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Doctors should never dictate your treatment choices

The way healthcare is delivered has changed over time. In days gone by, doctors practiced in a very paternalistic manner. They knew what was good for you, and you wouldn’t have had much choice. If a certain recommendation was made, there wasn’t much scope for asking questions, or considering alternate options. You had to accept whatever treatment they proposed, even when at times, such treatment wasn’t ever good for anyone.

Over time, the practice of medicine has changed dramatically. Medical advances have given us a wide scope of different treatment approaches, even when treating the same illness. Individuals have increasingly been recognized to have completely different responses to various treatments, mostly related to genetics and other unique biological characteristics. There’s also the matter of shared decision making between patients and their physicians. The physician’s role is to guide with treatment options, while the patient remains as the ultimate decision maker.

But medical matters are never simplistic. There are doctors who still feel the need to tell patients what to do, without ever giving leeway for patient choice and personal preferences. Equally, there are patients who easily get intimidated by doctors. Such patients may sometimes blindly accept treatment recommendations that are either suboptimal, or even inappropriate. All because there wasn’t a chance for decision sharing between the patient and the doctor.

How do you ensure your doctor never dictates your treatments? First and foremost, you must get a clear understanding of what you are ailing from. Get your doctor to explain everything in detail. Look up additional information about your illness. Wait and hear what the doctor recommends. Then ask questions. Why has one treatment option been recommended over another? What are the possible side effects or other complications? What are the expected recovery rates? How much will it cost you? Don’t stop asking questions until you are completely satisfied. Then tell your doctor the kind of treatment you will accept, and what you wouldn’t.

But what if the doctor really pushes for one treatment option over another? All you need to understand is why. If it doesn’t appear objective to you, then you must decline the recommendation. Never accept any medical persuasions or coercion, it may not be in your best interests. If your doctor has a problem with your decisions, so be it. You are the one undergoing treatment, not the doctor. And it’s your life, not theirs.

For emergencies, matters may be different. In such situations, doctors are obliged by law to act in your best interests. They should always recommend life-saving measures. But if in the right mental state, you are never ever obliged to accept even life-preserving recommendations. You reserve the right to say no to any doctor, even if it might end up killing you.

Dr Alfred Murage is a Consultant Gynecologist and Fertility Specialist. amurage@mygyno.co.ke

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