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#11
08-25-2007, 09:26 PM
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Re: Would you like your doctor to lie to you if you had cancer?
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[ QUOTE ] [ QUOTE ] I realize this has been common practice in some places in the past, but I would imagine that the USA currently, it would open up the doctor to a lawsuit too much. [/ QUOTE ] I would agree with that. In med school, I don't recall being taught to hide info as it would be fairly rare for a person to not want to know. But we do spend a lot of time in learning HOW to break bad news... [/ QUOTE ] I can envision some pretty complicated situations where chances of recovery are correlated strongly with the patient's emotional state. Say the drug treatment you were giving your patient was much more effective when given to people with low stress levels. Do you lie to them about their chances at living/drug effectiveness in this scenario, where it would actually maximize their chances of making it? [/ QUOTE ] If a drug is indeed proven to be more effective for people in a lower stress state, then highlighting its effectiveness wouldn't be lying necessarily. If the purpose of lying is to relieve anxiety and mislead the patient into thinking that the prognosis is better than it really is, then I think that's unethical and could lead to problems... [ QUOTE ] My personal feelings are that doctors are way too deified. I view them basically as glorified mechanics. I'm paying my doctor to render me a service, and I'm going to be pissed if he takes matters into his own hands because of some holier-than-though, paternalistic reasoning. [/ QUOTE ] Deified by whom? Patients? The media? It is very rare in my experience to encounter a patient who "deifies" his/her physician. But there are plenty of patients who listen to the advice of their physician and put a lot of trust in the doctor's judgement and counsel. I wouldn't characterize this as deification. As for the media, I'm not sure I really give a [censored] myself. As for "glorified mechanics", I'm not sure what you mean by that. I'm a cardiologist and manual dexterity is not necessarily needed for my practice. Are there less cerebral doctors and specialties? Absolutely. But to believe that all doctors practice with a cookbook in hand would be a big misconception. I'll stop here, don't want to hijack the thread... 
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#12
08-25-2007, 09:28 PM
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Re: Would you like your doctor to lie to you if you had cancer?
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Do you lie to them about their chances at living/drug effectiveness in this scenario, where it would actually maximize their chances of making it? [/ QUOTE ] there was a really great hbo movie about 4-5 years ago about a cancer patient (woman, british). I'll try to look up the name.
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#13
08-25-2007, 09:36 PM
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Re: Would you like your doctor to lie to you if you had cancer?
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#14
08-26-2007, 05:37 PM
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Re: Would you like your doctor to lie to you if you had cancer?
To not tell the truth would be absolutely unforgiveable IMO.
That said, given the specific conditions of this question, I actually thought about voting "I'd prefer you not tell me, so that my family can get rich off the lawsuit after I die." But that would be too selfish; I would want to destroy the practice of an unethical doctor, who didn't tell this sort of thing to his patient - but I wouldn't wish to entrap an otherwise fine doctor into lying just to me, just this one time, so I could ruin him to my family's profit.
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#15
08-26-2007, 06:36 PM
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Re: Would you like your doctor to lie to you if you had cancer?
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[ QUOTE ] I realize this has been common practice in some places in the past, but I would imagine that the USA currently, it would open up the doctor to a lawsuit too much. [/ QUOTE ] I would agree with that. In med school, I don't recall being taught to hide info as it would be fairly rare for a person to not want to know. But we do spend a lot of time in learning HOW to break bad news... [/ QUOTE ] Out of curiosity, how do they teach you to break the bad news?
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#16
08-26-2007, 08:46 PM
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Re: Would you like your doctor to lie to you if you had cancer?
[ QUOTE ]
[ QUOTE ] [ QUOTE ] I realize this has been common practice in some places in the past, but I would imagine that the USA currently, it would open up the doctor to a lawsuit too much. [/ QUOTE ] I would agree with that. In med school, I don't recall being taught to hide info as it would be fairly rare for a person to not want to know. But we do spend a lot of time in learning HOW to break bad news... [/ QUOTE ] Out of curiosity, how do they teach you to break the bad news? [/ QUOTE ] I honestly don't remember except there was some didactics about breaking bad news (e.g., prepare the patient, set aside some time, etc... some common sense stuff really) and some patient simulations. Some fake patients took bad news pretty bad... in those cases, i just shrug my shoulders and think oh well, i tried... glad it's not me dying (kidding!)
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#17
08-27-2007, 01:59 AM
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Re: Would you like your doctor to lie to you if you had cancer?
[ QUOTE ]
[ QUOTE ] I realize this has been common practice in some places in the past, but I would imagine that the USA currently, it would open up the doctor to a lawsuit too much. [/ QUOTE ] I would agree with that. In med school, I don't recall being taught to hide info as it would be fairly rare for a person to not want to know. But we do spend a lot of time in learning HOW to break bad news... [/ QUOTE ] This is true in the US, and in modern times, but this was very much not the case, say, 50 years ago, or even currently in many countries. There are plenty of cultures in which it is completely appropriate for the doctor to withhold the diagnosis from the patient. This is especially true since the patient has absolutely no input into the treatment plan or the overall care. All decisions are left to the physician, so it is a "need to know" basis, and the patient doesn't. This type of paternalism has fallen way out of favor here in the US, and in fact the pendulum has swung very far in the other direction, towards patient autonomy. Perhaps too far, in that now health care is like going to Burger King...patients have it their way, and the health care team is often just their to take orders and try to please. This is a little bit of a tangent, I suppose, but I bet if this poll were done in many Asian countries, for example, the results would be the exact opposite. Not exactly sure what this has to do with theism, though. Also, to the person who asked if I'd like to know the time and details of my ultimate demise, absolutely.
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#18
08-27-2007, 02:01 AM
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Re: Would you like your doctor to lie to you if you had cancer?
[ QUOTE ]
[ QUOTE ] [ QUOTE ] [ QUOTE ] I realize this has been common practice in some places in the past, but I would imagine that the USA currently, it would open up the doctor to a lawsuit too much. [/ QUOTE ] I would agree with that. In med school, I don't recall being taught to hide info as it would be fairly rare for a person to not want to know. But we do spend a lot of time in learning HOW to break bad news... [/ QUOTE ] Out of curiosity, how do they teach you to break the bad news? [/ QUOTE ] I honestly don't remember except there was some didactics about breaking bad news (e.g., prepare the patient, set aside some time, etc... some common sense stuff really) and some patient simulations. Some fake patients took bad news pretty bad... in those cases, i just shrug my shoulders and think oh well, i tried... glad it's not me dying (kidding!) [/ QUOTE ] Wow has medical school changed. I'm only just beginning my second year and we've had hours and hours of practice and instruction on delivering bad news, lots of lectures, videos, role-playing and such. It is a huge topic, mostly due (IMO) to the research showing that "relationship with physician" is far and away the most important determining factor in likelihood to sue (well above things like whether the doctor actually made a mistake or not).
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#19
08-27-2007, 02:02 AM
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Re: Would you like your doctor to lie to you if you had cancer?
[ QUOTE ]
[ QUOTE ] [ QUOTE ] I realize this has been common practice in some places in the past, but I would imagine that the USA currently, it would open up the doctor to a lawsuit too much. [/ QUOTE ] I would agree with that. In med school, I don't recall being taught to hide info as it would be fairly rare for a person to not want to know. But we do spend a lot of time in learning HOW to break bad news... [/ QUOTE ] I can envision some pretty complicated situations where chances of recovery are correlated strongly with the patient's emotional state. Say the drug treatment you were giving your patient was much more effective when given to people with low stress levels. Do you lie to them about their chances at living/drug effectiveness in this scenario, where it would actually maximize their chances of making it? My personal feelings are that doctors are way too deified. I view them basically as glorified mechanics. I'm paying my doctor to render me a service, and I'm going to be pissed if he takes matters into his own hands because of some holier-than-though, paternalistic reasoning. [/ QUOTE ] For example, the positive placebo effect is well documented in many diseases and conditions.
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#20
08-27-2007, 02:06 AM
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Re: Would you like your doctor to lie to you if you had cancer?
[ QUOTE ]
To not tell the truth would be absolutely unforgiveable IMO. That said, given the specific conditions of this question, I actually thought about voting "I'd prefer you not tell me, so that my family can get rich off the lawsuit after I die." But that would be too selfish; I would want to destroy the practice of an unethical doctor, who didn't tell this sort of thing to his patient - but I wouldn't wish to entrap an otherwise fine doctor into lying just to me, just this one time, so I could ruin him to my family's profit. [/ QUOTE ] There are situations in which lying or withholding the truth isn't REALLY lying. These are situations in which there is an implicit (or even better, explicit) agreement between the parties that one of them doesn't WANT to know the truth, if it is something terrible. It is absolutely not lying to tell my girlfriend she looks great in that dress. It is not lying to withhold a cancer diagnosis from an 80 year old Japanese woman (under certain circumstances, probably none that would occur in the US due to legal reasons). Personally, I agree with you and cannot imagine a situation in which I'd prefer to be lied to, but perhaps that is just my ego talking. Maybe I just feel like I'm mature enough to handle any situation, and maybe I'm not, but I feel very strongly that I deserve and desire the truth in any conceivable situation.
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