The SMILE trial is set against the background of an approach known as ‘biopsychosocial’. In the context of ME/CFS, this approach presupposes that the initial trigger of illness (e.g. viral) is no longer present and that the ongoing symptoms are a result of unhelpful beliefs by the patients that they have a chronic physical illness and consequent physical deconditioning, brought on by the patient’s fear that activity will harm them.
The following quote, from a conference on the biopsychosocial movement in 2002,
appears predictive of the denial of the right of parents
and child participants to informed consent to take part in the SMILE trial.
“Rather than start with the physicians, which might be quite a difficult task,
we could make a start with youngster in schools.
My experience is that they are much easier to educate.
The only barrier is the parents.
Once we have the child on our side we are in a very good position”.
Professor Trudie Chalder, 2002.
Extract from Proof Positive? 30th August 2005