Physician's Mantra?: "If You Can't Cure It, Your Job is Over"
The issue is simple: Should the doctor's job in interacting with a patient be to make a diagnosis, establish treatment and then cure the patient? Do all patients come to their physicians with the view that it is the doctor's duty to continue all medical management to a cure and if that is not at all times the physician's goal then their preoccupation with the patient's illness is over? This view seems consistent with what is happening in practice. When an illness appears terminal, there often seems to be a conflict between the physician's prognosis and advice that further treatment or procedures will be futile and to institute simply comfort care vs the patient or family's demands for continuing a program directed at attaining a cure or if not in their mind statistically possible at least go for a "miracle cure". Does the physician's duty toward the patient then stop if he or she cannot expect or provide a cure? Of course, I think not. But is that really what most patients and families expect of a physician? I must say, however, that when cure is not possible there may be a tendency by some physicians to forget that their professional and humanistic duty is to actively participate in a palliative role toward the patient. Their excuse to themselves might be "if you can't cure it, your job is over." ..Maurice.