{"id":32253,"date":"2014-09-04T10:54:50","date_gmt":"2014-09-04T09:54:50","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=32253"},"modified":"2014-09-04T12:01:51","modified_gmt":"2014-09-04T11:01:51","slug":"tessa-richards-when-doctors-and-patients-disagree","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2014\/09\/04\/tessa-richards-when-doctors-and-patients-disagree\/","title":{"rendered":"Tessa Richards: When doctors and patients disagree"},"content":{"rendered":"

\"Tessa_richards\"<\/a>The Ashya King case has gone global, and in the UK is assuming Mid Staffordshire proportions. The law, as interpreted, would appear to have totally overlooked the best interests of a gravely ill child: to have parents who love and care for you at your side.<\/p>\n

Amid the media hullabaloo, unfolding events, heated debate, and hasty responses, the seminal event: the \u201cbreakdown in communication” between the family and Southampton hospital staff, should prompt doctors everywhere to take a long, hard look at how they interact with patients and their families.<\/p>\n

Doctors are advised that decisions about treatment and best management should be shared, and take account of the concerns and perspectives of patients and their carers<\/a>. But it\u2019s not easy. Every day, doctors debate and are confronted with dilemmas around what constitutes best practice and how to apply it to the patient in front of them<\/a>. They also struggle to find the time\u2014or lack the skill or motivation\u2014to listen to patients, elicit essential information from them, and fully understand what matters to them.<\/p>\n

Patients and their families are often frustrated by this. Most \u201cget\u201d that there are constraints under which doctors and public health systems work. But when the stakes are high, they will\u2014and surely have the right to\u2014seek other options in or outside their own country, and to expect their doctors to listen and discuss their findings and viewpoints sensitively, however well or ill informed they may be.<\/p>\n

Ashya King\u2019s father scoured the internet and challenged the Southampton doctors’ decisions. It\u2019s a scenario that health professionals have got to get used to. Information is being democratised<\/a>, and suggesting patients should not access it on the grounds that it may mislead them is absurd. The new reality for doctors, as the jargon puts it, is to \u201cact as guide, not God,” and to avoid branding patients who do their own research as difficult.<\/p>\n

Doctors will inevitably be placed in situations where they don\u2019t know best and patients are repeatedly making this point. In a video clip from a recent medical meeting in Sweden (see below), one of The BMJ<\/em>‘s patient panel members uses his own experience of learning about lifesaving new treatment from an online patient community to suggest that not Googling your condition may be bad for your health.<\/p>\n