- Summary
- 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
- References
- Version history
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The absolute clarity of the legal status of ME/CFS is of immediate risk management importance, due its statutory, policy and third-party contractual implications frequently being ignored. These stem from habitually unlawful clinical judgement and arbitrarily discriminative administrative treatment that fail to account for the clarity of classification and associated lawful obligations.
The absolute clarity of ME/CFS legal status is of immediate risk management importance, due its statutory, policy and third-party contractual implications frequently being ignored and leading to habitually unlawful clinical judgement and arbitrarily discriminative administrative treatment
NHS SNOMED-CT officially and specifically classifies ME/CFS as a neurological disease under SCTID 52702003. The extreme physical nature of ME/CFS and irrelevance of non-biophysical assumptions have also resulted in 1) the removal of the term “benign” from myalgic encephalomyelitis in WHO ICD 10 2019 G93.9, in line with the empirical findings that it is unusually malign, and 2) somatic ‘Bodily Distress Disorder’ (BDD) has been marked as an express exclusion for ME/CFS in WHO ICD 11 (SNOMED CT is currently based on ICD 10 2016). This is in line with the consensus of neurological, immune, endocrine, metabolic and other biophysical abnormalities, which is corroborated by repeated findings that invalidate traditional non-biophysical explanations and treatments that are still marketed.
The material risk management and compliance significance of the above comes from normalised unlawful failures to implement consequent requirements in clinical and administrative decision-making. These failures are often aggressively persistent and thus further exacerbate reasonable claims of discrimination and reputational risk. The persistence of risk generation from unlawful misapplication of ME/CFS classification rules frequently forces NGOs to readdress discriminatory policy violations by frontline medical practice.
Unlawful failures are often aggressively persistent, pervasive and audacious, further exacerbating reasonable discrimination claims and reputational risks, in an unmanaged risk context of nullifiable indemnity insurance and materially significant risk of harm and loss
The pervasiveness and frequent audaciousness of unmanaged risk in this field is illustrated by 1) the minimal literacy needed to determine classification based requirements versus 2) the frequency of arbitrary misrepresentation of and/or literal mistruths about these requirements in communications to patients, clients or beneficiaries. The material significance of the above, duties of care and resultant liabilities are further informed by ME/CFS being empirically and repeatedly confirmed as more disabled than other maladies. The weight of the duty of care and consequent liabilities may scale with this and the impact of harm done, including claims for lifetime income lost/reduced with the possibility of nullified medical indemnification.
It is also key to highlight that once communication of facts regarding law, policy, clinical judgement or model limitations are communicated, the tenability of delaying or obfuscating terminal obligation/liability is negated further.
It must also be noted that the clarity of resultant obligations and implied liabilities can be further realised versus specific organisations by third parties’ targeted requests under the Freedom of Information Act (which can lead to poor reputational risk outcomes on public record).