Sixty seconds on . . . medical gaslighting
BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1974 (Published 09 August 2022) Cite this as: BMJ 2022;378:o1974
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Dear Editor
Astonishing reading this little article [1] that two years on the Cumberlege Review is not mentioned and is evidently completely forgotten [2].
Meanwhile, I read [3]
“As of 27 July 2022, for the UK, 172,476 Yellow Cards have been reported for the COVID-19 Vaccine Pfizer/BioNTech, 245,996 have been reported for the COVID-19 Vaccine AstraZeneca, 40,270 for the COVID-19 Vaccine Moderna and 1,791 have been reported where the brand of the vaccine was not specified.”
And:
“The MHRA has received 815 UK reports of suspected ADRs to the COVID-19 Pfizer/BioNTech Vaccine in which the patient died after vaccination, 1,297 reports for the COVID-19 Vaccine AstraZeneca, 65 reports for the COVID-19 Vaccine Moderna and 49 reports where the brand of vaccine was unspecified.”
It has also been stated elsewhere by the government:
“It is estimated that only 10% of serious reactions and between 2 and 4% of non-serious reactions are reported.” [4]
And yet we hear little about these poor people - we are too adept at making little things big and big things little. Another name for it perhaps is news management. After two years, and especially these two years we perhaps need to apply ourselves for more than a minute to what could possibly go wrong.
[1] Jacqui Wise, ‘ Sixty seconds on . . . medical gaslighting’, BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1974 (Published 09 August 2022)
[2] Helen Haskell, 'Cumberlege review exposes stubborn and dangerous flaws in healthcare', BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3099 (Published 06 August 2020)
[3] https://www.gov.uk/government/publications/coronavirus-covid-19-vaccine-...
[4] https://www.gov.uk/drug-safety-update/yellow-card-please-help-to-reverse...
Competing interests: AgeofAutism.com, an on-line daily journal, concerns itself with the potential environmental sources for the proliferation of autism, neurological impairment, immune dysfunction and chronic disease. I receive no payment as UK Editor. I also moderate comments for the on-line journal ‘The Defender’ for which I am paid. I am also a member of the UK Medical Freedom Alliance
Dear Editor,
My first reaction to this was “really?”. Even if there is a problem of dismissing symptoms I feel that using the term “gaslighting” is unhelpful.
True “gaslighting” is abuse. Does not taking symptoms seriously amount to gaslighting? It’s poor practice certainly but promoting it to gaslighting seems a bit of an excessive reaction. In my experience, a full and appropriate and professional and caring discussion in lay terms of the differential can be interpreted by an anxious patient as dismissal of symptoms, especially if the patient has fixed on a self diagnosis. I’ve certainly had one or two complaints in these situations. Elevate that appropriate assessment to the status of “gaslighting” risks labelling very good clinicians as serial offenders and may fix the patient in the wrong care pathway. We’ve all missed things through inappropriate reassurance but I doubt that amounts to gaslighting! In my experience it’s almost unknown in GP to not do a fairly large range of investigations in vague, inexplicable symptoms. I suspect true medical gaslighting must be vanishingly rare.
Competing interests: No competing interests
Dear Editor,
This short piece on 'medical gaslighting' raises the important point that doctors should always accept patient concerns about symptoms and never dismiss them as imaginary. But it also risks making the serious error of conflating considering a role for psycholgical factors in the aetiology of symptoms, with dismissing them, and the ordering of biomedical investigation as a key indicator of acceptance. The consequences of this line of argument are potential iatrogenic harms from denying patients a full understanding of their illness and the potential benefit of psychological treatments as well as increasing the risk of adverse consequences of unnecessary biomedical investigation. To say that invoking psychological factors is equivalent to dismissal is to retreat into a narrow biomedical reductionism that many of us hoped we had escaped long ago.
Competing interests: No competing interests
Gaslighting or psychologisation?
Dear Editor
I agree with others that the term gaslighting in relation to conditions like long covid is misleading. Gaslighting is a deliberate act by a person with malicious intent. The phenomenon described is consistent with psychologisation, defined in 1991. (1) The review by Goudsmit and Gadd includes a number of examples, some published in the BMJ to inform and warn.
1 Goudsmit EM, Gadd R. All in the mind? The psychologisation of illness. The Psychologist 1991;4:449-53.
Competing interests: No competing interests