- Context of unmanaged liabilities
- Enforceable obligations
- Obligation to not negate ME/CFS legal status
- Obligation to procure ME/CFS medical education
- Obligation to not mislead or evade diagnosis and to provide sufficient detail (FND, MUS, PPS, ‘dysregulation model’ and Long Covid examples)
- Obligation to not abuse power and authority
- Obligation to recognise ME/CFS patient housebound or carer status
- Tests of lawfulness
- Risks – compliance and operational
- Unlawful clinical judgement (examples)
- Expertise risk and reputational risk – medical and legal
- Illusion of legal authority vs medical law enforcement
- Knowledge-gap risk and audit trails (examples plus research-market inefficiencies)
- Freedom of Information Act risks – flawed clinical judgement, discrimination and education refusal
- Third party risk from preceding unlawful clinical judgement
- Liability, malpractice and indemnification
- Irrelevance of official edicts and officialised redistribution of liabilities to frontline balance sheets (vaccination and NICE guideline examples)
- Compromised indemnification, insurance cover nullification and liability for lost income
- Evaluating duties of care and unmanaged risk exposures
- Risk mitigation
- Version history
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The numbers of people affected by ME/CFS are significant. There are roughly twice as many sufferers as either Crohn’s disease or Lupus, roughly one and half times as many sufferers as HIV/AIDS in the European Union, and similar numbers of sufferers as either multiple sclerosis and Parkinson’s disease. The prevalence rates are significantly greater where normalised contra-scientific assumptions that mislabel fatigue are deployed.
It is well documented that ME/CFS patients are a neglected and misunderstood cohort and that GP-contact by ME/CFS patients is complicated. A large proportion of patients find that it is rational to avoid GP care, due to practical and human impacts of lack of knowledge, unlawful decision-making, gaslighting and false record taking. This is ironically the opposite of the frequent over-attendance that general practice is incorrectly trained to fixate on. Many ME/CFS patients do not attend their GP surgeries or even fall off GP registration entirely as a result, with an increasing risk of demonstrable causation.
The scale of the duty of care defines the scale of risk and potential liability. Being among the most vulnerable in society, the consensus quality of life statistics are repeatedly found as substantially worse or no better than most other diseases, essentially all of which do not carry an elevated likelihood of unlawful decision-making. These include HIV/AIDS, heart disease, congestive heart failure, cancer, stroke, kidney failure, lung disease, type 2 diabetes, osteoarthritis, multiple sclerosis, epilepsy, eosinophilic gastroenteritis, cystic fibrosis, sciatica and other maladies. It has also repeatedly been found that there is little difference in emotional or mental health, despite confirmation of ME/CFS as a greater physical disability.
ME/CFS patients are not just unusually neglected patients. They are unusually vulnerable, with little capacity to address issues that affect them, implying an additionally onerous risk-profile in clinical and reputational terms for frontline services.