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To what extent should we protect patients from themselves? Two things happened this week that had me considering this again.
One, some discussion on medical reddit popped up about how to handle people (chiefly young women) requesting sterilization at a young age especially prior to having children. This has obvious implications for regret and forcing people to be locked in to insufficiently considered choices.
Two I was talking to a friend who was complaining about a side effect of laser eye surgery and she said she was not told about the possibility. In talking to her she was very clearly told about the possibility of this side effect but simply didn't get it.
This is not uncommon. Either surgeons half ass the consent process, or patients just completely fail to understand and fully grok what we tell them. Generally both.
A different example - I've had the conversation "X problem is gone because of your medication, if you stop your medication X problem will come back" "okay doc I'm here to complain about X problem, I stopped my medication" a million times. Including with smart and highly educated people. People often don't understand what is told to them and that can include things like life altering surgery.
What do we do with this? Do we let people make mistakes? Where do we draw the line?
This topic comes up very frequently in medicine but the discussion quality is generally very poor "protect them from themselves unless they want such and such political topic in which case sterilize them at their request with no counseling etc etc." I think this community may have something more interesting to say.
I especially don't know how to handle this given the tendency to strongly protect autonomy in some areas but not others.
More general CW implications include the usual trans problem, but also "protecting people from themselves instead of the more specific patients.
A rather banal way to get patients to remember medical advice is to... actually write it down. Memory is fickle and people overestimate how well they remember details.
Always shocks me that I can go for a 15 minute check up where the doctor will say 10+ things I'm supposed to remember in detail and none of it is written down.
Doctors writing down their medical advice also solves the problem of patients lying (perhaps not even consciously) about what the doctor said, which is unfortunately common.
Interesting. I think this would work. Doctor just needs to make brief dot points and print it out. He can also save a copy of the notes to the patient's file (to cover his ass in the event of patient's lying).
Doctors are often lazy and or overworked though, so even though this would be a small amount of work, it would still be a not insignificant thing in the context of cramming even more activities into a 15 minute consultation.
It's pretty common to give print outs like medication information sheets, or something called an "after visit summary." Frequently what happens is that it gets comically enormous and useless as various stakeholders fill it with random bullshit.
Anything more personalized/off the cuff becomes extremely difficult, especially as corporate control of medicine pushes doctors to see more patients faster. Really hard to do when your visits are 15 minutes max and that's supposed to include your charting time.
Could you give any examples of "erroneous"? I've certainly seen "enormous"/"useless"/"random bullshit", and burying important truths in so much filler they get ignored might have consequences as bad as falsehoods, but I just don't recall seeing any likely falsehoods. Even the random bullshit is unevidenced rather than obviously untrue, along the lines of "let's put X in the list of possible side effects, as CYA, even though our only evidence for X is that in one study the treatment group reported it almost as often as the control group"...
Not nearly as common as death by volume of paperwork, but an example of actual errors is when practice changes due to new information, and nobody updates the info sheets.
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