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Medical neglect and abuse
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==Evidence == "The bastards don't want to get better" was how some nurses saw patients with [[Severe and very severe ME|severely ME]] during a clinical trial known as the [[FINE trial]].<ref name="Peters2011">{{Cite journal | last = Peters | first = Sarah | authorlink = | last2 = Wearden | first2 = Alison | authorlink2 = Alison Wearden | last3 = Morriss | first3 = Richard | authorlink3 = | last4 = Dowrick | first4 = Christopher F | authorlink4 = | last5 = Lovell | first5 = Karina | authorlink5 = | last6 = Brooks | first6 = Joanna | authorlink6 = | last7 = Cahill | first7 = Greg | authorlink7 = | last8 = Chew-Graham | first8 = Carolyn | authorlink8 = Carolyn Chew-Graham | date = Dec 2011 | title = Challenges of nurse delivery of psychological interventions for long-term conditions in primary care: a qualitative exploration of the case of chronic fatigue syndrome/myalgic encephalitis|url=http://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-6-132|journal=Implementation Science|language=en|volume=6|issue=1|pages=|doi=10.1186/1748-5908-6-132|issn=1748-5908|pmc=3259041|pmid=22192566|quote=there is sort of feeling that the patient should be grateful and follow your advice, and in actual fact, what happens is the patient is quite resistant and there is this thing like you know, “The bastards don’t want to get better...|via=}}</ref> This phase was published in the peer-reviewed scientific publication of the FINE Trial, which consisted of aerobic [[exercise]] and [[Biopsychosocial model|psychological]] treatments which were ultimately found to be ineffective.<ref name="Peters2011" /> The clinical trial was intended to determine if the treatments worked, but medical professionals including some nurses delivering the treatment, had become convinced that the treatments ''must'' work, they ignored harms, and angrily blamed patients who deteriorated or did not recover.<ref name=magicalmedicine /> Despite a number of patients significantly deteriorating, and at least one life-threatening medical emergency, patient harms were ignored both during and after the trial.<ref name="Peters2011" /><ref name=magicalmedicine /> Two patients with [[severe and very severe ME|severe ME]] who took part in the [[FINE trial]], a clinical trial including [[exercise]] and [[Biopsychosocial model|psychological]] treatment reported significant coercion harm during the trials, which medical professionals running the trials ignored and refused to document. Professor [[Malcolm Hooper]] published this account from one FINE trial patient: {{Quote frame|quote=At the start of the programme, Miss C defined her condition as being between 6 to 7 out of 10. A nurse visited Miss C at home and she was given a series of aerobic exercises to complete daily. The exercises largely involved walking, step aerobics done outside and other aerobics to be completed indoors... After the first month, she started to decline. Her symptoms increased in severity as the intensity and amount of exercise was increased. She reported this to the FINE team but was encouraged to continue even though she reported feeling unwell and that she was declining. She experienced an exacerbation of her gastrointestinal symptoms, which she was instructed to ignore and to continue with increasing the exercise time and intensity. After four months, Miss C’s health had deteriorated to the point where she could no longer continue to keep up with the programme. Her condition continued to decline. At this point she was very weak, her symptoms were severe and she had to spend three months in bed. This was reported to the FINE Trial team. Miss C reports that they were not interested in her deterioration. She was told that she had finished the trial and that she was considered a success and to be cured due to her initial improvement. This was distressing for Miss C as this was clearly not the case... there was no follow‐up care and all the counselling and support that was available during the trial was withdrawn... Since undertaking the graded exercise, Miss C now rates her condition to be 2 out of 10 and she continues to decline. She now has added disabilities that were exacerbated by the graded exercise regime.<ref name=magicalmedicine />{{Rp|437-439}}|source=Two FINE Trial Case Histories, Magical Medicine: How to Make a Disease Disappear | author = Malcolm Hooper | date = 2010<ref name=magicalmedicine />}}
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