In the past , life was much easier for both doctors and patients . Doctors assumed a paternalistic role and patients were happy to defer to them. This allowed the doctor to use his medical expertise to make the decisions for the patient. This was a win-win situation , when everyone was on the same page .
However , times have changed , and patients want more autonomy . They want more say in the medical decision-making process . Good doctors are also happy to incorporate the patient's wishes , preferences and desires . This is especially true during IVF treatment, which is elective , and is being done because the patient chooses to do it.
However, when I ask my patients how many embryos they’d like me to transfer for them, some of them conclude that I am a bad doctor because I don’t know what the right answer is, and need their opinion in order to decide.
I need to explain to them that as a professional, I will ensure that I will not allow them to make a wrong decision. However, when there are options, I will present these to the patient and allow them to decide for themselves.
I will not decide for them, because they need to live with the consequences of their decisions, and I cannot read their mind.
Conceptually, this is like a parent who allows the child to explore and run around freely on the play-ground – but will not allow the child to cross the boundary and play on the road. They can feel safe that I set the boundaries, to ensure that they will not make a dangerous decision which may end up harming them.
Thus, if a patient wants to transfer 1 blastocyst, or 2, I am happy to let them make the call. However, if they want me to transfer 3, then I put my foot down, and refuse to do so by explaining to them that transferring more just increases their risk of having triplets, without improving their chances of getting pregnant.
No comments:
Post a Comment