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"poorly controlled" = our fault

Spiker

Well-Known Member
Messages
4,685
Type of diabetes
Type 1
Treatment type
Pump
So, I know this guy, he's a T1, involved in some unpleasant litigation. His health is a material issue in this litigation. He has a letter from his hospital consultant stating he is poorly controlled, and advising what some of the implications of this fact are for current and future health.

The other side in this litigation are arguing that "poorly controlled" means it's his fault, under his control, his failure, and therefore they shouldn't have to account for his state of health.

Now you and I know that "poorly controlled" means "he's doing his best with the tools he's got, but he's just not succeeding, like very many other diabetics who don't manage to succeed with the tools we give them - no blame is attached".

However, given how the general public might interpret the phrase "poorly controlled", maybe it's time for a change of terminology from our dear Health Care Professionals?

Or am I wrong, and the HCPs actually are blaming those of us who are "poorly controlled" for being the cause of our own misfortune?
 
Spiker said:
Or am I wrong, and the HCPs actually are blaming those of us who are "poorly controlled" for being the cause of our own misfortune?
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You have to remember that unless the HCP uses insulin, they basically haven't clue they go by the book, end of story. Their book say's if you do A then B will happen, unfortunately your body hasn't read the book, which means it's all your fault when things do not go by the book.
 
This is a tough one.

I'm sure many type 1's know that insulin isn't the only thing that can have an effect on blood sugar.

Weather
Illness
Stress
Etc etc

But I can also see the HCP's perspective that you have been given the tools to do the job.

I think there needs to be more allowance for other factors. When nature stops working I.e the pancreas then any outside measure for control will always have room for error.
 
I guess it turns on whether "poorly controlled" is a statement of the outcome, or a statement of blame. It's not crystal clear.
 
Spiker said:
I guess it turns on whether "poorly controlled" is a statement of the outcome, or a statement of blame. It's not crystal clear.
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Which is also something that's open to interpretation I guess.

You could say "poorly control" to one person who might say "yes you're right my control has been awful"

Or another who might take offence to it and as some form of attack.
 
Spiker said:
The other side in this litigation are arguing that "poorly controlled" means it's his fault, under his control, his failure, and therefore they shouldn't have to account for his state of health.
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With the best will in the world, we can only do our best to manage our diabetes. Taking into account all the factors that influence blood sugar readings it could be classed as a miracle to get it right all the time.
Poorly controlled can mean that he is doing everything right but still does not have things under control. The consultant could be approached to rephrase the letter?
 
Also there is a lot to be considered. Did your friend ask for more help? Say he was concerned his levels weren't what they should be etc?

There has to be a balance and accountability on both parts
 

Is it deliberate 'poorly controlled' don't care, he will do what he wants and to hell with diabetes? Or is it, I am trying my best, whatever I do doesn't seem to be working well, is he asking for help, and advice (tbh some of the NHS diabetes advice is not great) what is poorly controlled to a diabetes specialist ?
Lots of factors can contribute to a our overall control, management, well being, our state of mind, illnesses or accidents etc. It's like being between a rock and a hard place
 

This guy requires a further statement from his consultant, expanding on the banner statement, to be honest. Is he using a solicitor with medical knowledge? Is the litigation at tribunal level or in some other forum at the moment, and is he driving it (claimant) or the other party?

Sorry to pose The Spanish Inquisition,.......... But it's what I do!! I can always think of a million questions.
 
I've always felt to blame for being poorly controlled hence going and getting more tools (CGM and LC)
 
You might also find that people have been given a set of tools that don't work in the way they have been described, which means that they have been unable to control in a way that they should, such as is the case with Lantus.

In some cases it is that people just haven't tried, your case 1 above.

In others it's mine here, where the tools are broken, the instruction manual is in Chinese, and the specialist trainer has no idea how to either read the manual or use the tool. In which case, who is to blame?

And what is the HCP definition of "Poorly controlled"? Certainly in this case it sounds like a way of putting the blame squarely on him.
 
I don't think the term "poorly controlled" is a statement of blame at all.

How else would you want it to be described?

How can it be describe in a way that someone won't interpret it offensively?
 
gemma6549 said:
I don't think the term "poorly controlled" is a statement of blame at all.

How else would you want it to be described?

How can it be describe in a way that someone won't interpret it offensively?
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Brittle diabetes? at least its then blaming the diabetes rather than the person?
 
Engineer88 said:
Brittle diabetes? at least its then blaming the diabetes rather than the person?
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But I still don't see why "poorly controlled" has to mean you are blaming the person?

When my control has been bad and the consultant has said to me it's "poorly controlled" I've said "yes you're right and I would like to look at ways to get it much better"

I haven't said "so you're saying this is all my fault?"
 
Could he borrow from epilepsy terminology, where "poorly controlled" is used more or less interchangeably with "intractable"? This shifts the "blame" from the sufferer to the disease.

Kate
 

Then your very lucky as I've always had it said with a sneer and "you really should try you know." (direct quote)
 
Engineer88 said:
Then your very lucky as I've always had it said with a sneer and "you really should try you know." (direct quote)
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But you can't apply personal experience from one consultant to everything.

I'm just being objective and saying that "poorly controlled" in the sense of this thread is not necessarily being used as a way of blame.

Luck has nothing to do with it, I take people's words for what they are and if I know that the "poor control" isn't directly or all my fault, then I'm not going to be offended by it.
 
gemma6549 said:
I don't think the term "poorly controlled" is a statement of blame at all.
Click to expand...
I guess many diabetics would see it as a statement of blame. If it is hard work to keep BG levels somewhere in a sensible range and therefore keep going, what might be an objective statement becomes a very perjorative one.

The term control in this context is a verb, and therefore "poorly controlled" implies that someone be doing something badly, which leads very strongly to feelings of blame on the person who must be the doer.

Similarly to @Engineer88 I've experienced some very clearly unambiguous comments relating to Hba1C results that are supposed to suggest that I could do better. Tone has been everything.
 
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When I was ill/accident/complications set in, my control was not 'well controlled', I did my utmost to get good stability, but it was out of my control. So I had poor control, which = negative, so could that be 'poorly controlled' but not deliberate on my part ? I could list a few of the things that' hit me' and my diabetes control very hard, but I don't want to go down that road.
It is true that because of our own unique personalities, it is how we interpret things.
So 'Poorly controlled' = negative to me.

Best wishes RRB
 

If it was from one consultant I would be able to brush it off, but it isnt. Its widespread understanding that diabetes if your fault and completely under your control. that is what the lawyers will understand as well as any Judge. Not glad, but glad its not just me @tim2000s
 
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