The Reason I'm not a Doctor part 2

Scenario 1, part 1 I want you to imagine you are a young family doctor and you have a patient, a young man in his early twenties, who has been battling cancer for the last year. During that year he's tried every treatment that is available, often with awful side effects, but all to no effect. In fact he's been told that he will most likely die. Now, as the family doctor, you've just discovered a new treatment that only has a 50% chance of working. Regardless of whether the treatment works or not, it will have horrendous side effects, much worse than he has had yet. Now, what do you do? If you decide to tell him how do you go about this?

My answer was this:
1. Make sure that before you even talk to the patient you have all the facts and/or relevant people to refer to. Remember it's a new procedure and you don't want to get up any false hopes

2. Choose an appropriate time/place to tell him about the news. For example, a family meeting (if appropriate) or some other support person in attendance when you tell him about the new procedure.

3. Make sure he takes some time to make the decision, even if they say yes/no straight away.

The Interview Panel's Response:

1. " Could you please explain your answer?" I was at a complete loss at what to say as I thought my answer was complete and covered the issue of informed consent and providing a supportive environment ie family/friends.

2. After I told them that I had said all I had to say, their was a general shaking of heads and frowns. They then asked the next part of the question "Your patient chooses to take the treatment. He has horrendous side effects, but it fails. He comes into your office and blames you for all that has happened to him. What do you do/say?"

My Response

Don't take it personally, especially as anger is part of the grieving process. Be patient. Get the patient's support people involved.

The Panel's Response

"Is that all?" This was said in an almost disbelieving voice by the doctor with the knighthood. I was at a complete loss trying to figure out what more they could want, so I asked them. Their reply made me realize that I was never going to make the grade. "You haven't touched on any of the possible legal issues. You haven't protected yourself."

My Opinion

I felt disappointed that the panel didn't seem interested in the caring side of my answer, the bit about the family/support people, choosing the right time in place. I felt I had met my obligation by making sure my patient was informed.

As for the second part of the question, I still don't know what else I could have done except to understand where my patient was at.

I am well over any thoughts of becoming a doctor, their loss.