“Doctor, is this really necessary?”
What are the risks?
What are other options?
What happens if I do nothing?”
These questions outlined by neurosurgeon, Christer Mjåset, should be part of every dialogue between doctor & patient in shared decision making for intervention.
If the doctor doesn’t prompt this conversation, the patient should.
Also ask, “what is the: best case, worst case, & most likely outcomes.” Sometimes people do not know what to ask after being told they would benefit from a procedure. A good doctor asks, “do you have any questions?” A great one will help the person identify their own values & bring context to the decision in relation to the individual’s desired objectives.
As Atul Gwande says, doctors must identify the goals of their patients. These conversations are sometimes lacking in treatment decision making. He says we should ask ourselves & our patients, “what is the goal? Are we fighting a disease for focusing on improving quality of life?”
We cannot allow ourselves to be a win at all costs profession. Inevitably we lose the battle if prolonging life is the only focus. We must draw our attention, & our patients’, to what brings them satisfaction in life & ways to more fully experience that in the face of their obstacles.