Dialogue Volume 13 Issue 1 2017 - Page 31

section Tk practice partner

When Values Clash

Bridging the divide if you disagree with patient choices


By Stuart Foxman illustration : sandy nichols

An exam room isn ’ t a courtroom . For doctors , the goal is to help patients , not judge them . “ You don ’ t need to share the patient ’ s values , goals and world views – but you should respect their right to hold them ,” says Dr . Jennifer Gibson ( PhD ), director of the Joint Centre for Bioethics , University of Toronto . Feelings can become heated . One bioethicist tells of a doctor who , upon being asked about an abortion , rebuked the patient : “ You ’ ll burn in hell .” Big moral debates in medicine focus on controversial issues like , most recently , physician-assisted death . Yet beyond matters of religion or conscience , value judgments occur routinely across health care . Bioethicists tell other stories too , about doctors who criticize choices their patients make . Like doctors who admonish patients who smoke or who fail to immunize their children . “ The research base leaves no doubt that clinicians make moral judgments of their patients … not only in egregious cases but also in everyday situations ,” concluded a review in the journal Philosophy , Ethics , and Humanities in Medicine ( 2010 ). The article called the problem “ pervasive ”, yet stated that “ the role of moral judgment is largely unrecognized in the literature on healthcare communication , caring , empathy and trust .” We all have our values and bring them to any encounter . That ’ s human nature . The expectation though is to remember your professional obligations to your patients and to ensure that your own values do not impact patient access to care .

Issue 1 , 2017 Dialogue 31