Cifu: "A patient, dealing with illness, in a completely foreign situation, often needs assistance articulating and applying his or her values and wishes."
Nailed it. There is a meaningful distinction between informed consent ("assent" in this exchange) and paternalism. In this particular case...
Cifu: "A patient, dealing with illness, in a completely foreign situation, often needs assistance articulating and applying his or her values and wishes."
Nailed it. There is a meaningful distinction between informed consent ("assent" in this exchange) and paternalism. In this particular case...
1. Dr. Z knew his patient and her values; a relatively rare thing for hospital-based physicians.
2. After offering his recommendations he still queried her wishes ("Is that alright?") and was presumably willing to honor them, even if she opted for a more aggressive course of treatment.
3. He talked with her post-hospitalization since patient wishes are often impacted by ICU stays.
Thank you for sharing this case and your humility/beginner's mind.
Those are great thoughts. I so appreciate when people read some thing I’ve written and their comments show me some thing I hadn’t realized. Thank you.
Cifu: "A patient, dealing with illness, in a completely foreign situation, often needs assistance articulating and applying his or her values and wishes."
Nailed it. There is a meaningful distinction between informed consent ("assent" in this exchange) and paternalism. In this particular case...
1. Dr. Z knew his patient and her values; a relatively rare thing for hospital-based physicians.
2. After offering his recommendations he still queried her wishes ("Is that alright?") and was presumably willing to honor them, even if she opted for a more aggressive course of treatment.
3. He talked with her post-hospitalization since patient wishes are often impacted by ICU stays.
Thank you for sharing this case and your humility/beginner's mind.
Those are great thoughts. I so appreciate when people read some thing I’ve written and their comments show me some thing I hadn’t realized. Thank you.