Chapter 31: Making Decisions about Treatment
|There is only one cardinal rule in medicine:
One must always listen to the patient.
- Oliver Sacks
Once you have discovered that you have a medical problem, the resulting tensions and anxieties can be difficult to cope with. In addition to the emotional and physical stress, you now find yourselves faced with making difficult decisions regarding treatment. The word decide comes from a Latin root meaning to cut away from, which essentially means that decision making by its very nature involves loss; i.e., giving up one or more treatment options while grasping another. The very act of not making a decision maintains the dangerous illusion that you can have it both ways: that there is no loss, no risk. However, not making a decision is, in a sense the worst possible decision of all! Unfortunately, most patients do not know how to make their own decisions , and expect their doctor to tell them what to do - they expect to be spoonfed! A good doctor can and will guide you conscientiously, and you should trust him sufficiently to be confident that he will not let you make a wrong decision. However, the final responsibility is always yours - you cannot abdicate it to anyone else!
The decision-making process is different for each patient and depends on individual situations and requirements. Some patients may opt for expensive, high-tech treatment, while others in the same situation may prefer to wait and watch.
The all-important question would be: what kinds of treatment are available? Youll often find that a variety of treatment options exist for instance:
Nowadays, there are various tools available to help you make your own decisions. For example, the Foundation for Informed Medical Decision Making, based in the USA, has developed shared decision-making programs on videos and CD-ROMs for common medical problems (such as breast cancer and hormone replacement therapy) which enable you to make up your own mind.
The main factors which can influence your decision are as follows:
It is for you to choose which one of the following best fits your own personal style for making medical decisions:
Just as there are no right or wrong styles, remember that there are no right or wrong decisions about your treatment, and as your options change with time, you may also change your priorities. Try to be as realistic and open-minded as possible. While the final outcome will always remain unknown at the time of making decisions, if you take the time and the trouble to make your own decisions, at least you will have the satisfaction of knowing that you tried your best!
Here is a sample worksheet for making medical decisions about treatment:
Option 1 Option 2 Option 3 Option 4
Decision (in the rank of choice)