.

Medical Ethics question

slumlord44slumlord44 Member Posts: 3,695 ✭✭✭
edited April 2012 in General Discussion
Friend of mine went in for Prostrate cancer surgery a while back. Going in he made it clear to the doctors and his wife and kids that he wanted to know exactly how bad it was and the details. He came through fine and is doing well now. He found out much later, after it was all over, that he only had a 20% chance of survival going in. He was pissed to say the least. Can they leagaly and moraly do this? I would sure want to know going in what the odds were.
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Comments

  • reloader44magreloader44mag Member Posts: 19,356 ✭✭
    edited November -1
    I guess I would be glad to be alive and doing well..question?...are his wife and kids doctors that were treating him?...strange post...my 2 cents
  • armilitearmilite Member Posts: 35,195 ✭✭✭
    edited November -1
    As long as I came out of the surgery okay I could not have cared less if they told me I had no chance of making it through what so ever going in.
  • slumlord44slumlord44 Member Posts: 3,695 ✭✭✭
    edited November -1
    Strange but true. His wife is an anastegelogist so I am thinking she may have had influence with the doctors. Guy has filed for divorce and this is one of the reasons the way I see it.
  • reloader44magreloader44mag Member Posts: 19,356 ✭✭
    edited November -1
    quote:Originally posted by slumlord44
    Strange but true. His wife is an anastegelogist so I am thinking she may have had influence with the doctors. Guy has filed for divorce and this is one of the reasons the way I see it.
    Well where do the kids fit in... sponge nurses?
  • reloader44magreloader44mag Member Posts: 19,356 ✭✭
    edited November -1
    quote:Originally posted by slumlord44
    Strange but true. His wife is an anastegelogist so I am thinking she may have had influence with the doctors. Guy has filed for divorce and this is one of the reasons the way I see it.
    He must be worth more alive than dead[;)]
  • ElMuertoMonkeyElMuertoMonkey Member Posts: 12,898
    edited November -1
    Why would he care what his chances of survival were? Would he rather have accepted the 0% chance of survival by not going through with the surgery? Was he planning on betting on his odds in Vegas?

    Sounds to me like your friend was just looking for any reason to divorce his wife. Not being informed of chances is a flimsy-* excuse and if I were a betting man, I'd bet the real reason is a bit deeper than just not being told of his survival chances...
  • reloader44magreloader44mag Member Posts: 19,356 ✭✭
    edited November -1
    quote:Originally posted by slumlord44
    Friend of mine went in for Prostrate cancer surgery a while back. Going in he made it clear to the doctors and his wife and kids that he wanted to know exactly how bad it was and the details. He came through fine and is doing well now. He found out much later, after it was all over, that he only had a 20% chance of survival going in. He was pissed to say the least. Can they leagaly and moraly do this? I would sure want to know going in what the odds were.See red above...Why?...would forego the surgery and die of cancer knowing a 20% survival rate....very strange post
  • JamesRKJamesRK Member Posts: 25,672 ✭✭✭
    edited November -1
    I don't know about the legally, but if I'm paying somebody United States Yankee cash money to tell me what kind of condition I'm in and they lie to me, I'm some kind of pissed.

    I doubt if I'd divorce the wife over it, but she would know I'm somewhat less than pleased.
    The road to hell is paved with COMPROMISE.
  • reloader44magreloader44mag Member Posts: 19,356 ✭✭
    edited November -1
    quote:Originally posted by JamesRK
    I don't know about the legally, but if I'm paying somebody United States Yankee cash money to tell me what kind of condition I'm in and they lie to me, I'm some kind of pissed.

    I doubt if I'd divorce the wife over it, but she would know I'm somewhat less than pleased.Why?
  • JamesRKJamesRK Member Posts: 25,672 ✭✭✭
    edited November -1
    quote:Originally posted by reloader44mag
    See red above...Why?...would forego the surgery and die of cancer knowing a 20% survival rate....very strange post

    If you want to go through life with other people making your decisions for you, that's your privilege. It's for your own good after all. That's almost as good as "It's for the children".

    It looks like you're in for a happy future. [:)]
    The road to hell is paved with COMPROMISE.
  • reloader44magreloader44mag Member Posts: 19,356 ✭✭
    edited November -1
    quote:Originally posted by JamesRK
    quote:Originally posted by reloader44mag
    See red above...Why?...would forego the surgery and die of cancer knowing a 20% survival rate....very strange post

    If you want to go through life with other people making your decisions for you, that's your privilege. It's for your own good after all. That's almost as good as "It's for the children".

    It looks like you're in for a happy future. [:)]

    This whole thread is based on an assumption that the wife and kids are somehow involved in the situation as to survival of this guy....The OP makes NO sense at all...other than the treating doctor part...who did he learn from that he only had a 20% survival rate...facts missing and conclusions being made[:)]....happens here ALL the time[;)]
  • JamesRKJamesRK Member Posts: 25,672 ✭✭✭
    edited November -1
    quote:Originally posted by reloader44mag
    This whole thread is based on an assumption that the wife and kids are somehow involved in the situation as to survival of this guy....The OP makes NO sense at all...other than the treating doctor part...who did he learn from that he only had a 20% survival rate...facts missing and conclusions being made[:)]....happens here ALL the time[;)]
    In the old days when any cancer was pretty much a death sentence it was common practice to tell the wife or husband and kids and advise them not to tell the cancer victim. The theory was to make the cancer victim's last days as worry free as possible for as long as possible.

    The theory sucked then and it sucks now.
    The road to hell is paved with COMPROMISE.
  • slumlord44slumlord44 Member Posts: 3,695 ✭✭✭
    edited November -1
    My thoughts exactly. It sucks. It is my decision as to weither to do surgery or not. If you know the odds it gives you the chance to say and do some things you may not otherwise say or do. Son let it slip to him after all was well.
  • woodhogwoodhog Member Posts: 13,115
    edited November -1
    I have found the relative chances for such things don't mean much. They do not take in to account any factors of the individual etc and are weighted buy the fact many receiving a surgery/procedure commonly have additional complications. His chances may very well have been much better,doctors dislike putting things in such a 'box' sounds like a pretty ungrateful person to me.
  • reloader44magreloader44mag Member Posts: 19,356 ✭✭
    edited November -1
    quote:Originally posted by woodhog
    I have found the relative chances for such things don't mean much. They do not take in to account any factors of the individual etc and are weighted buy the fact many receiving a surgery/procedure commonly have additional complications. His chances may very well have been much better,doctors dislike putting things in such a 'box' sounds like a pretty ungrateful person to me.
    well put
  • The artist formerly known as DanoThe artist formerly known as Dano Member Posts: 29,215
    edited November -1
    Talk about ethics.

    Where in the Hell do they get off, by making you wear those damn little exam room gowns? [:(!]
  • reloader44magreloader44mag Member Posts: 19,356 ✭✭
    edited November -1
    quote:Originally posted by BTDT
    Talk about ethics.

    Where in the Hell do they get off, by making you wear those damn little exam room gowns? [:(!]


    They have never made me wear a gown....the nurses prolly just want to know if you are a he or a she[:)]
  • roswellnativeroswellnative Member Posts: 9,401 ✭✭✭
    edited November -1
    I smell a lawsuit against a dr. that cured... what the ??????????????
    Although always described as a cowboy, Roswellnative generally acts as a righter of wrongs or bodyguard of some sort, where he excels thanks to his resourcefulness and incredible gun prowesses.
  • woodhogwoodhog Member Posts: 13,115
    edited November -1
    rumor has it BTDT dies those gowns pink and wears them around the house BACKWARDS
  • v35v35 Member Posts: 13,200
    edited November -1
    I cant grasp his thinking?
    I also question the claim he had only a 20% chance of surviving a prostate operation operation unless he had heart or other critical issues going in.
  • rongrong Member Posts: 8,459
    edited November -1
    Does this thread mean "Survival rate" from
    the Surgery or Ultimate survival rate from
    the Cancer?
    I had my prostate removed robotically and I
    understand the the survival rate of that operation
    is the same as any operation ,
    there are risks involved.
    This man must have underlying medical issues
    and if so ,I can see his concern.
    Certainly not enuff to divorce his wife tho.
  • nmyersnmyers Member Posts: 16,372 ✭✭✭
    edited November -1
    I don't buy your friend's angst.

    Prostate cancer is one of those diseases where there has been a lot of research done on predicting the outcome. "Going in", he had only his PSA & his pathology report showing his Gleason score; these are a rough predictor, & nowhere near certain. Like most prostate patients, he could have bought a copy of Dr Patrick Walsh's book, Surviving Prostate Cancer, which explains just about everything.

    Only the post-surgical pathology is definitive. That tells you if the cancer has spread beyond the capsule, to the vas deferens, seminal vesicles, & to the blood stream & other organs. At that point, you have a more complete picture of your condition, but long term survival for most patients has improved every year for the past 30 years. The % survival is always made looking back, not with the current treatment in mind.

    Neal
  • shilowarshilowar Member Posts: 38,807 ✭✭✭
    edited November -1
    quote:Originally posted by slumlord44
    Friend of mine went in for Prostrate cancer surgery a while back. Going in he made it clear to the doctors and his wife and kids that he wanted to know exactly how bad it was and the details. He came through fine and is doing well now. He found out much later, after it was all over, that he only had a 20% chance of survival going in. He was pissed to say the least. Can they leagaly and morally do this? I would sure want to know going in what the odds were.


    Interestingly JAMA recently released a study regarding this issue, discussing the whether it was ethical for a Dr. to lie to a patient, by omission or exaggeration of their prognosis. From a psychological perspective it may benefit the patient to have am exaggerated prognosis as emotional state can effect healing. In the PSA they stated that it is a gray area, and really depends on the nature of the lie and motivation for it. Human beings lie, mislead, exaggerate and or intentional misstate facts everyday for all sorts of good and bad motivations. Why would Drs be any different?

    Secondly, medicine is not an exact science, who is the expert that can say he had a 20% chance of survival, and not 25% or 40%, he is upset about something he shouldn't be in my opinion. Now if they remove his wanker instead of his prostate then he should be upset!!!
  • rhythm_guyrhythm_guy Member Posts: 1,524 ✭✭✭✭✭
    edited November -1
    Is he THAT disappionted to still be here knowing that he had a chance to turn down the surgery? Odd situation.
  • rongrong Member Posts: 8,459
    edited November -1
    I re-read the OP.
    It appears that he was "told"
    he had a 20% chance of surviving
    the operation, which leads me to believe
    he has other medical issues.
  • BarzilliaBarzillia Member Posts: 21,912 ✭✭✭
    edited November -1
    It was either a 20% chance of surviving surgery, which I doubt, or a 20% chance that surgery would provide a cure, or a 20% chance that surgery would provide any benefit at all.

    Sounds like a lot is not clear, and in times like that stress (imagine that ) plays a major factor in the patient's hearing.

    You could have an excellent chance of surviving surgery, and an excellent chance of seeing some benefit, but a relatively poor chance of ultimate survival for a long and healthy extended lifespan.

    Which none of us is guaranteed.

    If the guy is now sound and healthy, following a procedure that people knew he would not have undertaken if the percentages were explained in detail, I certainly see the problem but respectfully suggest the complaint be taken elsewhere.

    Life is not a tort.
    "Anger has two children -.hope, and courage." Augustine, Bishop of Hippo

    "Und es wird nicht hineingehen irgend ein Gemeines und das da Greuel tut und Luge,
    sondern die geschrieben sind in dem Lebensbuch des Lammes."
  • chollagardenschollagardens Member Posts: 4,428 ✭✭✭
    edited November -1
    Full disclosure. I had prostate surgery and was given full detailed information. It is possible that because a previous patient at the same hospital killed his doctor after the surgery that mabe they figured it would be a good idea to tell the patients the details rather than risk pi$$ing off more patients and dealing with civil and criminal legal problems.
  • JamesRKJamesRK Member Posts: 25,672 ✭✭✭
    edited November -1
    I don't like being lied to under normal circumstances. When I'm paying somebody to tell me the truth I won't accept being lied to.

    How about the real estate salesman who doesn't tell you your new house is in a floodplain because he wants you to enjoy the new house until it gets washed away?
    The road to hell is paved with COMPROMISE.
  • spasmcreekspasmcreek Member Posts: 38,925
    edited November -1
    he PAID for an EXPERT opinion for the TRUTH....why, family involvement affect a chance of bigger inheritance sooner ?????
  • rongrong Member Posts: 8,459
    edited November -1
    I've gone in for 9 surgical
    procedures and I've always
    been informed of what to expect.
    Never has a doctor lied to me except
    for the dick that got me hooked on oxycontin.
    "witdrawal is like the flu" my * it is.
    ron
  • BarzilliaBarzillia Member Posts: 21,912 ✭✭✭
    edited November -1
    quote:Originally posted by spasmcreek
    he PAID for an EXPERT opinion for the TRUTH....why, family involvement affect a chance of bigger inheritance sooner ?????


    He paid for the art of medicine.
    "Anger has two children -.hope, and courage." Augustine, Bishop of Hippo

    "Und es wird nicht hineingehen irgend ein Gemeines und das da Greuel tut und Luge,
    sondern die geschrieben sind in dem Lebensbuch des Lammes."
  • PanzerSlayer2PanzerSlayer2 Member Posts: 1,798 ✭✭✭✭✭
    edited November -1
    The doctor's only role is to make you better. If lying improves those odds then that's what they will do.
  • n/an/a Member Posts: 168,427
    edited November -1
    This really is not a medical ethics question....he wanted to know how bad it was and the details which from the reports he knew otherwise he would not have had the surgery...Knowing the odds doesnt make for an ethical question, BUT, sometimes knowing them can affect the results...

    That said, I believe an explanation is in order....If, going into surgery you are told you have a 20 percent chance of surviving, a person goes into the surgery knowing they have an 80 percent chance of dying...Now if they are told they have an 80 percent chance of surving the surgery, guess how the patient is going into surgery...

    They go in with an optomistic attitude, looking forward to waking up, you think the dr is going to say to you that you only have a 20 percent chance of getting thru this?...They might tell the family but they arent going to tell you...they want you to go into surgery with a good outlook, not bleak...Attitude can affect how the surgery goes...

    When Larry had his surgery for the abdominal aneurysm, the drs didnt give odds...they told of the risks, what could happen and the BEST that could happen...

    They didnt tell Larry but they told me when they took him into surgery...DONT LEAVE THE HOSPITAL...they needed me there in case the aneurysm ruptured ...He was told after it was over...Ethics?...no way in hell it was...my husband needed to go into that surgery with a very good outlook, not told his wife was not to leave etc...

    Read this on ethics..

    http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion10015.page?
  • KSUmarksmanKSUmarksman Member Posts: 10,705 ✭✭✭
    edited November -1
    I would think that if he indeed had 20% odds to survive the surgery, they should offer other options, like radiation seed implants or external beam therapy of some kind. From what they tell me, radiation is the preferred method of attack if the person has complications that would...well complicate...a prostectomy.

    If the surgeon gave him a rosier picture to convince him to have the surgery in spite of bad odds instead of consulting radiation oncology, I can see an ethics violation. At the same time I have a hard time imagining a surgeon caring so little for their patient.
  • nunnnunn Forums Admins, Member, Moderator Posts: 35,113 ******
    edited November -1
    What are the chances of dying on the table during an angiogram/stent placement procedure? I am sure that there is some risk, but no one explained the risk to me. When I had mine done, everyone acted as though it were as simple as having a toenail trimmed. Fact is, I needed the procedure done, and if I had not, I would probably not be here right now, so I did it.
  • dav1965dav1965 Member Posts: 26,544 ✭✭✭
    edited November -1
    With my cancer i knew if i did not have the operation i would die in a year. I had a 20% chance with surgery. I was told that they were going to do one thing and they had too do a whole lot extra. i had a lot of extra stuff done. Last week i found out they even done more. They removed stuff under my tongue also. I found that out last week. But its better than being dead by now.[:)]
  • slumlord44slumlord44 Member Posts: 3,695 ✭✭✭
    edited November -1
    The whole point here is that if I, as the paitient, want to know all the details and all the odds going into a surgery, I think I have the right to be told and no doctor has the right to lie to me or withhold any information.
  • reloader44magreloader44mag Member Posts: 19,356 ✭✭
    edited November -1
    quote:Originally posted by slumlord44
    The whole point here is that if I, as the paitient, want to know all the details and all the odds going into a surgery, I think I have the right to be told and no doctor has the right to lie to me or withhold any information.
    whatever
  • k.stanonikk.stanonik Member Posts: 2,170 ✭✭✭✭✭
    edited November -1
    I would think that holding back the information was for his own good.
    The stress of the surgery combined with the information they withheld might have caused complications that they were trying to avoid.
  • JamesRKJamesRK Member Posts: 25,672 ✭✭✭
    edited November -1
    quote:Originally posted by slumlord44
    The whole point here is that if I, as the paitient, want to know all the details and all the odds going into a surgery, I think I have the right to be told and no doctor has the right to lie to me or withhold any information.

    For what it's worth, I agree with you.
    The road to hell is paved with COMPROMISE.
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