By Robin Hauman Morris
Truth in advertising is hardly a novel approach. The mantra for Syms discount stores: “An Educated Consumer is Our Best Customer” rings provocative. Everyone wants a bargain, but do we gamble with our health in the process? Does a diagnostic label bring us to our knees? How so, does the public manage to skew scientific research or concrete data in favor of speculation? What bias alters the classification system admitting or denying diagnoses into a spectrum disorder?
Michael Specter’s new book Denialism, as reviewed in the NYTimes tackles the recent segue from science. The term “denialism,” used by Mr. Specter as an all-purpose, pop-sci buzzword, is defined by him as what happens “when an entire segment of society, often struggling with the trauma of change, turns away from reality in favor of a more comfortable lie.” Regarding the link between vaccines and autism, he ridicules Robert F. Kennedy Jr. (accused of writing an antivaccine article “knit together by an almost unimaginable series of misconceptions”)
Simon Baron- Cohen thoughtfully argues the dangers in eliminating Aspergers Syndrome from the spectrum of autism. The Short Life of a Diagnosis explains in careful detail that the The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, is the bible of diagnosis in psychiatry, and is used not just by doctors around the world but also by health insurers. The implication of diagnosis far exceeds the paper it is written on; what happens to the individuals who have already been diagnosed? What is their future regarding supports and services?
Dr. Cohen reminds us that the psychiatric manual is decided by a group of doctors who consider symptoms and behaviors, not biology. This is a significant point of fact. Adding and removing qualifications for diagnoses are part of the nomenclature, but it is not without caution and caveat. We don’t yet know if Asperger syndrome is genetically identical or distinct from classic autism, but surely it makes scientific sense to wait until these two subgroups have been thoroughly tested before lumping them together in the diagnostic manual.
I am the first to agree with the concept of an autistic spectrum, but there may be important differences between subgroups that the psychiatric association should not blur too hastily. Ultimately, the importance of science should prevail. It is an unbearable responsibility for parents and families to make decisions based on hearsay. Whom, where and when to trust should be more comfortable choices for the “educated consumer”. Hopefully, research and hard evidence will make the difference.