Tuesday, November 13, 2012

The Medical Profession's Expectation of Deference

This phrase from Graeme Archer, a few days ago, in the Telegraph, resonated with me:  "What doesn’t help is the attitude of the medical profession, which retains an expectation of deference, as though we haven’t seen scandal after scandal about patient care . . . ."

1 comment:

Jim deMaine, MD said...

Archer goes on to say in his critique of the Liverpool Care Pathway: "Likewise by each “ordinary” death. What is at very least required is for doctors to stop telling us that our views on how we wish to die are irrelevant, that only those with a medical degree can discuss ethics. The physician who will stand at my bedside, as the end of my fixed period approaches, may well have seen thousands of other deaths in his career. That doesn’t give him a better insight than that which I possess into how, or when, I should go."

The LCP is indeed controversial and according to Wikepedia up to half the patients are placed on the pathway without discussion with the families.

I would only hope that in the USA that we may be a bit better about the MD deference issue - or what I call the MDiety Syndrome. In our more modern era of shared decision making, unilateral MD decisions without informed consent would be a breach of trust and possible grounds for physician censure or legal action.

It's a broad brush to paint MD's or any group as acting uniformly arrogant in their interactions with others. It's nuanced, cultural, religious, and education based.

It's too bad that a popular hospice based care protocol like LCP may be used inappropriately at times. The MD should defer to the patient's wishes as voiced by the family trying to work out disagreements with conflict resolution techniques.