“They Said It Was All in My Head”: Bioethical Reflections on Misdiagnosis in Functional Neurological Disorder

Background: Functional Neurological Disorder (FND) is frequently associated with diagnostic uncertainty, stigma, and dismissal by healthcare providers. These experiences raise significant ethical concerns that extend beyond clinical error, impacting trust, identity, and patient well-being. Objective: This study aimed to explore the bioethical dimensions of misdiagnosis and clinical dismissal in FND by analyzing patient narratives shared publicly on Reddit. Methods: A qualitative narrative bioethics approach was applied to 704 Reddit posts from the r/FND subreddit. Posts were coded thematically and interpreted using the four principles of biomedical ethics—autonomy, beneficence, non-maleficence, and justice—alongside the concept of epistemic injustice. Sentiment and lexical analyses supported ethical interpretation. Results: Three core themes were identified: (1) Epistemic marginalization and loss of autonomy, (2) Harm and diagnostic drift, and (3) Struggles for ethical recognition and justice. Patients described feeling dismissed, misdiagnosed, and morally invalidated. Sentiment analysis revealed high emotional distress. Ethical failures included lack of informed dialogue, stigmatizing assumptions, and systemic disparities in access and credibility. Conclusion: Misdiagnosis in FND entails not only clinical misjudgment but also bioethical harm. To improve patient care, ethical literacy must be integrated into diagnostic processes, emphasizing epistemic humility, collaborative decision-making, and patient-centered recognition.