Patient Abandonment

 In Commercial Healthcare, Ethical Practice, Medical Ethics, Patient Welfare

After discussing a very controversial topic last week, David Fitzgerald is back with a topic that will divide opinions. If you want to read more about tough topics discussed by David in his previous videos, then check out his piece about “Complacency Alert” and “Ethics in Clinical Practice“.

Today’s hot topic is patient abandonment, an issue very rarely talked about which should interest everyone. In this article you can find a summary of David’s opinion and explanations on the subject, however, make sure you watch the full video below to know more about what he has to say!

Patient abandonment happens when a clinician or a specialist tells their patient they can’t do anything anymore to help them and, instead of referring their patient to a different specialist, they just dismiss them. This can be caused by a number of different reasons and one of the most common ones is lack of empathy. The clinician involved doesn’t feel much empathy for their patient’s situation, leading to two main ethical questions: is this the right profession for them and are they aware of other specialists that may be required for assistance and to give their medical opinion. 

So, patient abandonment comes in different forms and is caused by different reasons, of course, as David says, the elephant in the room is that some clinicians might decide not to refer their patient to a different specialist because they’re concerned about medical implications. This is perhaps the worst cause of patient abandonment, rightfully considered to be morally and professionally unethical. More often than you might think, in fact, clinicians and other specialists of the industry try to extract as many appointments as possible from their patients, even knowing that none of these will make the difference in the progression they should be making. This happens when the clinician’s decision is clouded by a commercial interest rather than the patient’s welfare.

How to avoid clinical abandonment?

Every clinician has the moral and professional obligation to ask themselves whether their services are still needed and, if this isn’t the case anymore, who is the best way to move forward for the patient. Besides referring them to a different specialist, in fact, some clinicians might also decide to inform their patients about their progression, making them aware that this might be as good as it gets, therefore seeking further professional help might be unnecessary. This, of course, gives the patient the chance to decide whether they want to proceed and contact a different specialist or stop there. When clinicians tell a patient that they’ve reached their limit of capacity, they’re doing everything in their power to avoid patient abandonment. David gives a very good example to make this concept easier to understand for everyone. If a patient wants to run a 10k marathon despite not being fit for it, it is the clinician’s role to inform them about the lack of physical capacities to reach such a high goal, advising the patient to go for a 5k marathon instead. Of course, there is freedom of choice and, if the patient feels confident enough to go for a longer marathon there is nothing the clinician can do. What matters the most and the message behind this example is for clinicians to always be honest with their patients. Pushing a patient’s limits is the best way to motivate them to improve, but every good practitioner should be able to understand when it’s time to stop their patients, once their limits have been reached.

David’s conclusions on the subject

The one above is just one of the many examples given by David in the video so, if you’re interested in knowing more about this controversial topic, we suggest you watch the full clip above.

The overall message David wants to give in this article is to trust clinicians who we know we can trust. As a patient, ask yourself questions about your clinician’s method and work ethics and, if you think that they’re doing their best to help you, then listen to their advise, which should be made in the interest of your wellbeing. The advice David gives to clinicians, instead, is to have some faith in their patients, who are often able to accept (to some degree) that their progression can no longer move forward and seeking help in other ways might just be a waste of time and money.

Patient abandonment is a very serious matter and, although we briefly talked about it in this article, David’s video is much more informative and detailed, so you should definitely check it out!

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