I've read most of this very interesting and entertaining book, written by Toronto psychiatrist Andrew Malleson. I'm not sufficiently familiar with the scientific literature to vouch for his conclusions, and there are places in the book where Malleson seems to me to go well beyond his own expertise and reach conclusions that are not directly supported by his evidence. Indeed, I think the book would benefit from being edited down by about a third, with the weaker and more speculative material deleted.
Nevertheless, there are many useful tidbits of information and startling hypotheses in this book, with sufficient citations to the academic literature that the reader could look up the relevant studies for himself if he is skeptical. This is certainly a book that should be on the shelf of, among others, (a) anyone who represents insurance companies in automobile accident injury litigation; (b) anyone interested in "junk science" in general; (c) anyone interested in how the medical profession, or elements thereof, sometimes creates official "illnesses" that are really just clusters of symptoms with no common or known physical cause; (d) anyone interested in the effects of litigation on accident victims, and whether the victimization that are required to exhibit for legal purposes may hinder their emotional and physical recovery; (e) anyone interested in somatic illnesses; (f) anyone interested in malingering and fraud in the workers' compensation and tort systems; and (g) anyone interested in how the legal system encourages, profits from, and sometimes precipitates (c).
Perhaps because the book was written by a Canadian and published by a Canadian press, it hasn't received much attention from American legal scholars since its initial publication in 2003; indeed, it has only been cited once on Westlaw so far. But the book provides abundant material to inform debates on a host of legal issues.
It hurts!
Fibromyalgia is not a bona fide physical illness, but rather a "diagnosis" that only attaches for "legal purposes"? Help me then to understand how it is that credible medical specialists, especially rheumatologists, offer that explanation ("fibromyalgia") for individuals who are not and will not be plaintiffs in a lawsuit, disability seekers, etc.?
I have always been skeptical about this entity which has rather "soft" diagnostic criteria and no unequivocal, entirely objective findings, especially since it is often a component of otherwise suspect injury claims. I am not persuaded, though, that "fibromyalgia...doesn't exist except for legal purposes." And DB, perhaps you shouldn't be so credulously accepting of a psychiatrist's testimony about the presence/absence of "organic" illness. (BTW, does Dr. Malleson testify on behalf of defendants in personal injury cases?) Now, if you want to go after something that is bogus to the core, take "multiple chemical sensitivities."
BTW, what "weaker and more speculative material" do you think should be deleted?
I have advocated/recommended in various settings compensation for those I believed on the basis of convincing evidence had physical problems that they deserved to be compensated for, and I have advocated/recommended against compensation for those who had no such evidence. Your (a) through (g) are appropriate enough, but there is an unfortunate lack of balance when all the attention goes to plaintiffs and nothing is said about less than honest medical/scientific defenses argued by defense attorneys on behalf of their clients. (Is "ho" acceptable here? If so, I will say there are both plaintiff ones and defense ones out there, especially in the medical malpractice arena.)
In addition, giving "nothing's wrong with you, you're just complaining about pain" a Latin name allows people to qualify for disability, take off work with pay, etc. It's an not unexpected consequence of laws designed to help people who are sick by forcing others to compensate them. At the margin, more people become sick. I'm sure neurodoc sees this in his practice, as I do in mine.
Amazingly, this describes the disease called "AIDS" which has scared people for 26 years. It really is just an umbrella designation for 20 or so old diseases (tuberculosis, pneumonia, yeast infection, diarrhea etc).
See, Dr. Peter H. Duesberg
The problem is that, as sophisticated as medicine is, we don't have perfect knowledge of the human body. Syndromes that involve chronic pain are frustratingly complex. And... none of that is help by the numerous ways in which our generous society "rewards" people for being sick or disabled. In my opinion, the majority of people that I have seen with the diagnosis of "fibromyalgia" were clearly malingering. Either for some sort of disability payments or for pain meds. Over time I have come to be pretty skeptical of that diagnosis.
And what's the solution? Binding arbitration?
(2) To reiterate, I don't know enough about the scientific literature to endorse the author's conclusions. But he raises enough provacative questions with citations to, and quotations from, the medical and scientific literature, that the book is well worth reading even if he not always right.
But, there is a cluster of people who suffer from such, and knowing what the genesis is, treatments such as antidepresents and rophanal, are easier to understand.