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(Dis)respect and shame in the context of ‘medically unexplained’ illness

A significant proportion of somatic symptoms remain, at present, medically unexplained. These symptoms are common, can affect any part of the body, and can result in a wide range of outcomes—from a minor, transient inconvenience to severe, chronic disability—but medical testing reveals no observable...

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Autor principal: Cheston, Katharine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796720/
https://www.ncbi.nlm.nih.gov/pubmed/35899324
http://dx.doi.org/10.1111/jep.13740
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author Cheston, Katharine
author_facet Cheston, Katharine
author_sort Cheston, Katharine
collection PubMed
description A significant proportion of somatic symptoms remain, at present, medically unexplained. These symptoms are common, can affect any part of the body, and can result in a wide range of outcomes—from a minor, transient inconvenience to severe, chronic disability—but medical testing reveals no observable pathology. This paper explores two first‐person accounts of so‐called ‘medically unexplained’ illness: one that is published in a memoir, and the other produced during a semi‐structured interview. Both texts are revelatory for their expression of shame in the context of encountering disrespect from healthcare professionals. The first section of my paper, clinical encounters, explores disrespect which, I argue, takes three interconnecting forms in these texts: disrespect for pain when it is seen as ‘medically unexplained’, disrespect for the patient's account of her own pain, and disrespect for the patient herself. The second section elucidates the shame that occurs as an affective and embodied consequence of encountering such disrespect. I claim that patients living with so‐called ‘medically unexplained’ illnesses suffer a double burden. They endure both somatic and social suffering—not only their symptoms, but also disrespectful, traumatic and shame‐inducing experiences of healthcare systems. I conclude with a reflection on the urgent need for changes in clinical training that could improve the quality of life for these patients, even in the absence of an explanation, treatment or cure for their symptoms.
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spelling pubmed-97967202023-01-04 (Dis)respect and shame in the context of ‘medically unexplained’ illness Cheston, Katharine J Eval Clin Pract Original Papers A significant proportion of somatic symptoms remain, at present, medically unexplained. These symptoms are common, can affect any part of the body, and can result in a wide range of outcomes—from a minor, transient inconvenience to severe, chronic disability—but medical testing reveals no observable pathology. This paper explores two first‐person accounts of so‐called ‘medically unexplained’ illness: one that is published in a memoir, and the other produced during a semi‐structured interview. Both texts are revelatory for their expression of shame in the context of encountering disrespect from healthcare professionals. The first section of my paper, clinical encounters, explores disrespect which, I argue, takes three interconnecting forms in these texts: disrespect for pain when it is seen as ‘medically unexplained’, disrespect for the patient's account of her own pain, and disrespect for the patient herself. The second section elucidates the shame that occurs as an affective and embodied consequence of encountering such disrespect. I claim that patients living with so‐called ‘medically unexplained’ illnesses suffer a double burden. They endure both somatic and social suffering—not only their symptoms, but also disrespectful, traumatic and shame‐inducing experiences of healthcare systems. I conclude with a reflection on the urgent need for changes in clinical training that could improve the quality of life for these patients, even in the absence of an explanation, treatment or cure for their symptoms. John Wiley and Sons Inc. 2022-07-27 2022-10 /pmc/articles/PMC9796720/ /pubmed/35899324 http://dx.doi.org/10.1111/jep.13740 Text en © 2022 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Papers
Cheston, Katharine
(Dis)respect and shame in the context of ‘medically unexplained’ illness
title (Dis)respect and shame in the context of ‘medically unexplained’ illness
title_full (Dis)respect and shame in the context of ‘medically unexplained’ illness
title_fullStr (Dis)respect and shame in the context of ‘medically unexplained’ illness
title_full_unstemmed (Dis)respect and shame in the context of ‘medically unexplained’ illness
title_short (Dis)respect and shame in the context of ‘medically unexplained’ illness
title_sort (dis)respect and shame in the context of ‘medically unexplained’ illness
topic Original Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796720/
https://www.ncbi.nlm.nih.gov/pubmed/35899324
http://dx.doi.org/10.1111/jep.13740
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