Reflections

The second and final part of the paper by Moynihan et al  Mild symptoms as portents of serious disease: irritable bowel syndrome Irritable bowel syndrome has long been considered a common functional disorder, and a “diagnosis of exclusion” covering a range of symptom severity, yet it is currently experiencing something of a global ``makeover.” Without question many people with the condition are severely disabled by their symptoms, but the arrival of new drugs has seen manufacturers seek to change the way the world thinks about irritable bowel syndrome. What for many people is a mild functional disorder—requiring little more than reassurance about its benign natural course—is currently being reframed as a serious disease attracting a label and a drug, with all the associated harms and costs. Confidential plan to “shape” medical opinion A confidential draft document leaked from a medical communications company, In Vivo Communications, describes a three year “medical edu...

This paper was published 13 years ago in the BMJ. It raises issues which are unfortunately as relevant today as they were when it was published. I am reproducing it, hoping that it will help to educate us to some of the issues that face healthcare today. It can be found here   Selling sickness: the pharmaceutical industry and disease mongering Ray Moynihan, Iona Heath, David Henry There's a lot of money to be made from telling healthy people they're sick. Some forms of medicalising ordinary life may now be better described as disease mongering: widening the boundaries of treatable illness in order to expand markets for those who sell and deliver treatments. 1 , 2  Pharmaceutical companies are actively involved in sponsoring the definition of diseases and promoting them to both prescribers and consumers. The social construction of illness is being replaced by the corporate construction of disease. Whereas some aspects of medicalisation are the subject of ongoing deb...