica Greco in Medical humanities 2019; 45: 183-187.

Responses to this paper:

More science and less philosophy needed, by Susanna Agardy, Retired due to ME/CFS

At the heart of Sharpe and Greco’s article lies the complaint that while cancer patients accept CBT/GET treatments for their fatigue, ME/CFS patients reject these treatments. Of course they do! ME/CFS patients have a different disease, the main feature of which makes them unable to increase exertion.

The article contains several omissions and misinterpretations…

The argument provides a rationale for a science-denying approach to ME/CFS and endangers patient welfare. It is a departure from the previous model of more directly trying to correct patients’ ‘dysfunctional thinking’ and consequent ‘deconditioning’. This version of the Emperor’s New Clothes is also unacceptable…

Science, physiology and clarification of misleading terms, by Adi C Wood, Scientist ME

The view held by these authors that chronic fatigue syndrome is an illness without disease is at odds with the findings of the National Academy of Science, physiological and bio-medical researchers worldwide…

Sharp & Greco want us to abandon science, by Michael N Dyson, Computer Technician

Sharp & Greco state: “This new approach assumes that the reality of illness has a complex and indeterminate character”.

If by this they mean that the cause of any given illness cannot in principle be determined – as I suspect they are – then it is clear that they are abandoning the scientific enterprise. We ask Sharp and Greco: do they say illness is an effect? If they do then ipso facto they concede it has a cause or causes, and it is the task of science, in the broadest sense, to elucidate those causes…

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