False Positives in Psychiatric Diagnosis: Implications for Human Freedom
Wakefield, Jerome C.
Theoretical Medicine and Bioethics 2010 February; 31(1): 5-17
Current symptom-based DSM and ICD diagnostic criteria for mental disorders are prone to yielding false positives because they ignore the context of symptoms. This is often seen as a benign flaw because problems of living and emotional suffering, even if not true disorders, may benefit from support and treatment. However, diagnosis of a disorder in our society has many ramifications not only for treatment choice but for broader social reactions to the diagnosed individual. In particular, mental disorders impose a sick role on individuals and place a burden upon them to change; thus, disorders decrease the level of respect and acceptance generally accorded to those with even annoying normal variations in traits and features. Thus, minimizing false positives is important to a pluralistic society. The harmful dysfunction analysis of disorder is used to diagnose the sources of likely false positives, and propose potential remedies to the current weaknesses in the validity of diagnostic criteria.
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The Ethical Problem of False Positives: A Prospective Evaluation of Physician Reporting in the Medical Record Dresselhaus, T.R.; Luck, J.; Peabody, J.W. (2002-10)OBJECTIVE: To determine if the medical record might overestimate the quality of care through false, and potentially unethical, documentation by physicians. DESIGN: Prospective trial comparing two methods for measuring the ...