Comment on:
Chronic fatigue syndrome comes out of the closet. [CMAJ. 1998]
Chronic fatigue syndrome or just plain tired? [CMAJ. 1998]
Chronic fatigue syndrome get court’s nod of approval as legitimate disorder. [CMAJ. 1998]
The 3 excellent articles on chronic fatigue syndrome 1–3 reminded me of the desperate need for a discussion of the ethics — or lack thereof — related to independent medical examinations of patients with this condition.
A recent 21-page report from an independent medical examination of one of my patients with chronic fatigue syndrome included 2 pages of error-riddled history and the results of only a cursory physical exam, along with a bold admission that a full physical examination had not been done. The other 19 pages, clearly based on a word-processor template, were peppered with such clichés as “illness-seeking behaviour,” “somatization syndromes” and “preconscious motives.” The fee assessed for this report was $1200.
I used to be asked by insurance companies to perform independent medical examinations (for the standard fee suggested by the Alberta Medical Association), requests that I always accepted. However, when it became known that, in appropriate circumstances, I might support a diagnosis of chronic fatigue syndrome, such requests ceased abruptly.
You can read the rest of this comment here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1230108/pdf/cmaj_160_5_638.pdf
Source: Voth A. What causes chronic fatigue? CMAJ. 1999 Mar 9;160(5):638. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1230108/pdf/cmaj_160_5_638.pdf (Full article)