not a small thing…

Posted on Monday 16 January 2012


DSM 5 Censorship Fails
Support from professionals and patients saves free speech

Psychology Today: DSM-5 in Distress
by Allen J. Frances, M.D.
January 12, 2012

Last week I described the plight of Suzy Chapman, a well respected UK patient advocate forced to change the domain name of her website by the heavy-handed tactics of the publishing arm of the American Psychiatric Association. The spurious legal excuse was commercial protection of the ‘DSM 5’ trademark; the probable intent was to stifle one of the Internet’s best sources of DSM and ICD information. This bullying could not have come at a worse time—just as final decisions are being made on highly controversial DSM 5 proposals and with the third and final draft due for release this spring. This is precisely when a ragged and reckless DSM 5 can most benefit from the widest and most open discussion. Though APA’s trademark claims were patently absurd, Ms. Chapman did not have the necessary resources for a protracted fight against a well staffed legal department. Visits plummeted drastically to her new Web address (reaching a nadir of just one hit per day) and the site faced months of slow recovery. But the good news is that APA’s clumsy attempt at censorship has backfired, free speech will prevail, and the site is now more popular than ever.
Suzy Chapman writes:
    "I want to thank the many psychiatrists, allied mental health professionals, and science writers who have spoken out in opposition to what they see as arrogant censorship on the part of the American Psychiatric Association. Their outpouring of concern has generated considerable interest on websites, blogs and social media platforms. This has increased the traffic on my site by many hundreds of visitors per day. The support of professionals and patient groups illustrates the power of the internet to resist suppression of patient advocacy and to promote free speech."

    "The purpose of my site is to raise public and stakeholder awareness of the forthcoming revisions of both DSM-5 and ICD-11. I endeavor to provide timely and accurate information about DSM-5, including: Internet commentaries on proposals; flag ups of journal papers and editorials; news releases and other media statements; and updates on changes to the DSM-5 timeline. I also cover progress on ICD-11, including activities of the Revision Steering Group; documents, presentations and videos; and updates on the ICD-11 timeline. I report on developments with the forthcoming U.S. ICD-10-CM and proceedings of a U.S. federal Advisory Committee to HHS in relation to coding issues. Finally, I follow the advocacy campaigns and initiatives relating to DSM and ICD classificatory issues. My objective is to help stakeholders understand the issues so that they may provide the most useful feedback to the revision process."

    "Despite all the controversies, despite the calls for independent review, despite all the delays and limitations of its field trials, DSM-5 hurtles forward towards publication in May 2013. During this final, decisive year of DSM 5 decision making, I shall continue to publish information, updates and commentaries to promote the widest possible dialogue around the drafting of this most important publication. My new site, ‘Dx Revision Watch—Monitoring the development of DSM-5, ICD-11, ICD-10-CM’ can be found at: http://dxrevisionwatch.wordpress.com."

    "This experience has taught me that the APA trademark claims were not only misguided, but probably legally indefensible. ‘Nominative fair use’ is permitted those who are publishing criticism within texts if use of the trademark is relevant to the subject of discussion or necessary to identify the product, service, or company. Courts have found that non-misleading use of trademarks in the domain names of critical websites [like walmartsucks.com] is to be considered ‘fair use’ by non-commercial users – so long as there is no intent to misrepresent or confuse visitors to the site and when it is clear that the site owner is not claiming endorsement by, or affiliation to, the holder of the mark"

    "I am very grateful for all the support received in the past week and the many emails thanking me for the work I do. It is gratifying to hear that not only do patients, caregivers and patient organizations rely on my carefully researched and presented content, but that so many professionals are also following my site and find it useful. This experience has been stressful, but I can now say confidently that APA’s actions have definitely backfired—the many hundreds of additional viewers discovering the site each day will expand its audience and its usefulness."
All of us owe great thanks to Ms. Chapman and to the Internet community whose ringing endorsement has allowed her not only to maintain, but also to enlarge, her readership. Ms. Chapman will continue to provide the field with the most current and most accurate reporting on DSM 5 during its endgame. I strongly recommend her website as the best clearinghouse for information on DSM 5. I join Ms Chapman in hoping that this embarrassing episode will discourage APA from all future efforts at abusive censorship—whether they are related to trademark, copyright, or confidentiality agreements. The field must remain vigilant in its efforts to contain APA commercialism and persistent in trying to penetrate APA’s secrecy and inbred decision making. APA must finally come to realize that DSM 5 is an open public trust, not a private business enterprise.
Suzy’s Site is a great resource, and I’m really glad people have found her new location –  http://dxrevisionwatch.wordpress.com. But this is about more than just Suzy’s site, it’s about the worst kind of arrogance – the worst kind because the people at the APA and the APPI don’t seem to have a clue how arrogant they really are. It’s not just Suzy Chapman. When POGO presented incontrovertible evidence that Drs. Charlie Nemeroff and Alan Schatzberg had published a ghost-written textbook, the APPI reflexly [and unconvincingly] jumped to their defense [roaches…]. When Dr. Allen Frances began to criticize the DSM-5 effort, the APA retaliated with a tasteless attack suggesting his motives were financial, lead by then President Alan Schatzberg [Setting the Record Straight: A Response to Frances Commentary on DSM-V], someone who has himself set a new standard for financial misadventure. And then there’s the secrecy and insularity of the DSM-5 Task Force, acting as if they own psychiatric diagnosis itself. So the Suzy Chapman story is yet another in a string of examples of the American Psychiatric Association becoming increasingly disconnected from its actual reason for being. Dr. Frances named his series in Psychology Today "The DSM-5 in Distress." That may not be broad enough to define the problem at hand. "The American Psychiatric Association in Distress" or perhaps even "American Psychiatry in Distress" may be more accurate. Defensive arrogance is a ill-advised posture for a time when there are so many questions about leadership and direction on the table.
  1.  
    Joel Hassman, MD
    January 16, 2012 | 11:06 AM
     

    Gee, are you really surprised that immoral, unethical people that work in places of leadership and authority practice projection, denial, displacement, and rationalization? Hmmm, what is the difference between addicts and KOLs? The latter is dressed better, and seem to be at more risk to others than the addict!

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