Bioethics Discussion Blog: Partially Misplaced Sympathy: Should the Doctor Get a Little?

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Saturday, December 27, 2008

Partially Misplaced Sympathy: Should the Doctor Get a Little?


To extend the discussion of the role of physician apology in the doctor-patient/family relationship, I would like to bring up another issue which is related.

Should all the sympathy be offered only to the patient or family who have experienced or suffered the results of a medical error or the failure, despite efforts by both the physician and the patient, to attain a cure? If so, considering the fact that the physician is an integral part of the relationship, is human, has feeling and conscience, that limiting all the sympathy to the patient or family, is in reality misplacing some of the sympathy. Shouldn’t some of it be directed toward the physician?

The public should not assume that physicians are not emotionally involved in the symptoms and course of a patient’s illness. Physicians are very much involved in the need to feel that have contributed to the patient’s well-being, to support their own feelings for professional self-confidence, to promote their own professional work to other patients, to avoid personally damaging incidents leading to malpractice suits or loss of license to practice. Even beyond these ego centered reasons, there are the humanistic feelings of empathy if not simple sympathy for their patient.

If yours or a family member’s disease did not end happily or the doctor made an error in judgment or technique, would you find that you could transfer some of the sympathy offered by others to you—to your doctor? ..Maurice.

Graphic: Photograph taken by me on 12-26-2008 at Descanso Gardens, La Cañada Flintridge, California.

2 Comments:

At Sunday, December 28, 2008 8:23:00 PM, Blogger Maurice Bernstein, M.D. said...

My thread was noted on the website "On Doctors Nurses and Patients":

Tim wrote: "Mistakes hurt no matter which side of the blade we’re on. If we expect a physician-patient relationship, we need to find some way to give the physician as much compassion as the patient."


I responded with the following:

Tim, but I want to emphasize, in addition to error, probably most common, especially in patients who have been fighting cancer with their oncologist or primary physician or who have a chronic "treatable disease" which then becomes untreatable (unresponsive to therapy) and the patient dies. There is no medical error. Should the physician who has led the fight with his or her medical skills and most likely has an unpaid investment of personal time and care along with an emotional investment of identification with the needs and burdens and the unique life of the patient have a right to part of the sympathy given to the family? Remember, sadness is part of the emotions also given to physicians. ..Maurice.

 
At Monday, December 29, 2008 6:52:00 AM, OpenID epadvocate said...

Dr. Bernstein,

As someone who represents the patient's point of view, I think we need to account for the fact that not all physicians approach errors, or the loss of a patient, in the same way.

While some (even, perhaps, the majority) truly feel bad when an error is made (or when they lose a patient, regardless of the circumstances)that's not true for all. My own experience was with the latter -- an oncologist who insisted I begin chemo for a deadly lymphoma diagnosis, who hadn't read the entire biopsy report which would have indicated there was a problem with the diagnosis. In fact, I didn't have lymphoma or any cancer at all.

That oncologist, like many other physicians I hear about from other patients, chose to arrogantly try to blame his mistake on me, which he did in a three page letter, after the NIH proved he was wrong. No apology. Just blame.

You can read more about my misdiagnosis here: http://trishatorrey.com/who-is-trisha/misdiagnosis/

Does that doctor deserve compassion? No way.

The bottom line to me is: No one ever intends to make a mistake, especially in medical care. I can't imagine how heartbreaking it is for a compassionate physician when he or she makes a mistake. If the physician behaves as a partner with the patient and family, if he or she is a compassionate member of the treatment circle, then of course, compassion is warranted for all members of the group.

But when that doctor arrogantly denies any wrongdoing, or treats his patients as if they are just one more human body that represents dollar signs -- then absolutely not. No compassion is deserved. In fact, I don't even believe that person should be allowed to practice medicine.

Trisha Torrey
Every Patient's Advocate
www.EveryPatientsAdvocate.com/blog
http://patients.about.com

 

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