Medical treatment involves very difficult experiences that most people do not wish to undergo. Doctors ordinarily avoid treating their own relatives and children because they may be swayed by the anticipated suffering into making the wrong decision. Just as it is hard to make a decision to put a relative into a painful situation, it is even harder to make this decision regarding yourself. The anticipated pain can override all the other considerations and short-circuit the decision-making process. In today’s managed care environment, time to counsel the patient is often not available. The patient’s decision may be guided by his irrational fears rather than by good information.
Highly skilled health counseling, liaison work, and emotional support is unfortunately necessary to get many people to do the difficult, scary things that they have to do to save their lives.
Massad (2000) wrote a touching piece in the Journal of the American Medical Association about his efforts to treat a woman’s cancer. The patient “did not seem relieved” when he explained that her cancer was small and that she had an “excellent chance for cure.” Instead, she just “shook” while he explained “treatment options” and cried when he asked for a decision. He told her to think it over and come back in a few days, but she failed to return. She “would not come to the telephone” when he called. Her daughter explained that her mother’s friends had convinced her that cancer treatment just increases suffering. So she didn’t return for immediate followup, as she was supposed to. Instead she simply waited until “her pain began to gnaw at her more intensely than her fear” and