Must doctors honor every request?
Aug 17, 2008
DOCTOR, what medicine should I take to increase the size of my hips?†asked a 24-year-old woman following an advert stating <i>“increase the size of your hips in 10 daysâ€</i>. With increased self-awareness, patients are requesting for more challenging medical interventions from doctors. <br>
By Dr. Robert Zavuga
DOCTOR, what medicine should I take to increase the size of my hips?†asked a 24-year-old woman following an advert stating “increase the size of your hips in 10 daysâ€. With increased self-awareness, patients are requesting for more challenging medical interventions from doctors.
Interestingly, doctors do not satisfy many of these requests because they feel they are ethically defeating.
“Some of the patients request for actions that are illegal,†said Dr. William (not real name), a gynaecologist who gets many abortion requests from teenagers at his clinic in Nsangi.
Ruth (not real name), a nurse, says patients sometimes ask medical professionals to perform legally impossible procedures like removing treatment for patients who are terminally ill.
Some requests are more troublesome. For instance, patients may request for interventions which prevent a doctor from providing quality care. This is the case with Jehovah’s Witnesses, who according to their beliefs, do not allow blood transfusions.
Dr. Samson (not real name) from Rubaga Hospital said treatment of the Jehovah’s Witnesses becomes more challenging when parents bring sick children and reject blood transfusions.
Other doctors complain that some patient practices defeat them in their provision of proper health care. Some patients request to combine herbal medicine with modern medicine.
“I have no problem with traditional medicine but… I do not like it when my patients use it in combination with the drugs I prescribe†said Dr. Andrew Kintu of Mulago Hospital.
Dr. Kintu added that although no comprehensive research has been done as regards the adjunct use of modern and traditional medicine it is probable that there may be some drug interactions which may affect the efficiency of the drugs.
Some doctors are reluctant to comply with the patient’s requests based ib their religious convictions. Annet, a Catholic nurse, said: “I am uncomfortable when prescribing emergency contraceptives.â€
She believes these pills given to a lady three days after having unprotected sex in fear of having conceived constitute abortion which is contrary to the her faith.
While it is clear that doctors and other health workers are not obliged to violate their religious beliefs, it is still unclear whether they have any obligations to patients whose requests they find inappropriate.
Dr. Moses Ochieng a medical ethicist at Mulago Hospital argues that the best thing these doctors can do is to refer their patients to other doctors who can give the desired treatment.
Dr. Ochieng further advised that patients should seek clarification from doctors as to why they cannot treat them. However, this may be unrealistic given the doctor: patient ratio of 1:24,725.
Some patients may request for treatment and medicines that are expensive. Dennis Obua, the Cranes striker, sustained an injury in 2007 during the Uganda’s clash against Nigeria in Namboole stadium which necessitated him an investigative procedure of Magnetic Resonance Imaging, which is unavailable in Uganda and is very expensive elsewhere.
When he requested the procedure to be done from Mulago Hospital he was referred to Nairobi and he had to foot the bills. Many patients don’t have the money although they would have benefited from expensive treatments so they receive cheap and ineffective treatments.
When doctors are confronted with such challenges, they have to choose between prescribing the cheap treatment with many side effects or the expensive-effective treatment.
Other requests come as result of conflict of interests between doctors and patients. For example, some patients request for strong painkillers and the doctors prescribe paracetamol (panadol). “I will never stop prescribing panadol, it is safe.
The other so called ‘strong painkillers’ may cause kidney failure and addiction if not properly used,†said Dr. Daniel Ssemakula of Mulago Hospital.
Therefore, because many times we make these requests, it is advisable that we as patients understand the range of treatments our doctors can use.
Further still, if a doctor cannot fulfill our requests, we shouldask for referrals to other doctors other than compromising our health.
Unique requests doctors get
Increase the size of women’s hips
Give tablets instead of injections
To withdraw treatment for terminally-ill patients with no hope for a cure
Not to perform blood transfusions as is the case with Jehovah’s Witnesses
Combine modern medicine with herbs
DOCTOR, what medicine should I take to increase the size of my hips?†asked a 24-year-old woman following an advert stating “increase the size of your hips in 10 daysâ€. With increased self-awareness, patients are requesting for more challenging medical interventions from doctors.
Interestingly, doctors do not satisfy many of these requests because they feel they are ethically defeating.
“Some of the patients request for actions that are illegal,†said Dr. William (not real name), a gynaecologist who gets many abortion requests from teenagers at his clinic in Nsangi.
Ruth (not real name), a nurse, says patients sometimes ask medical professionals to perform legally impossible procedures like removing treatment for patients who are terminally ill.
Some requests are more troublesome. For instance, patients may request for interventions which prevent a doctor from providing quality care. This is the case with Jehovah’s Witnesses, who according to their beliefs, do not allow blood transfusions.
Dr. Samson (not real name) from Rubaga Hospital said treatment of the Jehovah’s Witnesses becomes more challenging when parents bring sick children and reject blood transfusions.
Other doctors complain that some patient practices defeat them in their provision of proper health care. Some patients request to combine herbal medicine with modern medicine.
“I have no problem with traditional medicine but… I do not like it when my patients use it in combination with the drugs I prescribe†said Dr. Andrew Kintu of Mulago Hospital.
Dr. Kintu added that although no comprehensive research has been done as regards the adjunct use of modern and traditional medicine it is probable that there may be some drug interactions which may affect the efficiency of the drugs.
Some doctors are reluctant to comply with the patient’s requests based ib their religious convictions. Annet, a Catholic nurse, said: “I am uncomfortable when prescribing emergency contraceptives.â€
She believes these pills given to a lady three days after having unprotected sex in fear of having conceived constitute abortion which is contrary to the her faith.
While it is clear that doctors and other health workers are not obliged to violate their religious beliefs, it is still unclear whether they have any obligations to patients whose requests they find inappropriate.
Dr. Moses Ochieng a medical ethicist at Mulago Hospital argues that the best thing these doctors can do is to refer their patients to other doctors who can give the desired treatment.
Dr. Ochieng further advised that patients should seek clarification from doctors as to why they cannot treat them. However, this may be unrealistic given the doctor: patient ratio of 1:24,725.
Some patients may request for treatment and medicines that are expensive. Dennis Obua, the Cranes striker, sustained an injury in 2007 during the Uganda’s clash against Nigeria in Namboole stadium which necessitated him an investigative procedure of Magnetic Resonance Imaging, which is unavailable in Uganda and is very expensive elsewhere.
When he requested the procedure to be done from Mulago Hospital he was referred to Nairobi and he had to foot the bills. Many patients don’t have the money although they would have benefited from expensive treatments so they receive cheap and ineffective treatments.
When doctors are confronted with such challenges, they have to choose between prescribing the cheap treatment with many side effects or the expensive-effective treatment.
Other requests come as result of conflict of interests between doctors and patients. For example, some patients request for strong painkillers and the doctors prescribe paracetamol (panadol). “I will never stop prescribing panadol, it is safe.
The other so called ‘strong painkillers’ may cause kidney failure and addiction if not properly used,†said Dr. Daniel Ssemakula of Mulago Hospital.
Therefore, because many times we make these requests, it is advisable that we as patients understand the range of treatments our doctors can use.
Further still, if a doctor cannot fulfill our requests, we shouldask for referrals to other doctors other than compromising our health.
Unique requests doctors get
Increase the size of women’s hips
Give tablets instead of injections
To withdraw treatment for terminally-ill patients with no hope for a cure
Not to perform blood transfusions as is the case with Jehovah’s Witnesses
Combine modern medicine with herbs