A touch of MS: therapeutic mislabeling

Neurology
Adrienne R Boissy, Paul J Ford

Abstract

When psychogenic symptomatology is at play, a spectrum of ethical problems and considerations arise when patients want, and at times, insist on being given an inaccurate neurologic diagnosis. We use the example of multiple sclerosis (MS) to highlight the value considerations for clinicians when they face these types of cases. Given the ambiguities involved in its diagnosis and the significant risks of its treatment, MS represents a rich case study. This discussion highlights the potential harms of mislabeling such patients with MS when the neurologist is confident they do not have MS and offers suggestions about how to approach and manage these patients. Despite being expedient and well-intentioned, labeling psychogenic symptoms with a medically inaccurate diagnosis, such as a "touch of MS," constitutes a "therapeutic mislabeling" and sacrifices ethically important values incommensurate with the benefits gained.

Citations

Oct 22, 2013·Current Neurology and Neuroscience Reports·Andrew J Solomon, Brian G Weinshenker
Aug 7, 2013·Continuum : Lifelong Learning in Neurology·Andrew J Solomon, Eran Klein
Aug 12, 2014·General Hospital Psychiatry·Xavier F JimenezSyma A Dar
Jun 5, 2016·Continuum : Lifelong Learning in Neurology·Aaron E Miller
May 23, 2019·Journal of Neurology·Dennis WalzlJon Stone
May 28, 2019·Frontiers in Neurology·María I Gaitán, Jorge Correale
Nov 30, 2018·Revue neurologique·L Garcia-Larrea, K Hagiwara

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