Truthfulness is the foundation of the doctor-patient relationship, both as a method of discourse and as one of the "most widely praised character traits" of a doctor. Gone are the days when doctors withheld certain diagnoses or treatment details from patients. If anything, doctors today are often forced to disclose excess and sometimes unnecessary information due to concerns about liability or to patients who have already canvassed the Internet on their own and have pressing questions. The doctor's challenge is to present what he or she knows to be true about the diagnosis and its treatment options and to do so in a manner that truly informs the patient. But there are limitations and pitfalls to this process, as illustrated in the following paraphrased conversation I recently had with a seventy-five-year-old moderately demented patient and his wife:Marc E. Agronin, The Atlantic, october 24, 2011.
Patient: Doctor, I know I can still drive. Just let me take a test.
Doctor A: I'm sorry, Mr. K, but I can't help you with that. As we discussed, your memory impairment makes it unsafe for you to drive.
Patient: Just let me take the test. I can drive just fine.
Doctor A: The memory testing tells us that you would not be a safe driver.
Patient: My memory is not that bad. I know I can drive.
Patient's wife: Honey, I told you that the car is not working now and needs to be fixed. Let's talk about it later.
Patient: Okay.
giovedì 27 ottobre 2011
The Benevolent Deception: When Should a Doctor Lie to Patients?
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3 commenti:
Molto simpatico questo racconto. Ovviamente il principio di dover sempre riferire la verità nuda e cruda, ogni volta che è possibile farlo, ha più senso quando ci sia una piena capacità di recepirne il significato e valutarne le conseguenze.
Mai, salvo non gli venga espressamente richiesto dal paziente...di mentirgli.
Certo c'e' modo e modo di presentare una notizia, specie una talmente destabilizzante ed in grado di ledere la sensibiita', quale quella relativa al proprio stato di salute, specie se irreversibilmente compromesso.
francesco sirio
Francesco, non tutti sono abbastanza disposti alla negazione da chiedere una bugia e poi dimenticarsene (della richiesta) in modo da poterla prendere per verità.
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