And Coercion

by Joanna Smith on Apr 9, 2014

I was reading an article on atrial fibrillation in Medscape yesterday, and the article ended with a quote from Dr. John Mandrola:

“T he highest-quality care is when the patient chooses the path that best fits their values, preferences, and goals.

And we have made sure the decisions are not a result of ignorance or fear.”

To which I would add:  “….not a result of ignorance or fear or coercion.”

Sometimes clinicians can be very directive, either because that is their style, or because they believe that their patients will make better decisions that way.  For a clinician to say “if it were my family member, I would……” ignores the power of their words and thinking to sway their patients.  It is a gentle sort of coercion.

Better to allow the patient to come to their own decision.  If one of my clients asks me “what would you do if it were your family member?”, I gently tell them that what is most important here is for us to listen to their beliefs about what is best; what I might do for my own family member is not a model for them to follow.  Together we will find the answer that will fit for them.