In the past some people genuinely did not want to be involved in the decisions being made about their health care. They wanted a “take-charge” doctor who could “fix” their medical problems as quickly as possible without bothering them with the details. They accepted every decision their doctor made without allowing themselves the privilege of finding out about alternative treatment options and procedures and whether there were better, cheaper and less painful ways of getting better. Historically, patients were not empowered. Fortunately there are other options available today: informed consent and shared decision-making are modern realities.
Informed consent is a medico-legal term and what it boils down to is that, except in an emergency, you may not be given any treatment or subjected to any tests without your “informed consent” – you must be informed of the risks and agree to the treatment.
This may sound superfluous to the “don’t tell me what is wrong with me” proponents who will happily sign anything their doctors recommend, without thinking about it. However, it is so much more reassuring, and responsible, to be able to go one step further and to fully and actively participate in the planning of your own treatment – combining your doctor’s medical expertise with your personal values.
How to share in the medical decisions being made:
- Tell your doctor beforehand that you want to share in the decision-making process.
- Do your own research and find out everything you possibly can about your condition. Ask your doctor for references. Use Google, carefully and cleverly.
- Always ask “why?” before agreeing to any medical tests, medication or treatment and make it clear that you are not trying to be difficult but that you wish to be fully briefed about every aspect of your treatment.
- Always ask about alternatives: alternative treatments, medication, hospitalisation, recuperation plans, etc.
- Ask for time to consider your options; do not be rushed into anything. Except in an emergency situation, most doctors will agree. Don’t make rash decisions and, if in doubt, ask your doctor to refer you to a specialist, or get a second opinion.
- State your preferences (based on your doctor’s recommendations and your own research) clearly and discuss the pros and cons with your doctor. Decide beforehand how you would like to be treated should serious complications follow and your life be in the balance – draw up a “Living Will” and discuss it with your doctor and your family.
- Talk to your doctor about your expectations concerning the treatment, possible side effects, pain relief, recovery time, long-term limitations, etc. Make sure the benefits are worth the risk.
- Be prepared to accept responsibility for the outcomes – this is what shared decision-making is all about. Make your doctor your friend and health care partner rather than your boss!
There is more to this than perhaps meets the eye. We should all take an active role in our own healthcare. Part of the challenge is finding doctors and other healthcare experts who are willing to participate in these sorts of discussions, but this is getting easier over time (more and more healthcare experts “get it”). The other part of the challenge is accepting the responsibility ourselves. Our lives, our health, our decisions & choices, our responsibility.
Written by Dr Colin Burns
