In May 2013, the next edition of the primary guide psychiatrists and psychologists use to diagnose their patients is being released by the American Psychiatric Association. It’s attracted a shit-storm of criticism for it’s unilateral decision to make sweeping changes to the guide.
–British Psychological Society (BPS),
–Danish Psychological Association,
–Division of Behavioral Neuroscience and Comparative Psychology (Division 6 of APA)
–Division of Developmental Psychology (Division 7 of APA),
–Division of Clinical Psychology (Division 12 of APA),
–Society of Counseling Psychology (Division 17 of APA)
–Society for Community Research and Action: Division of Community Psychology (Division 27 of APA),
–Division of Psychotherapy (Division 29 of APA),
–Society for the Psychology of Women (Division 35 of APA),
–Division of Psychoanalysis (Division 39 of APA),
–Psychologists in Independent Practice (Division 42 of APA)
–Society for the Psychological Study of Lesbian, Gay, Bisexual, and Transgender Issues (Division 44 of APA),
– Executive Committee of the Society for the Study of Peace, Conflict and Violence: Peace Psychology Division (Division 48 of APA)
–Society for Group Psychology and Psychotherapy (Division 49 of APA),
–Society for the Psychological Study of Men & Masculinity (Division 51 of APA),
–Division of International Psychology (Division 52 of APA),
–Association for Counselor Education and Supervision (Division of the American Counseling Association)
–Association for Humanistic Counseling (Division of the American Counseling Association)
–The Association for Creativity in Counseling (ACC, Division of the American Counseling Association)
–Association for Adult Development and Aging (AADA, Division of the American Counseling Association),
–Association for Specialists in Group Work (ASGW, Division of the American Counseling Association),
–Counselors for Social Justice (Division of the American Counseling Association),
–American Rehabilitation Counseling Association (ARCA, Division of the American Counseling Association),
– American College Counseling Association (ACCA)
– American Psychoanalytic Association,
– American Family Therapy Academy,
–The Association for Women in Psychology,
–The Association of Lesbian, Gay, Bisexual, and Transgender Issues in Counseling (ALGBTIC)
–Society of Indian Psychologists
–National Latina/o Psychological Association
–The Society for Personality Assessment,
–The Society for Descriptive Psychology,
–National Alliance of Professional Psychology Providers,
–The UK Council for Psychotherapy (UKCP),
–Association for Contextual and Behavioral Science,
–Association of Counseling Center Training Agencies,
–Psychologists for Social Responsibility,
–The Constructivist Psychology Network (CPN),
–The Serbian Constructivist Association,
–Institute of Constructivist Psychology, Italy
– Italian Constructivist Society (S.C.I.)
–The Taos Institute
–Institute for Expressive Analysis
– Zhi Mian International Institute of Existential-Humanistic Psychology
–Institute of Expressive Analysis
–Patient Alliance for Neuroendocrineimmune Disorders Organization for Research and Advocacy (PANDORA),
–Psychoanalysis for Social Responsibility (Section IX of Division 39 of APA),
–Council on Illicit Drugs of the National Association for Public Health Policy
A focal point for discussion was set up by one British researcher on the domain dsm5watch.wordpress.com. Note the “watch” in the title indicating the blogger is clearly not claiming the trademark and the “.wordpress” domain indicating the site is a free wordpress hosted blog demonstrating it is 100% not for profit (no adverts are allowed on wordpress.com blogs). Despite this the APA issued a trademark based cease-and-desist. The blog has been relegated from readers favourites and google’s rankings but has come back with the new url: dxrevisionwatch.wordpress.com.
Champions of oppression shouldn’t crack open the champagne just yet however. A new domain, dsm5-reform.com has now entered the DSM-5 bashing game, along with dsm5sucks.com and dsm5band.com who have the slogan “insanity never sounded so good”, demonstrating once again that the Streisand Effect always prevails (more on that here). Shame on the the APA for using lawyers to bully a domain out of existence rather than engaging in the discussion.
According to the New England Journal of Medicine, after thirty years of silence, authors of a standard clinical psychiatric bedside test have issued take down orders of new medical research. Doctors who use copies of the bedside test which will have been printed in some of their oldest medical textbooks are liable to be sued for up to $150,000. The New England Journal of Medicine makes the stark comparison that “Google, Apple, Facebook, and Twitter all use open-source software at the heart of their products” yet when it comes to medicine, developments are very often, very far from open-source. This case demonstrates the tragic state of affairs that even the ghosts of positively ancient abandoned copyrights for the very simplest of ideas can be used to block new medical work through legal bullying. The basic nature of the information that is protected in this case only begins to illustrate the harm that is really possible when even more powerful and innovative ideas are placed under lock and key for the rest of living memory.
“For three decades after its publication, in 1975, the Mini–Mental State Examination (MMSE) was widely distributed in textbooks, pocket guides, and Web sites and memorized by countless residents and medical students…
New England Journal of Medicine (29/12/2011)
The test which is the “evaluation of choice for most general doctors” now requires a payment of $1.23 per copy which is likely to prevent it’s use in both teaching and clinical settings. More worryingly still, a new 16 item test known as the “sweet 16″ developed at Harvard that is based on the original 30 item screening test has been taken down due to legal orders.
“This action, unprecedented for a bedside clinical assessment tool, has sent a chill through the academic community”
New England Journal of Medicine (29/12/2011)
This news is highly relevant in light of the ongoing SOPA scandal that is currently threatening the internet as we know it. Many fail to realise that copyright is valid 70 years after the death of the author and up to 120 years after the creation of the work. The use of copyright law to prevent the clinical use of medical tests and to prevent new medical tests being developed is something many of us would only expect to really happen in dystopian fiction. The fact of the matter is that it is happening in real life.
Newman, J., & Feldman, R. (2011). Copyright and Open Access at the Bedside New England Journal of Medicine, 365 (26), 2447-2449 DOI: 10.1056/NEJMp1110652
Update (01/02/2012): Both Science and Nature have agreed to redact the papers.
The journals Nature and Science have this week been drawn in to conflict with the US government. The US National Science Advisory Board for Biosecurity has asked the journals to redact studies by two research groups who have created a new form of H5N1. The artificial strain can be spread between ferrets – typically a sign that the virus could spread between humans. The journals are objecting to the request, arguing that the information is valuable for public health.
The debate is set to be a ferociously contested one, with strong arguments on both sides and the legal territory completely without precedent. With one of the labs based in Rotterdam and one of the labs based in Wisconsin the question of jurisdiction is significant. The case made by the journals is that the mutated H5N1 virus could be used to create a vaccine. The paper would allow thousands of research labs around the world to work towards creating a vaccine for the virus. Scientists are predicting that the virus is likely to mutate soon without assistance so it is argued that the more people that are working on a vaccine the better.
Over 500 people have now been infected with H5N1 and 60% of those infected have died. The only reason we have not already witnessed a pandemic is that currently the virus can only be spread between birds. Birds can infect humans but the virus cannot currently be passed on to another human. This state of affairs will inevitably come to an end in the future when the virus mutates naturally. The argument is that when the virus mutates we will need to have a vaccine already made otherwise we will witness deaths of biblical proportions. There may be little time to waste, only yesterday in Hong Kong, 17,000 chickens were killed and a 21 day ban on poultry trading was enforced after a bird was found to be infected.
The research could however be a double edged sword. The strain that has been created is potentially a weaponised virus and the US government is likely to do everything in its power to prevent this research getting in to the wrong hands. Publishing the documents introduces the risk of the mutated version being released by a rogue lab. On the other hand restricting the research could prevent the knowledge being used by research groups that could create a vaccine.
The academic, moral and legal arguments combined with the international nature of the dilemma and the colossal implications of the decision make the case particularly extraordinary so we’re unlikely to see a decision any time soon. Potentially this is time that could be used to make a vaccine so if the virus mutates all on it’s own it will be a cruel irony that it was human nature rather than mother mature that prevented us from making a vaccine.
What do I think? I’m not in a position to make that decision but my two cents would be that the decision should fall very far in one way or the other. There are countless examples of the Streisand Effect, which dictates that if information is suppressed it spreads much faster and further than it would if it wasn’t. Based on the examples we have already seen the fact that scientists want this data available and the US government doesn’t suggests that once the data is privately released, someone somewhere will inevitably leak it. If they are going to keep this secret, they are going to have to do it properly.
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