2: Although patients might want to know if a treatment ‘works’, suppose they don’t want all the details?
It is important to strike a balance between information overload and depriving people of enough information to help them make an adequately informed choice. It is equally important to remember that a person may well need some information initially and more later on as they weigh the pros and cons needed to reach a decision.
During a consultation, both doctor and patient should feel satisfied that the patient has the amount of information needed to go ahead and select, with the doctor, what the current best course of action is.
But it doesn’t stop there. If, after spending more time thinking about things, the patient has more questions and wants more details, the doctor should help the patient find out what they might want to know, and help clarify anything that is unclear.
Some choices involve difficult trade-offs; it may come down to choosing the lesser of two evils. For example, in Chapter 4 we discussed aortic aneurysm – the enlargement of the main artery from the heart – which may develop fatal leaks. Major surgery can correct the problem, but one or two patients per 100 will die from the operation itself.
So there is a trade-off between the early mortality of the operation against the later risk of fatal rupture. Long term, an operation is the better bet, but some patients may reasonably choose not to opt for surgery, or at least delay it until after an important event such as their daughter’s wedding. So rather than diving blind into an ‘only hope’ solution, it is better to weigh up the risks and their possible timing.