When Patients Seem Overly Optimistic
Looking at images of his spine, Dr B sees Mr C’s pancreatic cancer had now metastasized, sprinkling a long stretch of his lumbar spine with ominous grey holes.
Mr C had previously asked that Dr B be direct with him, so she began as soon a she was settled in the chair in her office. “As you had been guessing from your new back pain, it looks like the cancer has spread to your spine.”
“I’d thought so,” said Mr C. “I’ve been reading more and more about new treatments, and I really think it’ll work out fine. I’ve just started a new chemotherapy and I have a big trip planned around the world for next year. Besides, this is a great hospital, and I know you’re the best in the field.”
“I’m glad you’re thinking so positively,” Dr B said carefully. “But your disease is moving much more quickly than I’d expected. These CT scans show that it is now in your spine.”
“Oh, I know. But the more I read about these new treatments, I really think it’s all going to work out fine,” Mr C repeated.
- What responsibility does the clinician have to make sure the patient accepts the gravity of the illness?
- What are the risks and benefits of being more explicit with the patient about the seriousness of the illness as opposed to allowing him or her to hold on to unrealistic hopes?
Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)
