Models of unexplained symptoms associated with occupational and environmental exposures.

Unexplained illnesses characterized by nonspecific, multisystem complaints are often attributed to occupational or environmental chemical exposures. This raises difficulties for the regulatory authorities, who are frequently unable to agree on the existence, nature, or source of such illnesses. It is proposed that many of these difficulties derive from an adherence to a traditional medical model of disease and that the application of a biopsychosocial approach would be more effective for both research and individual case management. A number of models derived from the field of health psychology are discussed in terms of their application to occupational and environmental syndromes. A specific example is described that relates to the health problems experienced by sheep farmers in the United Kingdom who are exposed to organophosphate-based pesticides. The source of their complaints and the responses of the health professionals and the regulatory authorities are discussed within the context of a biopsychosocial approach that focuses on illness rather than on organic disease as the unit of study and explores the interaction between the various physical and psychosocial variables involved. It is proposed that this approach, which is already well established in the fields of human and social sciences, should be adopted more readily by those concerned with occupational and environmental epidemiology

Medicine is patriarchal, but alternative medicine is not the answer

Women are over-represented within alternative medicine, both as consumers and as service providers. In this paper, I show that the appeal of alternative medicine to women relates to the neglect of women’s health needs within scientific medicine. This is concerning because alternative medicine is severely limited in its therapeutic effects; therefore, those who choose alternative therapies are liable to experience inadequate healthcare. I argue that while many patients seek greater autonomy in alternative medicine, the absence of an evidence base and plausible mechanisms of action leaves patients unable to realize meaningful autonomy. This seems morally troubling, especially given that the neglect of women’s needs within scientific medicine seems to contribute to preferences for alternative medicine. I conclude that the liberatory credentials of alternative medicine should be questioned and make recommendations to render scientific medicine better able to meet the needs of typical alternative medicine consumers