Misdiagnosis concerns highlighted by CNN

CNN points out that misdiagnosis of a disease that you don't have is quite common. The statistics (from a 2005 study in the Journal of the American Medical Association) show that doctors are wrong 10 percent to 15 percent of the time in their diagnosis. The story of one patient who was diagnosed with cancer and had a lump from her torso surgically removed, tells it all:
The oncologist told me that if I didn't begin chemo immediately," says Torrey, "I would be dead by Christmas."

The 52-year-old marketing consultant says she was petrified. But something in her gut told her the diagnosis was wrong.

Her doctor assured her it was right: two labs had confirmed the subcutaneous panniculitis-like T-cell lymphoma.

Against her doctor's orders, Torrey delayed chemo and went to another oncologist, who sent a tissue sample to the National Institutes of Health. The result: Torrey never had cancer.

The lump was a harmless fatty growth.
The patient was both "overjoyed" and "furious:" "She couldn't believe she had been on the verge of having chemotherapy for nothing."

The article goes on to ask how the patient could have known inside (so to speak) that the diagnosis was wrong. The article cannot really answer this question, because in the West the notion that people have body wisdom is generally not well accepted. Instead, there are some halfhearted scientific explications, some of which may be helpful, and none of which confirm that the patient simply knew. (Maybe she had a dream, a message from her unconscious, or listened to her guides, or tuned in to her body. Maybe she had information from an inner source, which could then alert her to try to get confirmation from an external, physical source.)

In any event, the tools offered include: check if you don't get better with treatment; symptoms don't match your diagnosis; diagnosis is based purely on a lab test; doctor attributes common complaints to an uncommon ailment; diagnosis usually involves a test you never received.

All these, of course, depend on an error being made by the physician. But there could be a misdiagnosis even without an overt mistake, simply based on overconfidence in a medical judgment that is not conclusively supported by the incoming evidence. CNN wants to help support the "Empowered Patient," and that is well and good but in the meanwhile, a healthy dose of skepticism about medical paternalism is always warranted, creating that delicate balance between respecting scientific knowledge and understanding that epistemologically, the realm of knowledge is always much larger than can be confined to a petri dish.
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Michael H. Cohen is Principal in Law Offices of Michael H. Cohen and also President of a nonprofit organization exploring legal, regulatory, ethical, and health policy issues in the judicious integration of complementary and alternative medical therapies (such as acupuncture and traditional oriental medicine, chiropractic, naturopathic medicine, homeopathy, massage therapy, energy healing, and herbal medicine) and conventional clinical care. Michael H. Cohen is author of books on health care law, regulation, ethics and policy dealing with complementary, alternative and integrative medicine, including Healing at the Borderland of Medicine and Religion, Complementary and Alternative Medicine: Legal Boundaries and Regulatory Perspectives (1998), Beyond Complementary Medicine: Legal and Ethical Perspectives on Health Care and Human Evolution (2000), and Future Medicine: Ethical Dilemmas, Regulatory Challenges, and Therapeutic Pathways to Health Care and Healing in Human Transformation (2003).
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