Barriers to effective prognosis conversations include knowledge deficits, misconceptions, cultural differences, and lack of motivation. These can be addressed head-on by good communication interventions.
AMA J Ethics. 2018;20(8):E757-765. doi:
10.1001/amajethics.2018.757.
Dr Whitney Riley Linsenmeyer joins Ethics Talk to discuss her article, coauthored with Dr Sarah Garwood: “Patient-Centered Approaches to Using BMI to Evaluate Gender-Affirming Surgery Eligibility.”
Some disability advocates take issue with the “normalization” goals of the medical model of rehabilitation, but expressions of that position can be dismissive of rehabilitationists’ efforts to remediate oppressive functional deficits.
AMA J Ethics. 2015;17(6):562-567. doi:
10.1001/journalofethics.2015.17.6.msoc1-1506.
The physician must help patients understand that all options—further testing, surgery, no action—carry risks and benefits. Disclosing the statistical probability of injury and other possible outcomes might help, but it can also hinder the process.
After assessing the reasons for a patient’s unrealistic hopefulness in the face of clear understanding, a clinician may believe that significant harm will come to the patient if he or she does not acknowledge the seriousness of the illness.