People with epilepsy : report of a joint sub-committee of the Standing Medical Advisory Committee and the Advisory Committee on the Health and Welfare of Handicapped Persons.

  • Great Britain. Standing Medical Advisory Committee
Date:
1969
Catalogue details

Licence: Public Domain Mark

Credit: People with epilepsy : report of a joint sub-committee of the Standing Medical Advisory Committee and the Advisory Committee on the Health and Welfare of Handicapped Persons. Source: Wellcome Collection.

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    45. We have considered whether the connotations of the term “epilepsy” con- tribute to the perpetuation of the stigma attaching to the condition and whether it should, in consequence, be abandoned. There is, however, a risk that the stigma attached to the word “epilepsy” would merely be transferred to the term that replaced it, and we came to the conclusion that it would be more profitable to continue to use the word but to concentrate on removing the misconceptions which surround it. This was also one of the factors which we had to consider in deciding how far separate provision should be made for people with epilepsy, though never a deciding one. Nevertheless we deplore the practice of describing © people as “epileptics” or, as in the terms of reference given to us, as “‘epileptic people’. 46. In paragraph 16, we referred to the fact that one of the statutory disabilities placed on people with epilepsy was embodied in the marriage laws. Under Section 9(1) of the Matrimonial Causes Act, 1965, epilepsy may, in certain circumstances, be a ground for annulling the marriage. We understand that the Law Commission is at the present time examining the position and we hope that it will be possible to recommend the removal of epilepsy as a ground for nullity. We think that such an action, by removing a general stigmatisation, would help in the task of modifying public attitudes towards epilepsy. DIAGNOSIS—-GENERAL 47. In considering the provision to be made for individuals with epilepsy, it must be borne in mind that they do not constitute a homogeneous group, but represent a wide spectrum from the nearly normal to the severely handicapped. Their needs differ, and it would be unrealistic to look for one pattern of service which would apply in all instances. Epilepsy presents in many ways; it is not a single clinical entity and its proper care and management will often require a multi-disciplinary approach, involving the family doctor, hospital consultants, social workers and others to ensure that the total needs of the patient and his family are met. 48. In view of the very wide range of disability it is extremely difficult to find a classification which would cover the medical, social and employment problems adequately. The Cohen Report divided people with epileptic attacks into four categories of disability based on the frequency of seizures and the degree of any associated disorder of intellect or behaviour; and the Report of a Sub-Committee of the Standing Medical Advisory Committee of the Scottish Home and Health Department(!5) has more recently classified patients according to their ability to carry out various jobs. 49. Pond et al(5) recognised, for assessment purposes, four groups. The first was made up of young children who have fits which soon stop and are not accompanied by any other disability. The second is a group at the other end of life and consists of people in whom terminal illnesses or senile changes are accompanied by epilepsy. The third are children whose fits may continue into adult life, often accompanied by other disabilities. The fourth group comprises the remainder, most of whom are adults and whose fits may begin when they are already settled into employment and marriage. Pond et al(5) stated that it is members of these last two groups who require the most comprehensive investi- gation, and we commend this as a useful guide.
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