Whiter than white?
Margaret Williams 6th November 2007
For the avoidance of doubt, what follows are excerpts from the BBC Radio 4 broadcast on “You and Yours” about ME/CFS that was transmitted on Monday 5th November 2007 and what Professor Peter White said after the programme (off-air) to Dr William Weir.
Dr William Weir: “This is a very, very severe illness”.
The interviewer (also named Peter White): “Professor White, you’ve already acknowledged that (lumping together heterogeneous states of chronic fatigue) is putting a lot of things in the same basket – that creates difficulties – isn’t that why perhaps people are so concerned, for example, and people accuse you of being too wedded to the fact that this is in the mind as opposed to the body?”
Dr William Weir: “Psychiatrists can be legitimately criticised because they tend to concentrate on the mind, although I’m glad to hear Professor Peter White say that this illness has physical components. Fundamentally, the cause of this is an organic disturbance of bodily function and I think the likeliest common denominator is a disturbance of the immune system. There is recent work which suggests that the immune system is up-regulated and causes symptoms which are the fundamental problem with this illness”.
When asked by the interviewer about the Canadian Guidelines, Professor Peter White said he did not like them: “The problem is, and the reason why I don’t use them, is they’re very complicated to use and would require me to actually do tests on my patients that I don’t think I ethically should be doing on my patients, and I don’t find them useful, and if Guidelines aren’t useful, then we don’t use them”.
The interviewer (Peter White), addressing Professor Peter White: “You mentioned tests that you don’t think it’s right for you to do, such as …?”
Professor Peter White: “Such as the tilt table test – I would have to exclude a condition called POTS (where the blood pressure falls on standing up). I don’t think that’s justified”.
The interviewer (Peter White): “So you think they’re unethical because they’re too demanding?”
Professor Peter White: “Yes”.
Dr William Weir: “A very large amount of money is currently being applied to research into disturbances of the mind in relation to this disorder and the biomedical causes of this condition have been neglected by the people who hold the purse strings”.
The interviewer (Peter White): “Why?”
Dr William Weir: “I think because the overall culture hitherto has been very much in favour of the psychiatric definition of this disease, and the psychiatric understanding of this disease. The current PACE study has been funded to an extent which I think should be equalled by appropriate medical study, and that’s not the case”.
The interviewer (Peter White): “Let me put that to Peter White – this is your field – has too much money been spent on the psychiatric side?”
Professor Peter White: “No – I don’t think so at all”.
Turning briefly to views on causation, Professor Peter White said: “On the aetiological side, we’re going to look at the reaction in the brain to cytokines to see if they are elevated, because we know that the immune system affects the brain, and so we’re going to look at whether the brain perceives fatigue abnormally in this illness, because we suspect it does”.
During the programme, Professor Peter White expressed support for the NICE Guideline, saying that NICE “thoroughly supports” cognitive behavioural therapy (CBT) and graded exercise therapy (GET) “for a very good reason – the research evidence is there”.
Can Professor White really be unaware that the evidence is simply not there, as has been demonstrated by many people, including Professor Malcolm Hooper and Horace Reid in their comprehensive analysis which NICE dismissed (see http://www.meactionuk.org.uk/FINAL_on_NICE_for_Gibson.html ) and by Dr Eleanor Stein, herself a psychiatrist, at the ME Research UK International Research Conference in Edinburgh on 25th May 2007, who expertly demolished the so-called “evidence” that is based on a heterogeneous population (just seven random controlled trials (RCTs) of CBT and a mere four RCTs of GET)? (see http://www.meactionuk.org.uk/Defiance_of_Science.htm ).
It is noted that Professor Peter White went on record saying: “If guidelines aren’t useful, then we don’t use them”. This dictum ought surely to apply equally to the NICE Guideline that he so ardently supports. However, in the case of the NICE Guideline, the difference is that there is a Government hit-gang in the form of The Commission for Healthcare Audit and Inspection ready and waiting to compel healthcare professionals to comply, whether or not they deem the NICE Guideline useful.
When transmission ended, Dr Weir turned to Professor White and said (words to the effect of): “Peter, I’m glad to hear you state ME is not a psychological disorder. This must mean that things have moved on from illness beliefs”, whereupon Professor White’s immediate response was (verbatim): “Oh no, it IS an abnormal illness belief”.
Also participating in the broadcast was Ondine Upton, a Trustee and former Chair of the charity Action for ME (AfME). Ms Upton went on record saying: “We’ve got to work with the doctors”.
One of those doctors with whom AfME has affiliated itself is Professor Peter White.
It is undeniable that on-air, Professor White affirmed his belief that ME is not a wholly psychological disorder, whilst moments later, but off-air, the same Professor White asserted about the same disorder that it is an abnormal illness belief.
This means that AfME is collaborating with a psychiatrist who on 5th November 2007 asserted that, despite the vast amount of evidence to the contrary, ME is an abnormal illness belief.
Are AfME’s members content that the charity is collaborating with a psychiatrist who asserts that ME is an abnormal illness belief?
19 November, 2007
An open letter to Professor Peter White
By Gurli Bagnall