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Values at the Crossroads of Neurology, Psychiatry, and Psychology
Paul J. Ford

Clinical neuroethics often engages a paradigm of medicine that has a significant discomfort with ambiguities. Uncertainty in both medical diagnosis and treatment constitutes the reality of many disease processes in which patients, families, and health care providers make health care decisions that deeply affect their lives. In particular, conditions whose neurological symptoms challenge our distin...

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Target Article

Silos of Silence, Stress, and Suffering: Patient and Physician Experiences of MUPS and Diagnostic Uncertainty
Chloë G. K. Atkins, Keith Brownell, Jude Kornelsen, Robert Woollard & Andrea Whiteley

Ours is a qualitative investigation that interviews practitioners and patients about the phenomenon of MUPS (medically unexplained physical symptoms)–i.e., the context of lacking clear diagnostic and treatment options and the experience of being “not yet diagnosed.” With regard to practitioners, since current diagnostic models in medical practice do not adequately account for patient symptom...

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Attitudes on Mind Over Matter: Physician Views on the Role of Placebo in Psychogenic Disorders
Karen S. Rommelfanger

Psychogenic movement disorders (PMD) mimic known movement disorders, yet cannot be attributed to an underlying neurological substrate. PMD has been reported to affect up to 15–25% of patients who visit specialized movement disorder clinics. The lack of mechanistic understanding of this disorder contributes to the hesitation of physicians to give a diagnosis of PMD, and patients often experience ...

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Half Someone Else's: Discourse and Trauma in the PNES Patient
Lauren Boehm

This article is about patients suffering from Psychogenic Nonepileptic Seizures (PNES), and the way they talk about their seizures. In terms of founding questions, data, and insight, it owes a tremendous intellectual debt to the “Listening to People with Seizures” project at the University of Sheffield, UK. The PNES diagnosis is notoriously difficult to make. Taking patients at their word is a...

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Faces of Fatigue: Ethical Considerations on the Treatment of Chronic Fatigue Syndrome
Smaranda Ene

Chronic fatigue syndrome (CFS) is a condition of undetermined etiology. CFS has been considered by some scholars (Ware and Kleinman 1992) to be a psychosomatic manifestation of sociocultural stress, while others have compared it to multiple sclerosis (Richman 2010) or traumatic brain injury (Bruno 2008). Although several neurological and neuroimmune disorder mechanisms have been proposed, the trea...

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Addiction: Current Criticism of the Brain Disease Paradigm
Rachel Hammer, Molly Dingel, Jenny Ostergren, Brad Partridge, Jennifer McCormick & Barbara A. Koenig

To deepen understanding of efforts to consider addiction a “brain disease,” we review critical appraisals of the disease model in conjunction with responses from in-depth semistructured stakeholder interviews with (1) patients in treatment for addiction and (2) addiction scientists. Sixty-three patients (from five alcohol and/or nicotine treatment centers in the Midwest) and 20 addiction scien...

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