Paul C. Rousseau, MD
Potential Financial Conflicts of Interest: None disclosed.
Rousseau PC. On Being a Doctor: Deflection of a Diagnosis. Ann Intern Med. 2007;147:432. doi: 10.7326/0003-4819-147-6-200709180-00017
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Published: Ann Intern Med. 2007;147(6):432.
TO THE EDITOR:
Annals of Internal Medicine recently published a piece I wrote for the On Being a Doctor series. In “Deflection of a Diagnosis” (1), I described the difficulty that a physician experienced in informing a terminally ill patient that he was dying. In fact, the physician was unable to tell the patient, instead deferring the discussion until a follow-up visit scheduled a week later. I have since received a few e-mails critical of my management of the case; however, I was not the physician in the scenario. I was merely an observer detailing the physician's angst in delivering bad news to a fellow human being. My hope was that selected physicians would objectively look at their behaviors after reading this narrative and change their patterns of practice to preclude such conduct in future encounters with terminally ill patients. That said, it is nevertheless hard to provide a “death sentence” to patients, particularly for young physicians who are still absorbing the art and wisdom of medicine that accrues with time and age. And certain patients are just not ready to hear the diagnosis the first time and may require a second, or even third, visit. But regardless of the timeframe involved, unless we are totally honest with patients, the physician–patient bond will shatter, and with that, hope for healing.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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