Wednesday, July 4, 2012

115. Independence Day

Seems only reasonable for a themed post.  We are all into patient independence these days. Forget "paternalism," where the doctor made all the decisions not only about the course of treatment but also whether or not the patient should even know the diagnosis.  Forget "informed consent," where the doctor still made the decisions but at least informed the patient who then gave consent.  Welcome "shared decision-making," where all the options, risks, benefits are laid on the table with a full discussion and then a consensus decision.  I suppose the next stage in this progression is, "you've googled it, tell me what you want me (the doctor) to do."

So, a 26 year old walks in and says she wants a hysterectomy because of painful menses.  She's already had a tubal ligation, so she's made it clear that she doesn't want/need her uterus for it's natural function.

Removing the uterus doesn't guarantee absence of pain.  "I know that."  And there are potentially life-threatening risks to major surgery.  "I know that too."  Can we keep the ovaries intact?  "No."

Okay, how does July 25th sound?

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