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The Problem of Futility: III. The Importance of Physician-Patient Communication and a Suggested Guide through the Minefield

Published online by Cambridge University Press:  29 July 2009

Dorothy Rasinski Gregory
Affiliation:
Center for Healthcare Ethics, St. Joseph Health System, Orange, California
Miriam Piven Cotler
Affiliation:
Health Research and Community Service, Department of Health Service, California State University, Northridge

Extract

As noted In Part II of this series (CQ 1994;3:133–142), perhaps the most critical elements to define in deciding when treatment Is futile are the goals of therapy from, both the physician's and the patient's point of view. A patient's personal goals are based upon value system., life goals, and personal definition of “quality of life.” These personal goals must then be interpreted and applied in a reasonable and realistic fashion against what the physician has previously described as the legitimate, objective, and attainable therapeutic goals. As far as possible, both, parties must work together to eliminate the uncertainties in their discussion. The ideal situation includes a competent, alert patient and a prudent, caring physician who have had a long-term ongoing relationship. The key to collaboration is communication: a sincere interest in and professional concern for the patient; a willingness to be honest and open; a commitment to talk and to listen; an attempt to make one another feel comfortable in the collaboration; and an effort to recognize and to overcome barriers to communication, whether barriers are personal to either the patient or the physician or are professional, institutional, or societal.

Type
Articles
Copyright
Copyright © Cambridge University Press 1994

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