AMA Journal of Ethics®

Illuminating the art of medicine

Journal of Ethics Header

AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. May 2001, Volume 3, Number 5.

Perspectives

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Through the Patient's Eyes: Moral Wounds: Complicated Complications

A patient recounts the psychological harm she experienced and lost trust in her surgeon after developing vocal cord paralysis as a result of a partial thyroidectomy.

As a complication of her partial thyroidectomy, Shari Munch, PhD, has permanent paralysis of one vocal cord, a possible outcome about which her surgeon did not inform her. In this JAMA article, Dr. Munch discusses the psychological harm and damage to trust caused by the surgeon's failure to tell her about the risk of vocal cord paralysis before the operation. She invited her surgeon, Dr. Lewis deKryger, to respond to her essay, and he did so. In his portion of the dialogue, Dr. deKryger explains that he decides what to tell patients preoperatively based on his assumptions about what they already know, e.g., the risk entailed in any surgery, and on his previous experience in performing the particular surgery they will undergo. He admits to not reflecting at length on the possible "moral wounds" of incomplete disclosure.

Munch S; deKryger L. Moral Wounds: Complicated Complications. [A Piece of My Mind]. JAMA. 2001;285:1131-1132.

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