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Slap: American Psychiatric Association Pressures Brit DSM5 Blogger Suzy Chapman

Slap: American Psychiatric Association Pressures Brit DSM5 Blogger Suzy Chapman

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If you have a serious interest in a brand, product or company, you can, in a few minutes, set up your own website with a clever domain name that includes your target.

Jim Romenesko did this with Starbucks Gossip. A group of unions and activists did this with Making Change at Wal-Mart. And a team of obsessive Clark Kent loyalists did this with the Superman Super Site.

A few years ago, British writer Suzy Chapman started tracking the proposed changes by the American Psychiatric Association (APA) to psychiatry's guidebook: the Diagnostic and Statistical Manual of Mental Disorders (DSM). She also tracked the development of the World Health Organization's International Classification of Diseases (ICD) and followed a number of related topics. She took her domain name from the 5th revision to the DSM,, and she developed a loyal following of patients and practitioners interested in how APA and WHO were changing the definitions of various health conditions. 

Over Christmas 2011, she received two "cease and desist" letters from American Psychiatric Publishing, an arm of APA. The letters were standard legal boilerplate, saying, among other things, "Your unauthorized actions may subject you to contributory infringement liability including increased damages for willful infringement."  The letters asked "that the DSM 5 mark is removed from the domain names, and social media accounts."

It's important to point out that Chapman is not making money on her site. She is not selling anything and does not have advertisers. She describes herself as an "advocate for the chronic fatigue syndrome community - one of a number of non-mental health patient groups that stand to be impacted by draft proposals for DSM-5." And, having no staff, no resources and no lawyer, she was shook up by the legal threats. I wrote to ask her about her situation, and she wrote back:

As stated in my site disclaimer, I derive no financial benefit from my site and there is no intent to confuse with APA or imply endorsement by APA. But not being in a position to enter into a legal wrangle versus a well-funded APA, I decided I had little choice but to comply with their demands and to change the site subdomain from to and also change the name of the site. 

Her web hits plummeted as a result and other sites that had her on blog rolls or had links to her previous posts suddenly lost track of her. The network of people that had been studiously following the developments in the DSM and the ICD systems on her site and sharing her work was broken apart. Chapman wrote:

When APA forced a change of domain, not only did this hurt those who follow my site for updates and commentaries on the DSM-5 process and for information on participating in the DSM-5 stakeholder review exercises, but they also hurt those who follow the site for information on the progress of two other classifications systems, ICD-11 and ICD-10-CM, who were also denied information because they could no longer find the site and because incoming links were now dead. So APA's action had ramifications for the dissemination of accurate and timely information to professional and patient stakeholders and advocacy organizations beyond those whose interest is in the proposed content of the APA's forthcoming diagnostic manual.

The outrage was immediate.

Dr. Allen Frances, past chair of the DSM-IV Task Force and professor emeritus at Duke University, wrote: "Using a trademark to suppress comment is a violation of APA's public trust to produce the best possible DSM 5. This is another indication that DSM has become too important for public health and for public policy for its revisions to be left under the exclusive control of one professional organization – particularly when that organization's own financial future is at stake."

Margaret Soltan, an English professor at George Washington University, wrote: "It's all part of protecting psychiatry's, and pharma's, enormous investment in retaining ownership of the who's mentally disordered franchise."

And Dr. Daniel J. Carlat, author of Unhinged, wrote: "In a democratic society, healthy dissent and debate is part of the package. It may be annoying, but that doesn't excuse the bullying tactics that the APA has chosen."

But doesn't APA have a legitimate interest in protecting one of its signature products? Let me know what you think in the comments below, at or via Twitter @wheisel. I'll discuss that dilemma more in my next post.

To read more posts in my Slap series, click here.


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The have a legitimate interest, certainly. But whether or not their actions are legitimate depends on what they're trying to protect. It seems to this layperson that the purpose of prohibiting trademark infringement is to prevent other parties from profiting from the trademarked property, or from damaging the property's reputation by creating confusion between the putative infringer and the real trademarked property.

So the question is: Does the legal threat achieve either of these aims? Or does it simply attempt to suppress criticism?

I have an opinion, of course, but it would be interesting to hear from an actual attorney with expertise in IP.

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I also think that APA is bullying Chapman, and wonder what an attorney thinks.

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[...] not move on with their lives. The author probably has as much right to sue APA as the APA did in suing UK blogger Suzy Chapman for infringement of patent in using the name of the DSM in her domain name, After [...]

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The DSM-V Task Force of the APA has called for public comment on the proposed revisions, in three periods. The last period is supposed to take place in the spring of 2012. This would seem to be an acknowledgment that groups beyond the APA are stakeholders in the result. That being the case, using trademark infringement to shut down a website critical of some of their proposed changes is an obvious move to stiffle a free and open discussion of their proposal. How can the public have any kind of informed input if the APA shuts down anyone expressing an opinion about DSM-V that differs with theirs? Why does the APA feel threatened by an open discussion of the issues? And what's next, threatening legal action against news outlets that report on all of the mental health professional organizations which are criticizing some of the proposed revisions?

Clearly Suzy Chapman was not using the DSM trademark for gain. The APA probably didn't have a legal leg to stand on, had the issue gone to court. But a lone blogger, a patient advocate who studies these issues in her spare time, doesn't have the resources to mount a defense against the legal teams employed by the APA. They know that, and so they can silence dissent merely by threatening legal action.

The real losers are the American people, both those that are diagnosed using less precise definitions of illness, and those who pay the bill for poorly diagnosed diseases, or the medicalization of non-disease states.

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[...] with confidentiality agreements and at protecting its trademark and copyright with bullying threats of lawsuits. But APA has been sadly incompetent and wildly profligate in the day-to-day work of actually [...]

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