There is an
interesting article with the above title in “The New Yorker” about doctor-patient
relationships. It concerns how to get a patient who is in denial or uncomfortable
with a certain treatment, in this case chemotherapy, to consider the alternatives. As a cancer patient, I want to feel in control of my options. Not being a
medical expert, I don’t know the pros and cons of different treatments. I need to rely on my doctors to give me their
opinion on what I should do but also the rationale for that course of
action. This was not always the way
patients were treated. The article states in part:
“As
recently as the nineteen-seventies, medical decision-making in the United States
was largely a doctor-knows-best endeavor. Physicians dictated clinical care
without feeling compelled to tell patients about their treatment alternatives.
Frequently, in fact, they did not even inform patients of their diagnoses.
Medical
practice has since undergone a paradigm shift. Physicians now recognize that
patients not only have both the right to information but also the right to
refuse medical care. Yet doctors are rarely taught how to partner effectively
with patients in making important medical decisions. There is a need for a
balance between helping patients make wise choices and respecting their rights
to refuse medical interventions.
This
raises a fundamental question about the doctor-patient relationship: Is modern
medical practice all about 'patient knows best’? Or do physicians still need, on occasion, to
cajole their patients into doing the right thing?
Most
well-trained physicians believe that it would be a dereliction of their duties
to act merely as information providers, standing aside while patients make bad
decisions. Experience provides them with an important perspective to guide
treatment decisions. Yet a purely medical perspective can cause physicians to
lose themselves in details and lose sight of the more human element of patient
care such as whether the chemotherapy that shrank the tumor would improve the
patient’s quality of life.”
Only
a patient can determine the balance they prefer between the quantity and quality of
life they want. As cancer treatment becomes more
advanced, options can become less clear in their ability to produce a high
quality life. I would hope that my
doctor would understand my preferences and give me the best option to keep my
quality of life - even if that means no treatment or palliative care instead of
intensive medical therapies that would cause harm.
The
link to the article is below:
