Defending the Indefensible

Purpose: This document, authored by Margaret Williams on December 27, 2011, critically evaluates Professor Simon Wessely’s article in The Journal of the Foundation for Science and Technology. It challenges Wessely’s assertions about Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), focusing on his claims regarding Graded Exercise Therapy (GET), the PACE trial, and the nature of ME/CFS.

Key Points:

1. Critique of Wessely’s Assertions
   • The document disputes Wessely’s portrayal of Chronic Fatigue Syndrome (CFS) as a multi-factorial illness involving behavioral and psychological factors.
   • Challenges Wessely’s claim that GET has an “impeccable safety record,” citing surveys and research that indicate its ineffectiveness and potential harm for ME/CFS patients.
2. Concerns About the PACE Trial
   • Points out methodological flaws in the PACE trial, including conflicts of interest, changes to entry criteria, and misreporting of outcomes.
   • Highlights evidence that many participants found GET and Cognitive Behavioral Therapy (CBT) unhelpful or harmful, contradicting the trial’s reported conclusions.
3. Empirical Evidence Against GET
   • References numerous patient surveys and studies showing that GET worsens symptoms in a significant proportion of ME/CFS patients.
   • Criticizes the continued promotion of GET despite substantial evidence of adverse effects.
4. Biomedical Evidence for ME/CFS
   • Emphasizes the growing body of biomedical research demonstrating ME/CFS as a complex neuroimmune disorder involving inflammation, immune dysfunction, and neurological abnormalities.
   • Notes advancements in research by experts such as Professor Nancy Klimas and Dr. Jose Montoya, which undermine psychosocial models of ME/CFS.
5. Ethical and Policy Implications
   • Questions the ethical implications of promoting therapies like GET in the face of contradictory evidence.
   • Highlights concerns about the influence of the Wessely School on healthcare policies and disability assessments.

Target Audience:

• Researchers and Clinicians: Professionals seeking to understand the controversies surrounding ME/CFS treatments.
• Advocacy Groups and Patients: Stakeholders advocating for evidence-based care and biomedical research.
• Policymakers and Media: Decision-makers and journalists examining healthcare policies and research integrity.

Overall Outcome: This document calls for greater accountability in the treatment and research of ME/CFS. By exposing the flaws in Wessely’s arguments and highlighting robust biomedical evidence, it advocates for a shift toward more ethical and scientifically grounded approaches to care for ME/CFS patients.