Dr Brent M. Kious joins Ethics Talk to discuss his article, coauthored with Dr Ryan H. Nelson: “Does It Matter Whether a Psychiatric Intervention Is ‘Palliative’?”
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.
The communication gulf is not only one of language, but also one of culture, understood broadly. And, despite the priority of medical concerns, every effort should be made to obtain consent consistent with appropriate care.
Fibromyalgia, with no positive tests, is a “foreigner” in the medical landscape. Medicine looks for signs of pathology, changes in the structure or function of organs. The mantra of physicians facing patients with fibromyalgia: “Your tests are normal.”
One strategy is to determine “triggers” that alert the primary clinician that the patient has a high symptom burden or difficulty coping with the diagnosis, prognosis, or treatment plans and should be offered palliative care services.