Medical decision making is better the PATH way

I was really excited when I read about Canadian ideas about the PATH style of decision making. Palliative And Therapeutic Harmonisation looks at older people with multiple conditions in a totally different way than the current ‘cult of cure’ approach. It’s less about keeping on ‘battling’, and more about quality of life and care at home.

Then I found four videos which go through the whole PATH to better decision making. In case you don’t have time to watch them all (and do please try to make time!), then here’s my summary.

Read more…

Talking is good – but is that enough?

Brendan McCann has written of how challenging it is for doctors talking. He is a 30 year old cancer doctor who was diagnosed with a rare cancer in his pelvis:

“My partner and I sat wide-eyed as the surgeon scrolled through the MRI scan … explained the diagnosis [and what was going to be done] … then we saw a kind nurse who gave me leaflets about [the specific cancer] and cancer support groups.” Luckily, Dr McCann’s cancer was surgically removed and he was told he needed no further treatment.

Afterwards, “as advised by the nurse, [Dr McCann] attended the cancer support unit.

My partner asked me why I was going.

‘Because I had cancer,’ I said.

Shocked, she replied, ‘What, really?’ ”

Dr McCann wrote of how “despite our best efforts, [doctors] are often asked to reiterate our explanations to patients or their relatives”. He commented that although it might be difficult for doctors talking, “next time [doctors] get frustrated by this, [they should] ask [themselves] this question: if the girlfriend of an oncologist didn’t even know he had cancer, what chance do the general public have of fully understanding their medical predicament?”

His article is headed: “It’s good to talk, actually talk

But is simply talking, even ‘actually talking’, enough?

Some other questions were also raised here for me, including about how:

  • Dr McCann was alone with a serious problem — his partner didn’t even think he had cancer;
  • the phrasing of the end question almost seems to perpetuate ideas about the technical mastery of doctors, and the limitations of patients — when doctors do not actually have full mastery over cancer, and patients are known to actively collude in the handling of bad news.

Read more in linked posts here and here.