One topic that returns again and again during our discussion of medical practices (and especially with regards to medical experimentation) is the distortion of the patient-doctor relationship that usually accompanies what today is often regarded as bad medicine or uncaring doctors.
I was especially struck by Audre Lorde’s description of the scare tactics used by her doctors to sway her decision about what treatment to use when her cancer returned: “What he [the doctor] said to me was, ‘If you do not do exactly what I tell you right now without questions you are going to die a horrible death.’ ” While it’s expected that a doctor would know more about treating cancer than the average person, statements such as these exploit that knowledge gap. If my life were at stake in a similar situation, I’d definitely want to know about all the options available to me and receive honest answers to my questions. An the end, the decision is still the patient’s to make. When patients are considered too ignorant to make these decisions on their own and doctors try to take that right away using scare tactics, it leads to abuses that we’ve seen in other readings and videos, such as the clitoridectomies forced on the Victorian era women from “Managing Women’s Minds” and on intersex babies.
The Grey’s Anatomy clip where Bailey confronts Izzie about her reasons for anonymously paying for Heather’s surgery also touched the topic of how emotionally involved a doctor should be when treating a patient. There seems to be this balance between remaining calm and objective and becoming emotionally vested in the patient’s recovery. But there’s also the danger of forgetting that the patient, too, is human when this sort of emotional distancing occurs—in the rush to protect their own emotional well-being, doctors may forget that in front of them is another human being with feelings and a life, not just another customer, experimental subject, oddity, or learning tool.
2 comments:
In The Spirit Catches You and You Fall Down by Anne Fadiman, we see a doctor patient relationship too. However, this relationship is full of distrust and frustration because of language and cultural barriers. Language barriers keep doctors from explaining Lia’s illness to her parents and also from communicating her treatments to her parents such as when and how to give Lia her medicine. Lia’s parents cannot communicate their own concerns about Lia’s treatments and their mistrust of Western medicine is seen in their unwillingness to give Lia her prescriptions. Cultural barriers create different stand points on health, medical treatments and disease. For example, doctors see Lia’s epilepsy as a terrible disease whereas her parents considered her epilepsy a sign of divine powers as well as being caused by Lia losing her soul. The doctors want to treat Lia with medication, but her parents believe that animal sacrifices can offer a cure. Lia’s weight also has opposing opinions. Her doctors view her weight as being unhealthy and troublesome because it makes it harder to find a vein to give her drugs to help her with her seizures. However, her parents see her weight as a sign of her health since most children in Laos do not eat well.
The differences in language and culture between the doctors and their Hmong patients ultimately result in frustration on both sides. Doctors are frustrated because of their patients’ ignorance and patients are frustrated because they cannot understand what the doctors want or feel that they are being coerced. You mentioned that “when patients are considered too ignorant to make these decisions on their own and doctors try to take that right away using scare tactics, it leads to abuses...” In the case with Lia, we see just this when it seems that Dr. Ernst fears her parents ignorance will end up causing Lia severe mental retardation or death, so he requests that Lia be taken away from her parents. We later learn, though, Dr. Ernst wanted to teach Lia’s parents a lesson for not following his orders and thus the incident was more of an issue of domination and power than outright concern for the well being of Lia.
It is interesting to think about why doctors today resort to scare tactics and why some of them seem so fixated on a certain agenda. I'm not sure but I feel doctors often do this in order to protect themselves from lawsuits or for malpractice. This may seem counter-intuitive in a way, but if something happens to the patient and it is found that the doctor had not expressed the "correct" course of action, it would put themselves at risk. Questions would be raised with why they didn't do what was best for the patient, etc.
The way America's legal system is set up, doctors are punished for mistakes that they make. They aren't supposed to make mistakes. I feel like doctors often resort to scare tactics in an effort to protect themselves, in a way.
This can be seen when Dr. Ernst reports Lia to CPS, as required by law. If he did not, and Lia died, Dr. Ernst would probably be punished for not reporting the situation to CPS. The book even states that Dr. Ernst would be granted immunity even if the basis of the report was incorrect. I feel that the decision to report Lia to CPS was motivated more to protect a career, rather than to exert power. In addition, Dr. Ernst genuinely felt that Lia needed the medication in order to get better, and that her parents were not giving her the best chance to fight the seizures.
Post a Comment