In my last post, Hope or Letting Go, I shared the story of a physician, Dr. Youn, still troubled by an incident that happened ten years ago. Since reading it, I've been bothered by some of the questions he posed.
For example, Dr. Youn asked if concern for the needs of the patient's loved ones ever take precedence over the patients' needs?
In a word: No.
Am I missing something? I hope I'm not alone in thinking this issue poses no dilemma. To accept someone as a patient under their care is to agree to advocate for this patient through thick and thin.
Patients and their caregivers should be able to trust that their physicians' words and actions are always said and done with the patients' welfare in mind.
Another topic that Dr. Youn raised has to do with hope. The story suggests that family members feel more hopeful for recovery if their loved one looks peaceful on a ventilator than if their loved one is awake and not on a ventilator, but writhing in pain.
In my next post I'll address this and other factors that affect family members' sense of hope.
The only time I can think of that might pose a dilemma is when a second family member is also the physician's patient. I can see how a doctor might then have a little hesitation over balancing both patients' needs, but even under those circumstances the needs of patient currently under care must come first.
So I agree: The needs of the patient always come first, the patient's loved ones' second.
Posted by: Finn | July 24, 2011 at 12:50 PM
I'm with you on this one, Wendy. Absolutely.
Posted by: Andrea Gauthier | July 24, 2011 at 02:30 PM
I wish I would have seen read or understood this comment about patients' needs coming first over patients loved ones. when my husband was dying from cancer, he very much wanted to see his parents. At the beginning of the disease when he thought he would recover, he didnt tell them and neither did his siblings. His parents were old and living in Tehran, Iran. But as he got worse, he wanted to see his parents very much.
His siblings who also lived in the US didnt want to tell their parents or ask them to come visit. I didnt know what to do. I intuitively felt that my husband in his 50's had a right to see his parents and that his siblings should oblige him. But his siblings kept telling me, they are old and this will kill them to see him like this.And my sister-inlaw even went so far as to tell me that I didnt care about her parents.
I felt like perhaps I was wrong, but my feelings were that my husband who was losing his life in his 50's
wanted to see his parents who had lived into their late 80's. and if the parents died, which I doubted would happen, well it was worth the risk for my husband to see his parents.
It was terrible, i regret so much that I wasnt more self-assured and didnt make it happen.
Posted by: laura paz | July 26, 2011 at 07:02 PM
Dear Laura,
You were in a difficult and highly emotional situation. And you were being told -- threatened -- that you'd "kill" your husband's parents by telling them about his illness and asking them to visit.
I assume your parents-in-law learned of his untimely death (yes?). I can only imagine how their shock, having been kept in the dark.
Today, the issue is what to do with your feelings of regret. My hope is that you forgive yourself that you didn't make the decision that you would make if you had it to do over again.
I phrased it that way because I don't feel you made a mistake. Clearly you tried to do the right thing.
We all have situations that, in retrospect or with added knowledge, we would like to have done differently.
May I suggest you write a letter to your husband, sharing what is in your heart? When done, put it with whatever mementos you have of your husband in your home (such as behind a photograph or in a box of his belongings).
I'm so sorry for your pain and your loss. May memories of happy times together with your husband comfort you.
With empathy and hope, Wendy
Posted by: Wendy S. Harpham, MD | July 26, 2011 at 07:39 PM