2019 DRAFT GUIDELINES FOR THE PREVENTION, DIAGNOSIS AND TREATMENT OF LYME DISEASE
Guidelines for management of Lyme disease from the Infectious Diseases Society of America are undergoing revision. As part of that process they've presented the draft for a period of public comment. My comments primarily address specific material in the guideline about management of "chronic Lyme disease". I have also suggested, as a general comment, that the guideline advances an attitude of hubris about management of patients with "chronic Lyme disease", because it fails to acknowledge the very serious risks that arise when poorly understood conditions are attributed to psychological causes in error.
The global diagnostic coding manual, the ICD, has recently been revised. In the new edition, ICD-11, the category of "Somatoform Disorders" will be replaced by the new category of "Bodily Distress Disorder". During the revision process the WHO posted a draft and invited proposals that comment on changes. This proposal suggests that the new construct of "bodily distress disorder" should be rejected on ethical grounds.
Note: This proposal has been escalated for consideration by the Medical Science Advisory Committee
ETHICAL DECISION MAKING ABOUT CHRONIC LYME DISEASE
Video presentation and statement to UN Special Rapporteur on Health and Human Rights as a member of the Global Ad Hoc Committee on Health Equity in ICD-11 Borreliosis Codes.
PROPOSAL: ETHICAL CLASSIFICATION OF ME/CFS
Public proposal at the Beta Draft for the new edition of the International Classification of Diseases (ICD-11). "Benign myalgic encephalomyelitis" (ME) and "chronic fatigue syndrome" (CFS) remain classified in ICD-11 in the neurological category of "postviral fatigue syndrome", though without exclusions to ensure that ME will not be captured with criteria for the psychiatric condition of "bodily distress disorder" in the general ICD, or "bodily stress syndrome" in the ICD for primary care (which has not yet been finalized).
COMMENTS ON PROPOSAL TO RECLASSIFY ME/CFS
Public comments at the Beta Draft for the new edition of the International Classification of Diseases (ICD-11), rejecting a proposal to reclassify ME/CFS under "signs and symptoms of musculoskeletal disorders".
STAKEHOLDER COMMENTS ON NICE PROPOSAL NOT TO REVISE THE GUIDELINE FOR ME/CFS IN THE UK - IN COLLABORATION WITH THE COUNTESS OF MAR
Comments submitted to the National Institute for Health and Care Excellence on behalf of the coalition of ME/CFS organizations known as "Forward-ME", in response to the preliminary decision not to revise the current practice guideline. That decision has now been reversed, and revisions are underway.
COMMENTS FOR HEARING ON FUNCTIONAL DISORDERS
Letter to the Health and Prevention Committee of the Danish Parliament on ethical concerns related to the Danish construct of “bodily distress syndrome”. Criteria for "bodily distress syndrome" have now been recommended for inclusion in the new edition of the global ICD for primary care.