What should we do next ?
As a doctor , it’s easy for me to be paternalistic , and tell them what to do . After all, this is what they expect from me – and pay me my consultation fees – for my medical advice.
However, I am allergic to doing this , because I believe in patient empowerment – that patients should make their own decisions for themselves , specially when this is an elective decision, which affects the rest of their life .
I explain to patients – I will share my medical knowledge with you , and I will explain to you what your options are . I will also make sure that you don’t make the wrong decision . However, it is your responsibility to decide for yourself – you can’t let someone else do this , no matter how experienced and expert I maybe.
Some patients understand the importance of this – especially younger patients; those who are well-educated ; and those who have a medical background . They understand that life is full of choices , and it’s far better for them to make the choices for themselves , rather than to depend on a third party , who may be a very good doctor , but is not a mind reader !
The family dynamics and personal preferences of each individual patient are very different, which is why we need to give them the power to choose for themselves .
However, most Indian patients are very uncomfortable with having a doctor who allows them to decide for themselves . It’s much easier for them to allow the doctor to decide , and this seems to be the default mode for most patients today.
Most Indian doctors are quite happy to make these decisions on behalf of the patient, because they really do not want to engage in extended conversations with the patients – this takes time ! However, I think this is a disservice to the patient and the doctor , because many doctors end up making decisions which maximize their revenue, and which are not always in the patient’s best interests. They continue doing this, because they believe they are making the right decisions for the patient- and they aren’t able to follow up what happened to the families 5 or 10 years down the road .
Thus, a doctor may advise a patient to use donor eggs in good faith, and even though she agrees, because she has been taught that what the doctor says is always right, she may not be happy, and may end up becoming an extremely unhappy mother , because she rejects the child because she doesn’t think the child has her DNA .
This is why doctors and patients need to understand the importance of respecting and trusting each other – they both add complementary value to the table, and are both on the same side.
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