de Schweinitz P. Is there a shaman in the house? J Am Board Fam Med. 2010 Nov-Dec;23(6):794-6. PubMed PMID: 21057077.
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Peter de Schweinitz, a Visiting Instructor at University of Utah School of Medicine, writes about a fundamental dilemma of modern medicine:
“As physicians, we render a clear synopsis of the medical facts. We seek to understand the values and preferences of the patient. We express respectful support for the autonomy of the family. But what happens when, despite our best efforts at education and explanation, the family cannot make a decision? Many families do not want us to stay neutral. They find ways to work around our neutrality. They say, “What would you do if this were your wife/husband/father?” Perhaps we’re quite aware that our words may deeply influence the trajectory of many lives. Some of us may feel comfortable accepting this responsibility. Others may not.”
In this context, Dr. de Schweinitz recounts a story of shared decision making between a veteran neurosurgeon and the family of a comatose patient who had suffered a hemorrhagic stroke, in which the neurosurgeon leaves behind the world of the rational and makes a statement that reconnects the family to their deepest values.
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