Division of Neurosurgery, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, 4 West Wing, Toronto, ON, M5T 2S8, Canada.
J Neurooncol. 2011 Aug;104(1):331-7. doi: 10.1007/s11060-010-0498-9. Epub 2010 Dec 14.
Given the trust the public places in the medical profession, the question of when it might be acceptable to minimally deceive patients, in their best interests, is a challenging one to answer. In this study, we explore neuro-oncology patients' attitudes towards dilemmas in which they may feel deceived, and with that information make recommendations on what steps physicians can take to avoid breaking that trust. Qualitative case study methodology was used. Thirty-two face-to-face interviews with post-operative brain tumor patients were conducted and recorded. Interviews were transcribed and subjected to modified thematic analysis. The majority of patients had a postsecondary education, and there was substantial religious and ethnic diversity among them. Five prominent themes arose from the analysis: (1) patients are hesitant about trainees working on their case, but they are more open to it if they expect the occurrence ahead of time; (2) patients wish to know the exact details when an error has occurred, even if it is of inconsequential effect for them; (3) patients generally prefer to know exactly what the doctor knows, even if nothing can be changed; (4) patients expect physicians to provide them with all the options and resources available; and (5) there are special cases in which patients accept a delay in knowing. Most neuro-oncology patients trust their physicians to make the best decisions for them, but that does not mean they would accept subtle forms of deception. Patients prefer to have all the information necessary in order to make their own decision.
鉴于公众对医疗行业的信任，在何种情况下为了患者的最佳利益而可以进行最低限度的欺骗是一个具有挑战性的问题。在这项研究中，我们探讨了神经肿瘤患者对可能感到被欺骗的困境的态度，并根据这些信息就医生可以采取哪些措施来避免破坏这种信任提出建议。采用定性案例研究方法。对 32 名接受过脑部肿瘤手术后的患者进行了面对面访谈并记录。对访谈进行了转录，并进行了修改后的主题分析。大多数患者都接受过高等教育，他们在宗教和种族方面存在很大的多样性。分析得出了五个突出的主题：（1）患者对实习生参与他们的病例持犹豫态度，但如果他们事先预料到这种情况，他们会更加开放；（2）患者希望在发生错误时了解确切的细节，即使这对他们没有影响；（3）患者通常希望确切地了解医生所知道的，即使什么都无法改变；（4）患者希望医生向他们提供所有可用的选择和资源；（5）存在特殊情况，患者可以接受延迟了解。大多数神经肿瘤患者信任他们的医生为他们做出最佳决策，但这并不意味着他们会接受微妙形式的欺骗。患者希望拥有做出自己决定所需的所有信息。
