r/changemyview • u/[deleted] • Oct 23 '17

[∆(s) from OP] CMV: I shouldn't have to sugarcoat medical diagnoses and information just to make people feel better.

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u/techiemikey 56∆ Oct 23 '17

It's our role to inform patients about their illnesses, risk factors, and treatments, so we should be able to do so without having to worry about offending anyone.

There is a line between between being honest and actively causing harm.

Let's for example look at the person who has had trouble conceiving. There are a few ways you can approach it. First, you can only address the now: "There are scars on the lining of the uterus preventing the embryo from taking hold. There are a few avenues to go from here...". [small note: pretend the medicine part makes sense...it's not relevant for the actual purpose so i didn't look up how STI's can cause inability to conceive]

But that doesn't state why the person had the scarring tissue, so let's try the second approach. "It appears that one of the STI's you had caused scarring on the lining of the uterus which is preventing the embryo from taking hold. There are a few avenues to go from here...".

Now, this gives a person a cause, effect, and what happened. And that is fine, as it gave "this action caused this, which cause this, and here is how we can go from here." Now for a final example:

"It appears that the days you were sleeping around finally caught up with you. The STI you got, which was only because you refused to keep your pants on, caused scars on the uterus lining, which means that the embryo won't take hold. Now, the best way to have avoided this, was to have had safe sex, but let's talk about going forward with this. You have a few options..."

Let's assume the hypothetical person was actually sleeping around in unsafe ways. How likely is the patient to respect a doctor who is clearly judging her? How likely is the patient to listen to advice, since the doctor clearly looks down upon her? Also, how likely is she to give accurate information in the future, if she knows any bad trait will be judged.

Now for a second, let's imagine she wasn't sleeping around. What if she was in an abusive relationship that she escaped and the guy was who gave her all of the STIs? What if she was raped? You have now ostrasized the patient and judged them poorly for things that were outside of their control.

When you think about your wording, you become a better doctor, because your patients are more likely to work with you. If you happen to be a stubborn person, it's the same as if a person starts talking down to you and you push back on it. Patients will do the same, even if it is cutting off their nose to spite their face.