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Oncology Based On Humanism

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March 3, 2015

Cancer patients often get lost in the complicated process of seeing medical specialists and treatments that they barely understand. Treatments with unpronounceable names, acronyms for chemotherapy and radiotherapy described with terms and technical data that the patient doesn’t understand. Some patients don’t even know the name of the doctor who treated them and describe their physical characteristics or the way he treated them. The patient feels that is being passed from hand to hand currency between doctors who unknowingly ask for blind trust. Humanity is missing or at least diluted.

Professionals are increasingly more trained, more specialized to keep up and to deliver what we believe is best for their patients. But the crowded consultations, the frenetic rhythm of work, administrative bureaucracy and disagreements in the interdisciplinary treatment do nothing but put a spoke in the wheels. It has bypassed the kindest and sacred. The face of their work is the human side. Is not sufficiently appreciated that necessary closeness in the doctor-patient relationship and ongoing training of physicians in this very important aspect of our profession. It seems that the most important thing is pretty survival curves exhibit statistically significant figures.

Current medicine is based on scientific evidence. We must continue on this path, but the evidence doesn’t give us, unfortunately, answers to everything. If so, the medicine would be simply a mathematical equation to solve. It is said that medicine is an art . An art where the physician’s experience and individual and unique characteristics of each patient make sense. Here is where the relationship that all patients, especially cancer patients, deserve.

The absence of humanism will condemn us to a spectacular failure.

Juan Irigoyen describes in his blog post “A day of treatment,” (in Spanish) the perception that the patient and family have of us as doctors. Reading it is an exercise in self-criticism andthought. Our goal should not be other than the patient seen in a holistic manner. As I always say we have to treat patients, not diseases.

Here is my Decalogue to apply humanism to oncology:

  1. Explain clearly intelligible and adapted to the level of each patient suffering from oncological disease.
  2. Empathize with the patient,showing closeness and dignity, respecting their privacy. Caring words and avoid euphemisms.
  3. Introduce the patient all treatment optionswith their pros and cons. Having a deliberative attitude towards them. Accompany and always respect the decision that the patient has taken.
  4. Report on how they will apply treatments, their succesion, most common side effects and their potential outcomes.
  5. Take into account the confidentiality and medical secret that the patient deserves to oncological disease.
  6. Respect the right to know, or even not, the prognosis of the patient about their disease. Never leave the care of a patient. Heal sometimes relieve often and to comfort always.
  7. Facilitate the work and knowledge between colleagues from different specialties whatever his rank and experience. Mutual respect is fundamental in interdisciplinary work.
  8. Always act under the principle of “primum non nocere“always evaluating the risk-benefit. Be careful when offering patients entering clinical trials. Inform patients of inclusion in them and their relevance to the advancement of knowledge well.
  9. Assess the cost-benefit of treatments and adjust the parameters of survival quality of life to make sustainable the complex web of current healthcare system.
  10. The ongoing and updated training is essential both in the scientific aspect as in the human. No use having good knowledge if we forget the human being behind each patient. It should be a good professional and a good human doctor.

Reposted from Un Rayo De Esperanza.

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