The patient had undergone an elective surgery to reduce “noisy breathing.” Post-op, she never got off the ventilator because of a lifelong neuromuscular disease. Who, in their right mind, would exchange noisy breathing with death on a ventilator for an elective, voluntary decision?
Everyone with a clinical background knew it would be hard for her to get off the vent if she had any surgery requiring intubation. The disease was clearly documented in her history. But she signed the same consent that every other patient with every other history would sign: In rare cases, you might die.
This tragic story highlighted for me how important it is for patients to have a thorough understanding of risks and benefits, and the choices available to them.
There is a unique risk to both the provider and the patient in every discussion of treatment. So why is the current risk discussion so universal and depersonalized?
The provider fears the human fallibility of their professional opinion, knowing it could be turned against them in a lawsuit.
The patient fears disability and death and is concerned about the weight of outside opinions on their life and limb.
Yet, the discussion of risk that occurs today is a canned discussion and many patients become desensitized to this universal warning. If it applies to everyone, it means nothing.
By Gayle Porter
