Bioethics Discussion Blog: April 2014

REMINDER: I AM POSTING A NEW TOPIC ABOUT ONCE A WEEK OR PERHAPS TWICE A WEEK. HOWEVER, IF YOU DON'T FIND A NEW TOPIC POSTED, THERE ARE AS OF MARCH 2013 OVER 900 TOPIC THREADS TO WHICH YOU CAN READ AND WRITE COMMENTS. I WILL BE AWARE OF EACH COMMENTARY AND MAY COME BACK WITH A REPLY.

TO FIND A TOPIC OF INTEREST TO YOU ON THIS BLOG, SIMPLY TYPE IN THE NAME OR WORDS RELATED TO THE TOPIC IN THE FIELD IN THE LEFT HAND SIDE AT TOP OF THE PAGE AND THEN CLICK ON “SEARCH BLOG”. WITH WELL OVER 900 TOPICS, MOST ABOUT GENERAL OR SPECIFIC ETHICAL ISSUES BUT NOT NECESSARILY RELATED TO ANY SPECIFIC DATE OR EVENT, YOU SHOULD BE ABLE TO FIND WHAT YOU WANT. IF YOU DON’T PLEASE WRITE TO ME ON THE FEEDBACK THREAD OR BY E-MAIL DoktorMo@aol.com

IMPORTANT REQUEST TO ALL WHO COMMENT ON THIS BLOG: ALL COMMENTERS WHO WISH TO SIGN ON AS ANONYMOUS NEVERTHELESS PLEASE SIGN OFF AT THE END OF YOUR COMMENTS WITH A CONSISTENT PSEUDONYM NAME OR SOME INITIALS TO HELP MAINTAIN CONTINUITY AND NOT REQUIRE RESPONDERS TO LOOK UP THE DATE AND TIME OF THE POSTING TO DEFINE WHICH ANONYMOUS SAID WHAT. Thanks. ..Maurice

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Tuesday, April 15, 2014

Patient Modesty: Volume 65







And the discussion continues. 
From Paul writing to Volume 64:

I wonder what women in general, as well as female nurses ,female techs, and other female providers would think if the gender numbers were reversed?

Imagine you go in for a routine exam with your female doctor because you don't want a male doctor. A male chaperone or student is brought in to the room to observe.
You either ask for him to leave or because you were blind sided by it you say nothing and go through it. Only to be angry about it later.

During your exam the doctor finds something and recommends a vaginal ultrasound. You ask for a female but there is only male sonographers that work there. You can say no or swallow your pride and do it. Another male will be assisting you find out at the last minute.

Time for a visit now to a gyn/urologist for a more invasive exam and a cytoscopy. Once again you choose a female doctor but when you arrive all the assistants will be male.

You are found to need an operation. When you arrive a male will be prepping you and another male catheterizing you. By this time you hate the medical system for having to go through all these embarrassing procedures with so many males involved. You say nothing because you are told all the men have seen it all before and your body is nothing special. They have seen it all before so it is silly and immature of you to feel this way.

This is what almost every male has to deal with when we go into the health system. They wonder why men do not go in for their exams. I wonder how many women would hesitate to go if this is what it was like for them?
Oh wait. I think there was something called affirmative action. Now they have female choice for doctors and a support staff of 95 percent women.

I sympathize with the issues of women posting to this site but being a male is even worse.



Which hand of a healthcare provider do you want touching you and whose eyes looking at you, male or female? Do you believe that gender is more important than skill or personality. ..Maurice.

Graphics: From Google Images.

NOTICE: AS OF TODAY JUNE 9, 2014 "PATIENT MODESTY: VOLUME 65 WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON VOLUME 66.

Monday, April 14, 2014

A Doctor's First Words to a Patient




“Interesting belt — where did you get that?”

“I see you are from Youngstown. The key question is, are you a Steelers fan or a Browns fan?”


Daniel R. Wolpaw, M.D., and Dan Shapiro, Ph.D. writing a Perspective article titled "The Virtues of Irrelevance" in the April 3 2014 issue of the New England Journal of Medicine present these as examples of possible opening remarks by a physician to a patient who appears with a medical problem.  The authors suggest that remarks such as these serve 4 "key purposes"  from the physician's point of view which, in establishing the doctor-patient relationship provide "ways to establish the connections that allow us to actually care for the person in front of us."  They explain: "First, they convey that we see the patient as a unique individual. Given the speed of medical practice, it is not surprising that patients worry that their individual concerns will not be heard. Second, these questions reveal that we have had shared experiences, that despite our training and attire we are not so different from the patient. Third, they communicate that we are observant and attending to details, which patients find comforting. And finally, they indicate that we are open to a conversation with the patient."


I am not going to start out with a detailed discussion on my part regarding the pros and cons of a physician beginning the doctor-patient relationship with what might seem as irrelevant communication. What I want to read is what my visitors to this thread think should be the opening question by a physician to their patient: "Tell me about your concerns" or something to that effect or instead to begin with "irrelevance" ..Maurice.



Graphic: Via Google Images from Wall Street Journal by Linzie Hunter and modified by me with Picasa 3.