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  #1  
Old 02-04-2012
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Medicolegal and Ethics How to deal with cheerful patient and poor prognosis!

A 61-year-old man has just been diagnosed with an inoperable brain tumor. Although his prognosis is poor, he continues to be cheerful and to talk amicably with all who visit him. When faced with a patient who appears cheerful in the face of a poor prognosis, the physician should do which of the following?
(A) Delay care for the patient until he accepts his prognosis
(B) Gently point out to the patient that he is in denial
(C) Remind the patient of his prognosis as often as possible
(D) Speak with his family about his condition
(E) Understand that the patient may need more time to adjust
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  #2  
Old 02-04-2012
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Ans ....... D ............
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Old 02-04-2012
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E......?????????
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  #4  
Old 02-04-2012
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I think E.
Its nothing wrong with being cheerful. He is using a mature defense mechanism where he is making most of his last days. Since he seems clearly aware of his condition.
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Old 02-04-2012
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i think it should be E.
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Old 02-04-2012
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It seems E.
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i think the answer is E.
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I would say E
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Old 02-05-2012
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I'll go with E
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yes patient is using defence mechanism (suppression) he is aware of his condition but then why he need more time for adjustmen ??


thats why i wil go with with (c)
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Old 02-05-2012
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i will go with Ans C
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Old 02-05-2012
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Quote:
Originally Posted by riya rai View Post
yes patient is using defence mechanism (suppression) he is aware of his condition but then why he need more time for adjustmen ??


thats why i wil go with with (c)
If you keep reminding him of his condition then aren't you going to scare the pt... And annoy him with it?
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go with D
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  #14  
Old 02-06-2012
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The answer is E.
Denial is often the first response to bad news. Many patients take a bit of time to accept fully a negative prognosis.The physician's role is not to foster denial,but to give the patient the time to come to grips with the reality in their own way. Every patient is different,and coping often requires time.
Delaying care (choice A) means delaying measures to improve the patient's comfort. Informed consent requires that the patient understand the diagnosis, not that they have a clear acceptance of prognosis. Pointing out to the patient that he is in denial (choice B)is confrontational and likely will be regarded as hostile. This type of confrontation may be appropriate if the denial is unending, but it is too harsh at this point in the process.Besides,no prognosis is ever certain.The physician's job is to listen to the patient's reality,not to try to force his or hers on the patient.
Reminding the patient repeatedly of his impending death (choice C)seems insensitive at best and cruel at worst.The physician's job here is to listen to the patient, understand his coping strategy,and assist as the patient moves through the coping process.
Communication must go from the patient to the family (choice D), not the reverse. The physician's interaction should be focused on the patient. The interaction at this point is simply more about the physician listening than talking
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The above post was thanked by:
Abdulaziz (02-06-2012), Amenah (02-06-2012), riya rai (02-06-2012)



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