My girlfriend is a second year medical student and she was telling me that in medicine, it is unethical to practice on a friend or family member. I asked her why, and all she could tell me is that is what she has learned. What is the big deal to treat someone you know?
It’s extremely difficult for you to provide the appropriate level of care. Your emotional attachment to the patient will probably cloud your better judgment in a number of cases.
I can imagine that one worry is that when there is a close relationship between pratitioner and… umm… practitionee… there is just too much uncertainty as to whether the emotions involved may affect the practitioner’s performance negatively in some way. Also, preventing people from practicing on people they know will go some way toward preventing even the appearance of favoritism, and that’s important.
-FrL-
When my mother was in nursing school, she practiced taking blood from me and my siblings. Come to think of it, I don’t know what she did with all that blood.
How can you say this? You’ve never even met me, nor do you have an concept of me emotional attachment.
You know, it’s probably better that you* don’t.*
I can’t quite parse this post because of (I think) a typo. Can you clarify?
-FrL-
It has nothing to do with YOU. It’s a general statement for anyone wishing to go into the field of medicine.
The teeming millions can’t judge my emotional attachment.
So human beings, in general, can’t seperate their emotional attachments?!?!?!?
Not all the time. A doctor has to be OBJECTIVE. Completely.
The risk is too much.
I just don’t understand how being emotionally attached to a person undermines my objectivity. When my girlfriend asks me “do you think I look nice in this red dress”, should I not answer because our relationship might be undermining my objectivity? Might I answer “you look fine dear”, when in actuality she looks messy?
In addition to the reduction of objectivity, practicing on friends and family creates multiple role relationships. This may not matter at some times and in some relatonships, but often is a source of considerable difficulty and distress. It can also create further ethical dilemmas and conflicts between what one would advise as a friend/family member and as a professional.
Can’t my girlfriend advise me as a professional even though we are in a relationship?
Okay, no, I don’t know you, nor your girlfriend, and it’s entirely possible that she would be a perfectly competent provider for you or her father or whatever. I was speaking in a general sense. But what if suddenly you have some sort of embarrassing problem? A possible sexually transmitted infection or something? Would you really want your girlfriend to be your doctor on that one?
Okay, let’s go to a slightly trickier issue. You break your collarbone and you get prescribed some scheduled narcotics for the pain. One week later, your painkiller script is up? If you roll over and nudge your girlfriend for a refill, how can she possibly make an appropriate or informed impartial clinical judgment?
On the one hand, how can she let someone she loves suffer through any unnecessary pain? But those narcotics also have a significant risk of attachment or abuse (just ask Rush Limbaugh). I assure you, that’s not a position she’ll want to find herself in, nor will she be your best bet as a healthcare provider. Also, for the greyer situations between antibiotics for strep throat or scheduled narcotics for an orthopedic injury, how does the line get drawn for what is and isn’t an appropriate condition for a family member or SO to treat?
From a merely pragmatic standpoint, although prescribing for family is strongly frowned upon in the medical community, prescribing for Vicoden will put that MD, PA, or NP onto the fast track at the deep-fryer in the local McDonalds.
This board has plenty of physicians that could describe the reasons for avoiding self-treatment or treatment of people that you have strong attachments to much more eloquently, and I hope one of them shows up in this thread.
I’m gonna go out on a limb here, apparently, and say, yes, that’s approximately correct. Most human beings find it difficult to reason about situations independently of their own emotional attachments to that situation.
In fact, it’s difficult for me to imagine anyone seriously thinking otherwise. This is just a fact about what we might call “the human condition.” Our emotions tend to cloud our thinking.
Am I misunderstanding you somehow?
-FrL-
She may be able to advise you in a general way, with a referral to another practitioner. However, if she gets involved in diagnosing you or prescribing for you or engaging in treatment, she is in violation of boith the law and her ethical code and, from a pragmatic standpoint, could be removed from her program (while in training) or lose her license (once licensed). Since she’s a student, all of her practice must be in supervised settings and known to the person whose license she’s working under. Bottom line: Anything else is illegal and unethical.
This post puzzles me. In the final sentence, you seem to be indicating you are likely to tell your girlfriend she looks fine when in actuality she looks messy. Well, this perfectly illustrates the reason why you shouldn’t be your girlfriend’s doctor. Your emotional involvement with her, apparently by your own admission, tends to color your ability to act objectively towards her.
But you seem to think you’ve made a point against this view. I don’t see how that’s supposed to work.
-FrL-
As your girlfriend has already told you, it would be unethical to do so.
Can you imagine a psychiatrist having her husband for a patient and trying to remain objective about what he has to say about his marital problems? What about an internist who subjects his children to unnecessary tests in his panic to make sure that he doesn’t miss some dreaded illness? What about the physician who has his girlfriend checked out for HIV without her knowledge or permission? What about the doctor in love who is pressured for vicodin perscriptions by the woman who might otherwise leave him?
The same ethical considerations are true in other professions. Lawyers generally don’t represent family members in major cases. Teachers don’t usually have their own children in their classrooms except in home schooling. But it is particularly important in medicine because of life and death issues.
Psychologists can’t diagnose or treat our family or friends. In fact, we’re to enjoined to avoid social or professional relationships with our clients’ family and friends.