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Doctor-Patient Relationship: By: Mergerizka Amiko Kapindo

1. The document discusses the doctor-patient relationship and the importance of trust, communication and respect between doctors and patients. 2. It outlines the duties of good doctors, including prioritizing patient care, maintaining safety and quality standards, communicating effectively, and upholding patient confidentiality and trust. 3. Barriers to effective communication are explored, including authoritarian doctor attitudes, patient anxiety or impairments, and lack of shared language or cultural understanding.

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47 views

Doctor-Patient Relationship: By: Mergerizka Amiko Kapindo

1. The document discusses the doctor-patient relationship and the importance of trust, communication and respect between doctors and patients. 2. It outlines the duties of good doctors, including prioritizing patient care, maintaining safety and quality standards, communicating effectively, and upholding patient confidentiality and trust. 3. Barriers to effective communication are explored, including authoritarian doctor attitudes, patient anxiety or impairments, and lack of shared language or cultural understanding.

Uploaded by

chanyunda
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Doctor-Patient

Relationship
BY: MERGERIZKA AMIKO KAPINDO

DOCTOR PATIENT RELATIONSHIP BY MERGERIZKA AMIKO 1


Introduction
Doctors and patients interact; it demands respect, and if the doctor also displays
compassion, sets the scene for the development of trust. Physicians must never forget that
patients are individual human beings with problems that all too often transcend their
physical complaints. Patients do not fail treatments; treatments fail to benefit patients.

Most patients are anxious and fearful. Physicians should instill confidence and offer
reassurance but must never come across as arrogant or patronizing. The doctor– patient
relationship is in itself therapeutic; a successful consultation with a trusted doctor will have
beneficial effects irrespective of any other therapy given. The ideal patient-physician
relationship is based on thorough knowledge of the patient, mutual trust, and the ability
to communicate.

DOCTOR PATIENT RELATIONSHIP BY MERGERIZKA AMIKO 2


Duties of a good doctor

Patients must trust doctors with their life and death. To justify that the
Doctor must show respect for human life.
Knowledge, skills and performance
• Make the care of your patient the first concern.
• Provide a good standard of practice and care.
Safety and quality
• Protect and promote the health of patients.
• Take prompt action for patient safety, dignity.
Communication, partnership and teamwork
•Treat patients as individuals and respect their dignity.
•Respect patient’s right to confidentiality.
•Work in partnership with patient
•Work with colleagues in the ways that best serve patient’s interests
Maintaining trust
• Be honest and open and act with integrity
• Never discriminate unfairly against patients or colleagues
• Never abuse your patient’s trust

DOCTOR PATIENT RELATIONSHIP BY MERGERIZKA AMIKO 3


Difficulties In the doctor-patient relationship
Regardless of experience and skill, at some point in a doctor’s career, the doctor–patient
relationship will break down. It is important to recognize a breakdown in the relationship quickly
and, whenever possible, identify the reason. If patients are unhappy with an aspect of their care,
they are entitled to a prompt, open, constructive and honest response that includes an
explanation and, if appropriate, an apology. It is also important to reassure the patient that the
issues raised will not adversely affect their future care.
However, the longer one takes to address a problem, the more difficult it becomes to
resolve. The patient may continue to be dissatisfied with the doctor and it may be most
appropriate for another colleague to take over their care. It is important to reflect on such
incidents, to identify whether one would approach a similar challenge differently next time.

DOCTOR PATIENT RELATIONSHIP BY MERGERIZKA AMIKO 4


Some Barriers to Good Communication
in Health Care

The Doctor
• Authoritarian or dismissive attitude
• Hurried approach
• Use of jargon
• Inability to speak first language of the patient
• No experience of patient’s cultural background
The patient
• Anxiety
• Reluctance to discuss sensitive or trivial issues
• Misconceptions
• Conducting sources of information
• Cognitive impairment
• Hearing/speech/visual impairment

DOCTOR PATIENT RELATIONSHIP BY MERGERIZKA AMIKO 5


Doctor-Patient Communication
Effective communication between doctor and patient is a central clinical function that
cannot be delegated. Most of the essential diagnostic information arises from the interview, and
the doctor’s interpersonal skills also largely determine the patient’s satisfaction and positively
influence health outcomes.
When a patient sees a doctor, he has some expectations and hopes. He expects the doctor to
be interested in him as an individual. He wants to be listened, so that his fears can be expressed
and his burdens shared.
To be able to meet these expectations the doctor must develop certain skills. He should have
the patience to listen to the patient’s complaints and try to understand what is trying to convey.
The bond of trust between the patient and the doctor is vital to the diagnostic and therapeutic
process. It forms the basis for the doctor-patient relationship.

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CASE ANALYSIS
TRUTH-TELLING IN THE DOCTOR-PATIENT
RELATIONSHIP: A CASE ANALYSIS

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Medical background
An 18-year-old woman, Miss P, approaches the transplant centre stating that she would like to
donate a kidney to her father. She appears to be highly motivated to donate, is healthy, and testing
indicates that she is medically suitable.
The potential recipient, Mr. P, is a 50-year-old man who has polycystic kidney disease. He has been on
haemodialysis for six months but has noticed that his strength is deteriorating and that he does not feel
well on dialysis.
Transplantation is considered the best form of treatment for his end-stage renal disease (ESRD). The
waiting time for a cadaveric transplant is approximately four to six years and the results of transplantation
from living donors are better than those obtained from cadaveric donors.
HLA testing shows that Mr. P and Miss P are a one-anti- gen match, which means they cannot be
genetically related. The test is repeated and the results are confirmed. Neither Mr. P not Miss P give any
indication that they believe they are not blood relatives. The testing was not done to establish paternity
and, from a medical point of view, the findings do not preclude Miss P from donating to Mr. P.

DOCTOR PATIENT RELATIONSHIP BY MERGERIZKA AMIKO 8


Psychosocial background
Miss P is a full-time student with a part-time job. She lives with her presumed father and
stepmother. Miss P was born abroad and her parents were not married. When her parents
separated, Mr. P immigrated to North America with his daughter. Miss P has had no further
contact with her birth mother. Mr. P married six years ago, and Miss P states that she has a good
relationship with her father and step- mother.

DOCTOR PATIENT RELATIONSHIP BY MERGERIZKA AMIKO 9


Analysis
1. 4 Box Method of Clinical Ethics
Medical Indication Patient Preferences
- A 50 year old man, Mr. P who has polycystic kidney disease has Medical treatment has applied according to the standard
been on hemodialysis for 6 months but has noticed that his operational procedure.
strength deteriorating and that he doesn’t feel well on dyalisis.

- Transplantation is considered the best form of treatment for


his end stage renal disease.

- An 18 year old woman, Miss P approaches the transplant


center stating that she would like to donate a kidney to her
father.

- HLA testing shows that Mr. P and Miss P are a one-anti- gen
match, which means they cannot be genetically related. The
test is repeated and the results are confirmed

Quality of Life Contextual Features


Patient’s quality of life will get better if he does the kidney Doctor decided to choose the non-disclosure horn based
transplantation. mainly on the potential detrimental effects of disclosure on the
patients. The non-paternity is not relevant to the medical
  possibility of transplanting the kidney from Miss P to her father.

DOCTOR PATIENT RELATIONSHIP BY MERGERIZKA AMIKO 10


2. Ethical Dilemma

◦ Beneficence: doctor decided the non-disclosure horn because based mainly on the potential detrimental
effects of disclosure on the patients
◦ Autonomy: doctors should disclose medically relevant information which patients could reasonably to be told
even the result of HLA testing that showed they were not biologically related wasn’t the purpose of the test.

Prima Facie: Beneficence

3. Ordinary and Extraordinary

◦ Ordinary: a daughter wants to donor her kidney to his father.


◦ Extraordinary: HLA testing shows that Mr. P and Miss P are a one-anti- gen match, which means they cannot
be genetically related

DOCTOR PATIENT RELATIONSHIP BY MERGERIZKA AMIKO 11


Conclusion
Although it is commonly heard that doctors should always ‘tell the truth’, it is not always clear what constitutes the
‘truth’ in any given context. The American Medical Association’s Principles of Medical Ethics, which state that a
physician ‘shall be honest in all professional interactions’ and should ‘strive to report physicians engaging in deception
to appropriate entities’ are thus misguided. The duty to tell the truth is not absolute but can be outweighed by other
moral considerations, such as the obligation not to cause great and avoid-able harm.

When moral agents suspect a moral dilemma, open discussion with colleagues from different personal and
professional backgrounds is desirable to appreciate diverse viewpoints, tighten one’s arguments and heighten
awareness of personal biases. Finally, moral dilemmas should always generate a further discussion about possible
ways to avoid similar problems in the future. Asking patients early on in the doctor–patient relationship how much
they would like to know is one way to tailor information to the preferences of individual patients.

Whatever the individual position on the case, all will agree that it is desirable to avoid such ethically (and emotionally)
difficult situations.

DOCTOR PATIENT RELATIONSHIP BY MERGERIZKA AMIKO 12


References
Sokol, Daniel. 2006. Truth-telling in the Doctor-Patient Relationship: A Case Analysis. Medical Ethics Unit,
Department of Primary Health Care and General Practice, Imperial College London, United Kingdom.

Mohanty, 2017. Doctor-Patient Relationship. Beyond Medicine Chapter 219. Pg-1011-13

DOCTOR PATIENT RELATIONSHIP BY MERGERIZKA AMIKO 13


Thank you 

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