steve

So, you KNOW MRI's cannot show pain? Wow! I was not aware you are a medical doctor.

Actually Steve, I conceded that there is new research, that you quoted, that shows that MRIs can identify activity in the brain that diretly relates to pain.
What I'm correcting is your use of this article to indicate that doctors practicing medicine currently use MRIs as a diagnostic device for measuring pain. They do not. It is not currently a tool for use in diagnosing pain in any hospital or emergency room. Thre is only an isolated study at one institution. Perhaps some day it will serve as such, but for now, it isn't a validated medical diagnositc tool for pain.
What doctors use in practice are various subjective scales. Similar to how they attempt to guage depression.
You've hear of people with a high pain threshold? and those with a low pain threshold?
How some people require few pain meds for the same operation that another patient requires heavy medication? Its all subjective...
And it can be dificult to diagnose.

Pain can never be faked? Back injuries in car accidents never result in people faking chronic pain for an insurance settlement?
You've never heard of the controversy over the diagnosis of fibromyalgia? There is a debate about the actual effect of the condition including the chronic pain that always presents? ... Of course some people think these people are just faking....

Tom and you might want to actually educate yourself on what depression is before you keep offering profundities. Depression is a condiition that often leads to suicide. Some 34,000 people will commit suicide in the US this year. Its the number 2 cause of death of those of college age . Often severe depression precedes suicide attempts.
I've had three friends lose depressed college aged children to suicide in the last 4 years. One friend lost two, and another has a second child with the same history of depression as the first that took his life. Trying to help someone who's depressed can be a real helpless feeling , especially as the consequences of depression can be fatal.
A few myths, which the two of you seem to be enveloped within:
The following are myths about depression and its treatment:
source: http://www.medicinenet.com/depression/page2.htm

•It is a weakness rather than an illness.
•If the sufferer just tries hard enough, it will go away.
•If you ignore depression in yourself or a loved one, it will go away.
•Highly intelligent or highly accomplished people do not get depressed.
•People with developmental disabilities do not get depressed.
•People with depression are "crazy."
•Depression does not really exist.
•Psychiatric medications are all addicting.
•Psychiatric medications are never necessary to treat depression.
•Medication is the only effective treatment for depression.
•Children and teens should never be given antidepressant medication

Depression often leads to suicide?
wow, who knew that?

I don't think Steve says it doesn't exist, I know I don't say it doesn't exist, it certainly does!
every one of your bullets above ("bullets" how dangerous a term?) is correct
but can you tell me how does sitting at home help them feel better?

rickyp wrote:steve

So, you KNOW MRI's cannot show pain? Wow! I was not aware you are a medical doctor.

Actually Steve, I conceded that there is new research, that you quoted, that shows that MRIs can identify activity in the brain that diretly relates to pain.
What I'm correcting is your use of this article to indicate that doctors practicing medicine currently use MRIs as a diagnostic device for measuring pain. They do not. It is not currently a tool for use in diagnosing pain in any hospital or emergency room.

Didn't say it was in common use.

Actual pain cannot be faked. That was the point of the illustrations. Sadly, there is no reaching you.

And your source for your claim is, per usual, your own belief. And nothing more. Thats not authoratative.

Here's a medical response:

It’s amazing how often health providers get asked directly or indirectly whether someone experiencing pain is ‘faking’ it. The short answer is the most accurate – we can’t tell. We’re not lie detectors, there is no ‘gold standard’ to work out whether someone is pretending or not, and the question is based on erroneous thinking about pain and pain behaviour.
I can understand several things about the question ‘can you tell if he’s faking’. Pain behaviour elicits strong emotions in observers – it’s designed to do just that! It communicates, and something we like to do as humans is work out whether someone is lying or not. The problem is – we’re not very good at telling who is and is not lying (but we like to fool ourselves that we personally don’t fall for liars!).

In a litigation or compensation situation, it would be great to work out exactly ‘how much’ each pain is worth in order to give it a dollar value, and determine compensation. But – pain can’t be measured directly, we have to use pain behaviour as the next best thing – and pain behaviours are influenced by a whole lot of things. So it’s not a very reliable measure.

Another reason for wanting to know ‘is he faking’ is how far to ‘push’ the person into doing more. The underlying concern is ‘will I cause harm’. And again we really don’t have any useful measure if we try to have pain or pain behaviour as our guide. We need to use something else – radiological union perhaps, control of a load, heart rate and respiration.

BUT the question is based on the assumption that there ‘should’ be a certain amount of pain behaviour for a certain amount (or length of time since) tissue damage. And there simply isn’t.

Some allied questions….‘can’t you use functional capacity testing to work out whether someone’s faking?’ No – sorry. A functional assessment, just like any physical examination or test, tells you what the person will do, and perhaps how consistently they will do it – today. Few, if any, FCE’s have demonstrated predictive validity - that is, they don’t accurately predict how much someone will or won’t do in a day-to-day ‘real’ situation, in fact they won’t tell you what the person can and cannot do at all.

The whole detailed rresp[oonse is here:
http://healthskills.wordpress.com/2008/01/15/faking-or-malingering-or-exaggerated-pain-behaviour/

I don't expect you'll bother to read it.

tom

I don't think Steve says it doesn't exist, I know I don't say it doesn't exist, it certainly does!
every one of your bullets above ("bullets" how dangerous a term?) is correct
but can you tell me how does sitting at home help them feel better?

My guess is that it doesn't. But deep depression is totally debilitating and there are poeple who cannot physically function when a cycle of severe depression hits.
My whole point in this is that I trust medical practitioners who have the knowledge and training to be able to diagnose and treat depression over ignorant individuals who simply want to express their stereotypical prejudice as if it were wisdom.
And who treat their own isolated experience as worth more than the empiracal knowledge of the medical sciences and professionals.

if they can't function, they stay home. Why I should pay for them is beyond me. If they are of able body they should work, no guess work there huh? Doesn't matter if the depression is real or not, they still go to work and suffer with the rest of us poor saps.

rickyp wrote:And your source for your claim is, per usual, your own belief. And nothing more. Thats not authoratative.

Here's something authoritative and universally accepted: you are a moron.

What I said was actual pain cannot be faked. People can pretend to be in pain, but the neurological response we call "pain" cannot be faked. If it occurs, the subject is experiencing real pain. That is not my opinion. It is medical fact.

NO ONE but you, which means NO ONE ELSE ON THE PLANET, would think that no one can pretend to feel pain. Anyone who watched Paul Pierce carted off in a wheelchair knows that.

Let me give an example so simple even you might grasp it: when you go for a physical and they tap your reflexes or check to make sure you have feeling on the bottoms of your feet, you actually feel it. Can someone pretend to feel it? Yes, but the sensation of feeling it--the transmission of that feeling to your brain cannot be faked.

Again, you mindless buffoon, how many fights have you been in? Actual, physical fights? Guess what? I've been in plenty and you know what? Some of the people on the other end lied about what happened and made complaints of pain that were absolutely impossible.

So, I understand that people can LIE about pain. That is not the same as faking the physiological aspects of it. This cannot be done.

Is that sufficiently simple for you???

rickyp wrote:My guess is that it doesn't. But deep depression is totally debilitating and there are poeple who cannot physically function when a cycle of severe depression hits.

How many people have you observed with severe depression? For how long? How do you know they were not faking? What is your expertise? If none, how do you know they "cannot physically function?" How long does a "cycle" last? How is their medication determined?

My whole point in this is that I trust medical practitioners who have the knowledge and training to be able to diagnose and treat depression over ignorant individuals who simply want to express their stereotypical prejudice as if it were wisdom.

You stated your opinion. According to you, that's not authoritative. Now you say that others, who have far more knowledge and experience than you are "ignorant?"

What, precisely, about the science, gives you such confidence in doctors in this particular arena of Depression? Is it the fact that they have to guess what medication to use? Is it the fact that they cannot objectively measure Depression?

And who treat their own isolated experience as worth more than the empiracal knowledge of the medical sciences and professionals.

In this particular area, modern science is about two steps ahead of Voodoo. And, it has absolutely zero means for detecting fraud. One more hint: there's nothing in it for them to detect fraud except they lose a customer.

GMTom wrote:

So, before the net was in place, how were things? All hunky dory?

Nope
But is it any better at all now?
Nope
..so why spend the billions to see no difference?

Do you have qualitative and quantitative data to show how things are not better now than before Welfare?

Or is this just the usual "it bust be so because I think it is" that comes from the 'common sense' brigage?

and that depression issue, my ANECDOTE fits well here, my two (ex)neighbors both came down with depression at the same time, gee how coincidental the two laziest people anyone could know managed that?

Who knows. I know people who have depression who were not lazy. The fact that some people scam the system still doesn't tell you how many there are, what proportion they are of genuine cases, and what the effect would be of making changes.

But hey, who needs evidence based policy what you have the power of the mighty 'I reckon'?

http://www.nwcn.com/news/washington/DSHS-shake-up-following-series-of-KING-5-investigations-118588979.html

I applaud the State of Washington in this action to curb welfare abuse by recipients and businesses alike. (About dang time!)

So is this discussion about fraud and a lack of enforcement? Or are you complaining about social benefits lawfully available?

I am not complaining about lawful benefits. Hence the name abuse.

Very good, so how many times did you and Tom report the unlawful use of welfare to the authorities and what were the outcomes?

I have done it twice, and saw no results from that action.

Hang on a minute though? Most of the thread was not about actual fraud, but people gaming the system legally. Are you now saying that we had that debate with you and Tom and you didn't mean what you were saying???

I agree that fraud is bang out of order and that it should be punished. I was warning about the costs of doing so properly let along exhaustively, and as bbauska calls for across the board cuts, I wonder how he squares that with a demand for more and better detection.