An article published in the July 2019 issue of the journal Cambridge Quarterly of Healthcare Ethics discusses how empirical work has shown that patients and physicians have markedly divergent understandings of treatability statements. For example, in the context of a serious illness, a physician might say, “This is a treatable condition,” or “We have treatments for your loved one.” Although in this particular instance, the emphasis is on the doctor-patient relationship, it is not difficult to imagine how interactions of a similar nature occur regularly between members of the allied health professions and the patients whom they treat.
A suitable venue to explore this phenomenon would be a rehabilitation center. Patients arrive there after the occurrence of traumatic brain injuries, various kinds of cancer, heart disease, stroke, and injuries sustained in falls and accidents, to mention just a handful of problems that necessitate long-term treatment. Usually, teams involving physicians and nurses from different specialties and allied health personnel (e.g., physical therapists, occupational therapists, respiratory therapists, and speech-language pathologists) work in sync with one another to address the many ailments that can affect patient well-being. It clearly is in the best interest of patients and their caregivers to begin their interactions on a positive note by recognizing that treatment interventions can produce salubrious outcomes. A key ingredient in achieving success is to foster patients’ resilience by encouraging them to maintain a belief that all the effort and time they must devote to becoming healthier are worth such an investment of personal stamina, combined with a willingness to continue undergoing treatment.
As the journal article points out, physicians often do not intend treatability statements to convey improvement in prognosis or quality of life, but merely that a treatment is available. Similarly, patients often understand treatability statements as conveying encouragement to hope and pursue further treatment, although this result may not be intended by physicians. A radical divergence in understandings may lead to severe instances of miscommunication, a situation that can arise from the lack of shared experience between practitioners and patients accompanied by differing assumptions that each party makes. Thus, apart from the laying on of professional hands, it is incumbent on the part of caregivers to pay close attention to the quality of communication that occurs with patients. Informed consent and shared decision-making are two aspects of this process that can play a definitive role in improving an agreed-upon understanding of everything that treatment statements actually entail.
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