{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:32:54Z","timestamp":1789061574236,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T00:00:00Z","timestamp":1658880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A significant proportion of somatic symptoms remain, at present, medically unexplained. These symptoms are common, can affect any part of the body, and can result in a wide range of outcomes\u2014from a minor, transient inconvenience to severe, chronic disability\u2014but medical testing reveals no observable pathology. This paper explores two first\u2010person accounts of so\u2010called \u2018medically unexplained\u2019 illness: one that is published in a memoir, and the other produced during a semi\u2010structured interview. Both texts are revelatory for their expression of shame in the context of encountering disrespect from healthcare professionals. The first section of my paper, clinical encounters, explores disrespect which, I argue, takes three interconnecting forms in these texts: disrespect for pain when it is seen as \u2018medically unexplained\u2019, disrespect for the patient's account of her own pain, and disrespect for the patient herself. The second section elucidates the shame that occurs as an affective and embodied consequence of encountering such disrespect. I claim that patients living with so\u2010called \u2018medically unexplained\u2019 illnesses suffer a double burden. They endure both somatic and social suffering\u2014not only their symptoms, but also disrespectful, traumatic\u00a0and shame\u2010inducing experiences of healthcare systems. I conclude with a reflection on the urgent need for changes in clinical training that could improve the quality of life for these patients, even in the absence of an explanation, treatment\u00a0or cure for their symptoms.<\/jats:p>","DOI":"10.1111\/jep.13740","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T06:24:36Z","timestamp":1658989476000},"page":"909-916","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["(Dis)respect and shame in the context of \u2018medically unexplained\u2019 illness"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6433-8831","authenticated-orcid":false,"given":"Katharine","family":"Cheston","sequence":"first","affiliation":[{"name":"Institute for Medical Humanities Caedmon Building Durham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0306312720940405"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cml016"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmu067"},{"issue":"488","key":"e_1_2_9_5_1","first-page":"231","article-title":"Beyond somatisation: a review of the understanding and treatment of medically unexplained physical symptoms (MUPS)","volume":"53","author":"Burton C","year":"2003","journal-title":"Br J Gen Pract"},{"issue":"16","key":"e_1_2_9_6_1","first-page":"279","article-title":"Somatoform disorders and medically unexplained symptoms in primary care","volume":"112","author":"Haller H","year":"2015","journal-title":"Dtsch \u00c4rztebl Int"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(01)00223-9"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2012.09.010"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2016.08.015"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2007.07.003"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/15265161.2018.1445312"},{"issue":"47","key":"e_1_2_9_12_1","first-page":"803","article-title":"Non\u2010specific, functional, and somatoform bodily complaints","volume":"109","author":"Schaefert R","year":"2012","journal-title":"Dtsch \u00c4rztebl Int"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2011.01.007"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp19X701249"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/medhum-2018-011598"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/2049463714535372"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.325.7378.1449"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.12481"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732314566326"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/14768320600976224"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/028134399750002827"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2004.02.010"},{"key":"e_1_2_9_23_1","volume-title":"It's All in Your Head: Stories from the Frontline of Psychosomatic Illness","author":"O'Sullivan S","year":"2016"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1353\/ppp.2020.0052"},{"key":"e_1_2_9_25_1","volume-title":"The Lady's Handbook for Her Mysterious Illness","author":"Ramey S","year":"2020"},{"key":"e_1_2_9_26_1","doi-asserted-by":"crossref","unstructured":"SubramaniS Biller\u2010AndornoN.Revisiting respect for persons: conceptual analysis and implications for clinical practice.Med Health Care Philos. Published online April 10 2022:1\u201010.doi:10.1007\/s11019-022-10079-y","DOI":"10.1007\/s11019-022-10079-y"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2015-004034"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-006-0054-7"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7338.623"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/01973530903316922"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/01973533.2013.856782"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/medhum-2016-011159"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1987.00370090129021"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11019-015-9654-5"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/medhum-2017-011186"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/medhum-2017-011392"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordhb\/9780190947750.013.12"},{"key":"e_1_2_9_38_1","volume-title":"The Second\u2010Person Standpoint: Morality, Respect, and Accountability","author":"Darwall SL","year":"2006"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/00455091.1999.10715990"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2017.11.020"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-017-0972-6"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2007.03.008"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.3109\/0142159X.2012.660219"},{"key":"e_1_2_9_44_1","first-page":"33\u2010","article-title":"The role of patient\u2010led education initiatives in medical education","volume":"2","author":"Jha V","journal-title":"Innov Entrep Health"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/tct.12400"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2923.2009.03530.x"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.325.7368.818"}],"container-title":["Journal of Evaluation in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.13740","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jep.13740","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.13740","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T07:47:10Z","timestamp":1692604030000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.13740"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,27]]},"references-count":46,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1111\/jep.13740"],"URL":"https:\/\/doi.org\/10.1111\/jep.13740","archive":["Portico"],"relation":{},"ISSN":["1356-1294","1365-2753"],"issn-type":[{"value":"1356-1294","type":"print"},{"value":"1365-2753","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,27]]},"assertion":[{"value":"2022-04-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}