Response to Dr. Manu -Finale

[Guest guest]

References:

*Question to Dr. Manu*

http://www.me-net.combidom.com/index.htm

*Reply -Question to Dr. Manu*

Help ME Circle, 13 March 2007 - see Co-Cure:

http://listserv.nodak.edu/cgi-bin/wa.exe?A2=ind0703b & L=co-cure & T=0 & P=6499

Reply -Question to Dr. Manu-2

http://www.me-net.combidom.com/index.htm

Response to Dr. Manu -2

http://www.me-net.combidom.com/index.htm

Response to Dr. Manu -3

http://www.me-net.combidom.com/index.htm

Response to Dr. Manu-4

http://www.me-net.combidom.com/index.htm

*Reply from Dr. Manu*

http://www.me-net.combidom.com/index.htm

*Response to Dr. Manu-5*

http://www.me-net.combidom.com/index.htm

`````

After sending out *Response to Dr. Manu-5*, in which I

promised to stop with this series, I checked my web mail and

found some more replies to Dr. Manu.

One of them was a reaction to Dr. Manu about his answer

(*Reply from Dr. Manu*) to Schweitzer's

*conflicts of interest*. (Response to Dr. Manu -3) - see

addresses above.

Because this subject was not explored by others and specially

because I'm a great admirer of the writings by Herd (one of

the *founding fathers* of the ME/CFS movement), I will break my

promise and can't resist to publish his excellent article below.

~jvr

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Re: Reply from Dr. Manu

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It appears to me that Manu is trying to be cleaver in his

side stepping the matter of potential financial conflicts of

interest.

Declaration of conflicts of interest are a serious matter in

medicine. Disclosure of conflicts of interest is usually mandatory

when submitting papers to peer reviewed medical journals or

when presenting at many conferences. This is not the case when

one submits an editorial letter or when publishing a book.

Why Manu would feel the need to avoid the matter of

financial conflicts of interest and appear to be defensive about

the subject, leads one to believe he has something to hide,

something that may contribute to his very controversial views

about ME/CFS.

Many doctors and patients alike view his positions about the

illness to be not only unsound, but repeatedly disproved by a

great deal of mainstream medical research. So what is it that

leads Manu to so vigorously hold onto his repeatedly

disproved position about ME/CFS? Might the answer lie in

those undisclosed financial conflicts of interest?

Manu notes that " most senior faculty members are

consulting for state and federal agencies, medical journals, book

publishers, insurance companies, drug manufacturers and law

firms. " There is a vast difference between the potential position

influencing effect of consulting to a medical journal or book

publisher and that of an insurance company or drug

manufacturer, the latter two of which Manu is known to

have done.

Drug companies and insurance companies are driven by profit.

They expend considerable funds to those who are willing to

promote positions that are in the economic of their companies.

Case in point, it is in the economic interest of insurance

companies to present that ME/CFS is not a disabling condition,

or that those afflicted are not disabled so they do not have to pay

out disability claims. Manu does not deny in his

communications that he has derived income from the insurance

company MetLife.

At the AACFS conference held in San Francisco it became

known that he was deriving income from an insurance company.

Standing before the attendees wearing an expensive looking

blue silk suit and European looking shoes he stated he'd bet

everything in his pocket that CFS proved to be a psychological

condition. And then boasted, and I have a lot in my pocket.

Apparently the insurance companies were paying him well.

I believe he has also testified as an expert witness on behalf of

insurance companies at disability court cases.

Years earlier he gave a lecture about CFS being a

psychological condition to psychiatrists at a free dinner meeting

paid for entirely by the pharmaceutical company Eli Lilly makes

Prozac and other antidepressants.

Apparently Manu has refined his thinking further since

then. He states the following in part of the dialog that has recently

been taking place. " I do not favor a psychiatric explanation for

chronic fatigue syndrome... I recognize the fact that patients

diagnosed with CFS suffer and have physical and psychological

symptoms, but there is no proof that CFS, as currently defined,

is a physical or psychiatric disease. "

I dare say if he made such a statement at the recent 2007

IACFS conference he'd have gotten nothing but smirks and

snickers from the hundreds of doctors present.

That position sounds like a court room type attempt to have your

cake and eat it too.

So is he saying ME/CFS is somatoform disorder? Somatoform

disorders still would fall under the umbrella of being psychiatric

conditions.

" Somatoform disorders represent a group of disorders

characterized by physical symptoms suggesting a medical

disorder. However, somatoform disorders represent a

psychiatric condition because the physical symptoms present in

the disorder cannot be fully explained by a medical disorder,

substance use, or another mental disorder. These somatoform

disorder physical complaints challenge medical providers who

must distinguish between a physical and psychiatric source for

the patient's complaints. Often, the medical symptoms patients

experience may be from both medical and a psychiatric

illnesses. Anxiety disorders and mood disorders commonly

produce physical symptoms. " Excerpted from:

http://www.emedicine.com/med/topic3527.htm

Presenting ME/CFS as a somatoform disorder at the 2007

IACFS conference would have drawn just as many snickers from

the doctors present.

When Manu states, " ...there is no proof that CFS, as

currently defined, is a physical or psychiatric disease, " he is

showing that he either refuses to look at or consider the breadth

of research conducted on the illness by main stream highly

respected doctors or he can't be bothered with keeping up with

that research. In either case, such entrenchment has the

appearance of a strong motivation being present that goes well

beyond the realm of scientific accuracy. In such cases one can

presume that motivation is economic. And as such

Schweitzer was very correct in noting that Manu's conflicts

of interest.