The Rare Cure and Doctors’ Goal: Recognizing the Goals of Their Patients
When a physician proposes a treatment for any illness, there become two goals which must be reached and resolved, one of the patient and one of the doctor. The goal the patient usually would be a cure, relief of pain and suffering and a return to an active and normal life. If cure is unlikely some patients’ goal would be to continue the attempt while others would accept the prognosis and seek other reasonable goals. Treating an illness, the goal of the doctor would be to control the pain and suffering and to perform what could be professionally accepted as clinically reasonable management to reach for a hopeful cure. If the cure is found to be rare, then some doctors might find the goal should be to follow what they think the average patient would want, a cure, and continue with energetic treatment toward that goal but failing to ask for their patient’s own goals. Other physicians faced with the possibility of only a rare cure would communicate with the patient and learn about the patient’s goal and then provide education of the patient about the reality of the situation and go from there stressing realistic management.
An example of the behavior of two doctors facing the incurable disease of the same patient can be found in the blog description by the patient “Can Good Care Produce Bad Health” by Amy Berman. Read the story and return and tell me what you think. If you had a disease with only a rare cure, what would you want? ..Maurice.
1 Comments:
Good article. It seems pretty clear to me. Asking a patient what his or her goals are regarding treatment, especially in cases like the one described here, should be protocol. A question should be included on patient surveys -- "Did your physician ask you about your treatment goals and take them into consideration?" We can see, even in this case, the patient isn't comfortable challenging the doctor, asking him why he isn't taking her goals (or even asking about them) into consideration. The doctor's comment that his patient's don't complain to him about the side effects of the kind of treatment he's recommending, is revealing. Patients won't tell many things to their caregivers unless they're asked and they believe that the caregiver isn't asking by rote but really wants to hear and cares about the answer.
Doug Capra
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