Should a line be drawn in what a doctor tells a patient?

[Bells]

In the past, the patient was rarely ever told too much by the doctor and as a result, they were always kept in suspence and the doctor would therefore be in an almost godlike position over the patient, who would hang on every word for some tidbit of information about their illness. Things have now changed and the doctor is now more actively involved in the patient's recovery and also in sharing their diagnosis. And while this is a major breakthrough, there are however, some occasions when the doctor should basically keep some opinions to themselves. I shall give you one such example.

Today my family received some sad news about a beloved member. My uncle has been suffering from heart disease over the past 10 years and as a result has suffered many heart attacks. This week has seen another such episode which was further complicated by his contracting pneumonia. While in most people this is a serious but treatable disease, for someone like my uncle, who has a very weakened heart and lungs, this is potentially deadly. Now today, my uncle, who had been rushed to hospital after he'd been sent home yesterday due to bed shortages, was given his prognosis by the doctor attending him at the hospital.

Imagine a man who is in extreme stress, having great difficulty in drawing breath and who had just had yet another small heart attack only just an hour before being faced by a man in a white coat and a clipboard. This doctor barely looked at my uncle as he told him that his heart was severely damaged and his lungs were filled with fluid and as a result his heart could not pump properly to clear out this fluid (which was commonly known to my uncle). He then went on in the same manner and told this poor man that as a result of this, in the event of another attack they would not be resuscitating him as it would be a waste of time and not worth it because he probably would not make it anyway. Now imagine anyone telling you that it is a waste of time to try and save your life and that it's not worth it. But it got worse. This charming doctor (and yes I am being sarcastic) then informed his patient that he could die at any time as his heart could just stop, be it while he was awake or asleep and in such an event, they would do nothing to help him because as he again repeated, it would be a waste of time and hospital resources to do the impossible.

Now I am sorry, but while I may be emotionally involved as the patient is my uncle, I think that doctors should not be telling their patients that they aren't worth the effort of resuscitation because it probably would not work. Am I wrong in this?? When I saw this particular doctor afterwards I asked him how he could have done this and his response was that a patient has a right to know what to expect. And while he is correct in this, I just feel that a doctor should never tell a patient that is would be a waste of time to resuscitate them. Is it wrong to want to strangle this doctor with his stethoscope for being so cruel?

 

[Marigny]

that's horrible

some doctors aren't very diplomatic in that sense. But that is unusual that the doctor would say that in that manner.
The patient does have a right to know but you can't actually regulate how a doctor would be able to apply his method of administrating his advice, expertise and knowledge.
Though I think that in every case, everyone deserves a positive outcome no matter what happens.

 

[fadingCaptain]

The doctor should have told the family first and left it to them to communicate it on. He showed poor judgement IMO. All doctors are not equal and some have better people skills than others..

 

[goofyfish]

Originally posted by Bells
...told this poor man that as a result of this, in the event of another attack they would not be resuscitating him as it would be a waste of time and not worth it because he probably would not make it anyway.

I could well be wrong, but I believe that medical staff are required to resuscitate a patient unless they have a signed order, from the patient, indicating otherwise. It is more likely that the patient/family misheard due to their distress.

Originally posted by fadingCaptain
The doctor should have told the family first and left it to them to communicate it on. He showed poor judgement IMO. All doctors are not equal and some have better people skills than others...

I disagree. While the doctor may have had a poor bedside manner, I feel that a patient should be spoken to directly. A physician should fully inform the patient about his or her health care and treat the patient as a partner in the healing process - they are due a frank discussion about their situation. Failure to keep the patient informed of all pertinent health information is a failure to respect the patient, and could have legal ramifications as well.

:m: Peace.

 

[fadingCaptain]

Goofy,
Yes I agree with what you said. It just seemed like an extreme example telling him they would not attempt resuscitation. Plus the timing seemed rather poor. It should had been handled better but you are the right...the patient should know and be spoken directly to.

 

[Bells]

Well, as an update, the family contacted my uncle's heart specialist and informed him of what the attending doctor had told my uncle. He was appalled and called this doctor and it seems abused him for his callousness. The attending doctor came to my uncle's room when we were all there and apologised for the way he had delivered the news. The hospital board has also apologised to my uncle and his wife for the distress they were caused. The doctor had put in my uncle's file a do not resuscitate order which was not signed by my uncle or any member of his family... he did this because he thinks that my uncle's heart can no longer be resuscitated. Whether he is right in this or not, it was not his decision to make. This episode has caused extreme grief and heart ache for my uncle and the rest of us as his family. As a result of what has occured in regards to this DNR order, the hospital board is now investigating after being pushed to do so by my uncle's long time heart specialist.

Goofy while I totally and 100% agree with you that a patient needs to be told directly about their illness.. and I stated this before in my post.. there is a way to do so. And the way he did was wrong and painful to the patient and his family. My uncle is back in hospital and his specialist has informed us that it will be difficult for him to fight this and we need to be ready for the worst. He also informed my uncle of this but he, unlike the other doctor, did not tell my uncle that he was not worth resuscitating. He told him that there is still a chance if he fights as much as they.. the medical staff.. are fighting for him. A doctor has to give his patient some hope while telling them the truth and also what to expect. My uncle was comforted by this and he is a lot calmer now about what awaits him and what is wrong with him. The other doctor was ordered by the hospital board to not approach my uncle or his family due to the distress that he caused to all concerned. As to the DNR.. my uncle has to date not signed it and his long time specialist has not even brought it up to him as he does not feel that is something he should worry himself about. The specialist has told my uncle that he should only concern himself with feeling better.. the rest would be dealt with if and when the occasion arises..