Physicians' role in care of loved ones
Online posting: March 18, 1997
Published in print: May. 15, 1997 (CMAJ 1997;156:1377)
Re: Too close for comfort? A family physician questions
whether medical professionals should be excluded from their loved
ones' care, by Dr. Michael C. Klein, CMAJ
1997;156:53-5 [full text / résumé]
We read with great interest Dr. Klein's experiences with the
hospital care of his wife after she suffered a debilitating
stroke. Klein shares his views on whether a physician who is a
family member should be excluded from a loved one's care. It is
commonly held that it is improper for a physician to be involved
in the care of a loved one because his or her judgement may be
clouded and perspective lost. However, in Klein's case he was the
substitute decision-maker or he may have had power of attorney
over his wife's care. In such a situation, decisions must include
the opinion and informed consent of the family member, regardless
of his or her profession. Therefore, deciding the extent to which
family members need to be involved based on their occupation is
discriminatory.
In our surgical practice we have always tried to include the
opinion and comments of family members who are physicians, but
only if the patient approves. We have found that this practice
pleases the patient, puts the family at ease, helps build trust
and rapport with the family and provides us with a contact who
can then share information with other family members.
Klein describes a rather disturbing incident that occurred
when "one nurse asked [him] to leave, saying that she couldn't do
her work with [him] there." This would be considered completely
unacceptable on a pediatrics ward, where children rely on the
comforting hand of a parent or guardian. Why is this any
different if an adult patient is involved? Again, if the
patient's best interests were kept in mind, these confrontations
would never happen.
We have never asked a family member to leave unless it was
necessary for patient comfort. Indeed, several of our patients
are physicians. If we were the least bit unsure about our skills
as health care providers, how would we deal with these patients?
If one of us has a problem with someone observing our technique,
the problem lies with the worker and not the observer. The
patient should not suffer because of it.
Carmine Simone, PhD
Division of Clinical Pharmacology
Hospital for Sick Children
Toronto, Ont.
placgrp@sickkids.on.ca
Martin Seidenschmid, DDS, MD
Philadelphia, Pa.
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