A mother said, "My daughter was valedictorian recently. I'm proud to say it because she had a very hard beginning, and spent many weeks in an ICU after she was born. The neonatologist said she will never be in a regular classroom."
Time and again, I read stories in which doctors make dire pronouncements and are proven wrong. In Judaism we have the principle: doctors are permitted to heal (with Hashem's help). They have no right to make pronouncements about the future.
They make dire prognostications in the name of honesty and enabling parents or the patient to be prepared, but since they aren't prophets and are sometimes (often?) wrong, what they say is cruel and counter-productive. As authority figures, what they say carries a lot of weight and it can be very hard to be optimistic and have bitachon in the face of bad news from a doctor.
How many parents have gone through months of agony because a doctor said their unborn child would not be normal, would be deformed, until to have a healthy child be born? I'm always left wondering whether the doctor interpreted the information correctly and the couple's prayers changed things, or the doctor was mistaken from the get-go. I don't know, but I have read numerous stories in which this happened. True, the doctor's negative expectation may have been the impetus for lots of prayer and good deeds, but that did not give him the right to scare people who won't abort and can't do anything about the situation.
It would be helpful if someone collected many of these stories, verifying the information, i.e. what the doctor said and what actually happened, in categories like: pregnancy, preemies, illnesses, comas, what faculties and abilities patients were told they could and could not regain, and how many years they were told they would live. It would be a great resource in bolstering our faith in the Rofei chol basar.
I think that what drives doctors to include negative predictions or possibilities when speaking about a patient's prognosis, is that if the doctor tells the patient that "everything will be alright" and that does not happen, the doctor will be held accountable. We were also told that our preemie might not walk or talk, not as an absolute prediction but as a possibility to be prepared for. The doctor is trying to say that his treatments are not a guarantee for success. Some people die from routine treatments that are generally considered safe. The outcome of anything is unpredictable. The doctor is better off saying that a small percentage has a bad result, or we don't know what the future holds for this child, or based on what the ultrasound shows, there is a possible abnormality. People often want statistics and survival rates, even if those odds might not be the patient's odds. The flip side of a doctor telling a patient that his days are numbered, is the patient who does not get his affairs in order because he believes that he will get well. There is also the patient who will spend his last dime and last months of life chasing alternative treatments that may have saved a handful of lives but largely rely on shoddy evidence of having cured disease. He refuses to believe the doctor so he blows the time that he has left on earth.
ReplyDeleteThe flip side of the doctor who warns that the patient is on a slippery slope if he doesn't heed medical warnings is the doctor who fails to tell the patient that his health habits are killing him. The patient's family is hoping that the patient will be scared and decide to improve.
As many medical stories exist of patients who were told by doctors that their days were numbered and they went on to live long lives, there are also stories of patients whose doctors dismissed serious ailments as "nothing" and the patients died of curable diseases.
Doctors have to develop a lingo such as, "the average patient with your condition has such and such an outcome but each situation is individual" or "the risks associated with this treatment are such and such." Patients usually appreciate when doctors are frank in saying things like, "preemies often benefit from physical therapy" or "your mother may not be safe living alone anymore." I think that doctors have gotten away from the role of telling patients what decisions to make. They might tell the patient to "do their homework" and research the options or they might outline the existing options for the patients to make choices.
It is basically all in the wording.
I just wanted to add that our preemie who we were told might not walk or talk has just received smicha (rabbinic ordination) this morning in Morristown, NJ.
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