DR CHONG Siow Ann must be commended for bringing up for public discussion a difficult topic for patients, families and doctors ("Is harm done when a diagnosis is doctored?"; last Saturday).
Doctors must not lie, misrepresent, deceive or defraud in their dealings with patients and their families.
Integrity and transparency are essential for building trust.
Families here do ask doctors to not inform the patient of the diagnosis and prognosis for serious illnesses, like cancers, and end of life issues.
This often occurs when the patients and families opt for family-centred medical decision-making.
The Asian cultural concept of filial piety requires adult children to care for and protect elderly parents.
This duty extends to protection from bad news.
At the same time, patients, especially the elderly and those not fluent in English, seem to voluntarily withdraw from participation in medical decision-making.
Medical ethics and health law based on Western values find such collusion unacceptable, as patient autonomy seems to be sidelined.
Patients who are adequately informed often deal better with the effects of disease and treatment.
Doctors should, thus, engage with the patient to determine the level of information needed and the preferred medical decision-making model.
The question is not whether doctors should be truthful in sharing medical information, but how and when the truthful information is to be shared.
Skilful information sharing is like a good medical prescription, marked by the right dose, right timing, and right mode, so that it serves the patient's best interest.
Insensitive information dumping, though truthful, causes despair in the patient and is disrespectful to the family.
Skilful information sharing by active, empathic listening and responding can make the bleak truth acceptable by offering caution with hope.
Truthful information sharing which promotes patient autonomy must always be an act of compassion.
A collaborative relationship based on mutual trust and respect is essential, in order to take into account the patient's needs, the family's preferred medical decision-making model and the doctor's need to uphold professional standards of medical ethics and law.
Health-care organisations should give priority to such relationships forming and thriving in the clinical situation.
T. Thirumoorthy (Dr)
Doctors must not lie, misrepresent, deceive or defraud in their dealings with patients and their families.
Integrity and transparency are essential for building trust.
Families here do ask doctors to not inform the patient of the diagnosis and prognosis for serious illnesses, like cancers, and end of life issues.
This often occurs when the patients and families opt for family-centred medical decision-making.
The Asian cultural concept of filial piety requires adult children to care for and protect elderly parents.
This duty extends to protection from bad news.
At the same time, patients, especially the elderly and those not fluent in English, seem to voluntarily withdraw from participation in medical decision-making.
Medical ethics and health law based on Western values find such collusion unacceptable, as patient autonomy seems to be sidelined.
Patients who are adequately informed often deal better with the effects of disease and treatment.
Doctors should, thus, engage with the patient to determine the level of information needed and the preferred medical decision-making model.
The question is not whether doctors should be truthful in sharing medical information, but how and when the truthful information is to be shared.
Skilful information sharing is like a good medical prescription, marked by the right dose, right timing, and right mode, so that it serves the patient's best interest.
Insensitive information dumping, though truthful, causes despair in the patient and is disrespectful to the family.
Skilful information sharing by active, empathic listening and responding can make the bleak truth acceptable by offering caution with hope.
Truthful information sharing which promotes patient autonomy must always be an act of compassion.
A collaborative relationship based on mutual trust and respect is essential, in order to take into account the patient's needs, the family's preferred medical decision-making model and the doctor's need to uphold professional standards of medical ethics and law.
Health-care organisations should give priority to such relationships forming and thriving in the clinical situation.
T. Thirumoorthy (Dr)
