Treatment decisions in high-risk situations require a dynamic relationship between doctor and patient in which patient preferences and clinician recommendations contribute equally in shaping a final treatment decision.
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.
Eitan Neidich, Alon B. Neidich, David A. Axelrod, MD, and John P. Roberts, MD
Geographic disparities in availability of organs for transplant have spawned for-profit companies that help patients get on waitlists in more than one region and arrange travel for them if an organ becomes available.
Requirements for informed consent are relatively vague and the exceptions are few, so it is in the physician’s best interest to inform patients about proposed treatment options, ascertain that they understand their choices, and secure their consent.
Discussing CAM offers an opportunity to study the development of basic medical science that refuted vitalism, homeopathy, humoral theory, miasma theory, the doctrine of signatures, and other prescientific myths that persist today.