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» Ship of Fools   » Community discussion   » Purgatory   » Cyberchondria, Googly diagnosis and treatment (Page 2)

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Source: (consider it) Thread: Cyberchondria, Googly diagnosis and treatment
Jane R
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# 331

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It's not a new idea though; as mdijon pointed out earlier, the idea that patients should have control over what happens to their own bodies and must consent to treatment is a cornerstone of medical ethics.

Explaining all the options available and asking the patient to choose is just the latest way of doing this.

Posts: 3932 | From: Jorvik | Registered: May 2001  |  IP: Logged
cliffdweller
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# 13338

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quote:
Originally posted by Jane R:
It's not a new idea though; as mdijon pointed out earlier, the idea that patients should have control over what happens to their own bodies and must consent to treatment is a cornerstone of medical ethics.

Explaining all the options available and asking the patient to choose is just the latest way of doing this.

Sure, but some medical professionals are better st this than others. There's a reason why they get the big bucks. If all they're going to do is offer a bewildering array of options without giving any professional recommendation they're no more useful than Dr Google

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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner

Posts: 11085 | From: a small canyon overlooking the city | Registered: Jan 2008  |  IP: Logged
Jane R
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# 331

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True. I believe medical schools are now providing courses on communicating with patients... which is great until you run up against a language barrier. My Other Half recently suffered an injury whilst working (temporarily) in France. He managed to understand most of what the doctor said (especially the important bit, that his arm wasn't broken), but failed to realise that he'd been given a prescription for heavy-duty painkillers until he got home and I translated the paperwork from the French hospital for him...

[ 06. July 2017, 10:42: Message edited by: Jane R ]

Posts: 3932 | From: Jorvik | Registered: May 2001  |  IP: Logged
mdijon
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# 8520

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Some aspects of the decision aren't to do with expert opinion, but to do with values. And here the doctor really needs to hear the values of the patient.

For instance, take an elderly patient, somewhat prone to falling and housebound, but with an irregular heart beat that carries a risk of stroke. The risk of stroke can be dealt with by warfarin, by aspirin, or by nothing.

Warfarin is best able to reduce the risk, but carries the greatest risk of bleeding complications, and requires frequent blood tests.

The doctor can't decide on the best course of action without knowing how badly the patient detests being carted out of the house, how the patient values risk of death versus risk of disability, whether the patient fears bleeding more than stroke for emotional reasons, and how the patient feels about risk in general.

Answers to those questions are very context specific. The doctor can't simply ask the patient for a scale of 1 to 10 on each then make a decision.

In old paternalistic days the doctor would have just decided since they know best, but if the patient can absorb the information then once they have grasped the risks they know everything the doctor knows. The difficult part of the decision is the trade-off of very different kinds of risks and the patient is the expert in how they feel about that.

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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon

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Jane R
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Yes, and there may be practical reasons for preferring one course of action over another. I refused an operation for my carpal tunnel syndrome on the grounds that the recovery time was too long. I might have been more enthusiastic if the doctor had been able to guarantee an improvement in the symptoms... but she couldn't. So we went with the second option of physiotherapy and painkillers, which improved it well enough. And I didn't have to spend weeks off work trying to do everything one-handed.
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