When neurologist and patient disagree on reasonable risk: new challenges in prescribing for patients with multiple sclerosis

Norman J KachuckUniversity of Southern California, Keck School of Medicine, Los Angeles, CA, USAAbstract: New more powerful therapies for the treatment of multiple sclerosis may also confer a potential for unprecedented life-endangering side effects. How does a physician respond to a patient&amp...

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Autor principal:	Kachuck NJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/be798b95f75e4e0ba2267b0d1476072e
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spelling	oai:doaj.org-article:be798b95f75e4e0ba2267b0d1476072e2021-12-02T05:42:21ZWhen neurologist and patient disagree on reasonable risk: new challenges in prescribing for patients with multiple sclerosis1176-63281178-2021https://doaj.org/article/be798b95f75e4e0ba2267b0d1476072e2011-04-01T00:00:00Zhttp://www.dovepress.com/when-neurologist-and-patient-disagree-on-reasonable-risk-new-challenge-a7145https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Norman J KachuckUniversity of Southern California, Keck School of Medicine, Los Angeles, CA, USAAbstract: New more powerful therapies for the treatment of multiple sclerosis may also confer a potential for unprecedented life-endangering side effects. How does a physician respond to a patient&#39;s request for a treatment the benefit of which cannot be clearly established as worth its risk? The current challenge with prescription of natalizumab (Tysabri&reg;, Biogen Idec) is used to illustrate how this conflict creates an opportunity to re-examine our goals as physicians and the nature of the physician-patient relationship. Understanding the physician&#39;s role in that partnership, and the ethical and psychological issues impacting on how reasonable risk is determined, can improve the neurologist&#39;s capacity to explicate such quandaries. Redefining what is required to mediate disagreement between doctors and patients about reasonable risk is at the heart of why many of us became physicians. However, such nuanced interpersonal dynamics of patient care can be neglected due to the time and resource pressures of our practices. These demands have increased the seductiveness of the efficiencies promoted by the trend toward the pseudoobjectification of evidence-based care, which has arguably monopolized the healing conversation often to the detriment of the shared narrative. We examine and attempt to reframe the fiduciary and biopsychosocial contretemps of the doctor and patient disagreeing on risk, emphasizing its humanistic, relational dimensions.Keywords: multiple sclerosis, natalizumab, medical ethics, medical decision-making, patient-physician relationship Kachuck NJDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2011, Iss Issue 1, Pp 197-208 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Kachuck NJ When neurologist and patient disagree on reasonable risk: new challenges in prescribing for patients with multiple sclerosis
description	Norman J KachuckUniversity of Southern California, Keck School of Medicine, Los Angeles, CA, USAAbstract: New more powerful therapies for the treatment of multiple sclerosis may also confer a potential for unprecedented life-endangering side effects. How does a physician respond to a patient&#39;s request for a treatment the benefit of which cannot be clearly established as worth its risk? The current challenge with prescription of natalizumab (Tysabri&reg;, Biogen Idec) is used to illustrate how this conflict creates an opportunity to re-examine our goals as physicians and the nature of the physician-patient relationship. Understanding the physician&#39;s role in that partnership, and the ethical and psychological issues impacting on how reasonable risk is determined, can improve the neurologist&#39;s capacity to explicate such quandaries. Redefining what is required to mediate disagreement between doctors and patients about reasonable risk is at the heart of why many of us became physicians. However, such nuanced interpersonal dynamics of patient care can be neglected due to the time and resource pressures of our practices. These demands have increased the seductiveness of the efficiencies promoted by the trend toward the pseudoobjectification of evidence-based care, which has arguably monopolized the healing conversation often to the detriment of the shared narrative. We examine and attempt to reframe the fiduciary and biopsychosocial contretemps of the doctor and patient disagreeing on risk, emphasizing its humanistic, relational dimensions.Keywords: multiple sclerosis, natalizumab, medical ethics, medical decision-making, patient-physician relationship
format	article
author	Kachuck NJ
author_facet	Kachuck NJ
author_sort	Kachuck NJ
title	When neurologist and patient disagree on reasonable risk: new challenges in prescribing for patients with multiple sclerosis
title_short	When neurologist and patient disagree on reasonable risk: new challenges in prescribing for patients with multiple sclerosis
title_full	When neurologist and patient disagree on reasonable risk: new challenges in prescribing for patients with multiple sclerosis
title_fullStr	When neurologist and patient disagree on reasonable risk: new challenges in prescribing for patients with multiple sclerosis
title_full_unstemmed	When neurologist and patient disagree on reasonable risk: new challenges in prescribing for patients with multiple sclerosis
title_sort	when neurologist and patient disagree on reasonable risk: new challenges in prescribing for patients with multiple sclerosis
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/be798b95f75e4e0ba2267b0d1476072e
work_keys_str_mv	AT kachucknj whenneurologistandpatientdisagreeonreasonablerisknewchallengesinprescribingforpatientswithmultiplesclerosis
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When neurologist and patient disagree on reasonable risk: new challenges in prescribing for patients with multiple sclerosis

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