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In May, I started this blog when I was facing a dilemma: I wanted to bounce ideas off you as to whether I should send an old man for surgery or not (link). Now I am writing in to tell you that I did send him up for surgery and my worst fears came true.

 

No, my worst fear was not that the patient died during surgery. It was that the family holds me, atleast indirectly responsible for the sad outcome.

 

In May I wrote, ‘The family looks up to me to take a decision. “We trust you. Do whatever is best for him. But please make sure that he’s alright”. The last line is a killer!’

 

After the patient died, the family came back and met me. Sons came in first. It was not very difficult to say that I was sorry for the family’s loss of a parent and that we had done everything we could, and that some times it helps to be fatalistic. We went through the fact that both I and my surgeon had explained that the surgery carried a reasonably important risk of dying for the patient. The sons had actually signed the high risk consent after appropriate counseling. Perhaps they understood that we had not intended that the patient should die! They left thanking my fidgety self for taking care of their father during his illness and last moments.

 

Then the inconsolable daughter walked in. She did not and does not even now understand that 10% risk of dying during surgery meant that out of 10 such patients one will actually die. “I thought it’s just a 10% risk, but if you had told me that he is going to die during surgery, I would have convinced him against it”

 

Huh?

 

At a point of time I had to be a bit impatient. When we explained 10% risk of dying, we didn’t mean that 10% of his body will die and the rest will go home fine! We actually meant that there is a real possibility of dying…she told me that the family had trusted me because of the way I had taken care of her father for nearly two years. But the misgiving with which she finally walked away was that had I not advised him to go for surgery, he would have lived for some more time. Given the fact that he was quite sick the last few days, I was not sure of how long he would have lived but then how could I argue on that?

 

My point is not that it was after a truly sincere debate that I had resorted to surgical advice. I can’t tell the family that it was such an important dilemma that it turned me into a blogger!

 

My point is: Doctors are going to take hard decisions. Some of their patients are going to die. It never matters how much science or philosophy goes behind those decisions: if your decision was followed by death or disability, you will be held responsible for it!

 

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One Comment

  1. i cn understand ur dilemma dr.. nobodyz responsible for anybodyz death.therez only one thing which cn bring death to lyf iz birth!.ssssbcoz of birth death iz certain.if there ws no birth,den therez no ?of lyf n eventually no death atall.sooo dis philosopical n logical xplantion iz worth keeping in mynd for all of us.dis wil help all of us to liv d livez v hv until our death.v all knw dat our bodies r not immortal.lyfz wayz r means for the end.
    may b soulz r immortal(i dont knw!).soo let us stay calm…
    thanklu.tc..


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