| Pages:
1
2
3 |
EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
|
|
Discussion of end of life care
I received a U2U from a member of this forum who has a family member who has a very serious illness and the Mexican Doctor has forbid all family
members to tell the patient. The member wants to know if this is Mexican law or not. As far as I know no Mexican law states a family member cannot
inform someone of a life-threatening or terminal illness. In the United States, the US Medical Board Exam in fact states that you MUST inform the
patient of their condition, unless they have been deemed incompetent to make life or death decisions (i.e. decisions concerning continuing treatment,
such as dialysis), regardless if the family wants to tell the patient or not. The doctor should tell the patient first about their illness directly
and not sugar coat anything. The doctor in this case probably does not want to upset the patient, fearing the information could weaken the patient's
condition further. But it is clearly disrespecting a competent, alert and oriented individual their rights to full knowledge of their diagnosis and
denying them the right to plan or discontinue treatment with the knowledge they will receive. I would inform the patient if the family feels that is
the right move.
[Edited on 9-26-2013 by EnsenadaDr]
|
|
|
DavidE
Ultra Nomad
Posts: 3814
Registered: 12-1-2003
Location: Baja California México
Member Is Offline
Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
|
|
Is this posed in form as to be a question?
Your local ministerio publico representing the state of B.C. would have the definitive answer to this if it is a question regarding the law.
A Lot To See And A Lot To Do
|
|
|
motoged
Elite Nomad
Posts: 6481
Registered: 7-31-2006
Location: Kamloops, BC
Member Is Offline
Mood: Gettin' Better
|
|
Doc,
This will be an interesting thread 
I think that they should get a new doctor and diagnosis....if they get the same diagnosis, at least they will have a more professional and ethical
practitioner who respects the patient enough to be honest....if I have a month to live, I want at least 29 days notice....not 4. 
Don't believe everything you think....
|
|
|
elizabeth
Senior Nomad
Posts: 742
Registered: 7-30-2004
Location: Loreto, BCS
Member Is Offline
|
|
Assuming an adult conscious competent patient, what right does the doctor have to give medical information to anyone other than the patient (unless,
of course, the patient has given consent).
|
|
|
EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
|
|
Well David I am almost 100% certain that MD's down in Mexico are in charge of their own patients as to informing them about life-threatening or
terminal illnesses. I have never had a doctor tell me they were going to consult the law about what to do with a patient, at least in Mexico. And as
for informing the family about a terminal illness, there is no law saying you cannot do this. It is up to the discretion of the doctor. | Quote: | Originally posted by DavidE
Is this posed in form as to be a question?
Your local ministerio publico representing the state of B.C. would have the definitive answer to this if it is a question regarding the law.
|
|
|
|
EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
|
|
The ones that don't want the patient involved in their own care or decisions. It's not easy to tell someone they are very sick or have a terminal
illness. | Quote: | Originally posted by elizabeth
Assuming an adult conscious competent patient, what right does the doctor have to give medical information to anyone other than the patient (unless,
of course, the patient has given consent). |
|
|
|
durrelllrobert
Elite Nomad
Posts: 7393
Registered: 11-22-2007
Location: Punta Banda BC
Member Is Offline
Mood: thriving in Baja
|
|
| Quote: | Originally posted by elizabeth
Assuming an adult conscious competent patient, what right does the doctor have to give medical information to anyone other than the patient (unless,
of course, the patient has given consent). |
Janean wrote:
"..the Mexican Doctor has forbid all family members to tell the patient.."
Sounds like the family members already know but the patient doesn't
Bob Durrell
|
|
|
EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
|
|
Yes Bob that is the case. | Quote: | Originally posted by durrelllrobert
| Quote: | Originally posted by elizabeth
Assuming an adult conscious competent patient, what right does the doctor have to give medical information to anyone other than the patient (unless,
of course, the patient has given consent). |
Janean wrote:
"..the Mexican Doctor has forbid all family members to tell the patient.."
Sounds like the family members already know but the patient doesn't |
|
|
|
DavidE
Ultra Nomad
Posts: 3814
Registered: 12-1-2003
Location: Baja California México
Member Is Offline
Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
|
|
"I'll never forget that insufferable bastard in Washoe Medical Center in Reno Nevada that refused to tell me outright that I had Acute Myleogenic
Leukemia. He hemmed, he hawed. He refused to tell me or even offer a discourse about how "long" I had. Pertinent, succinct questions.
Finally after having his "chastised" eaten raw, he yelled.
"You have about eight months without treatment. Now, are you satisfied?!!!"
A Lot To See And A Lot To Do
|
|
|
EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
|
|
David I did a little more investigation on the "laws" and found the IMSS patient's rights which in actuality are very similar to the American Patient
rights. The three violations of these rights in the case of the patient that does not know her diagnosis are the following:
Información precisa, oportuna y veraz sobre tu diagnóstico, pronóstico y tratamiento.
Precise, timely and truthful information about your prognosis, diagnosis and treatment.
The patient discussed in this post does not have a diagnosis, prognosis or treatment plan because the physician has not discussed it with her.
Aceptar o rechazar el tratamiento o procedimiento terapéutico que se te ofrezca.
The right to accept or reject the treatment or therapeutic procedure that is offered to you.
Since the patient is not aware of the diagnosis, the patient does not have the right to accept or reject the treatment or therapeutic plan.
La confidencialidad de la información que proporciones a tu médico.
Confidentiality of information pertaining to the patient that the doctor is aware of.
As Elizabeth mentioned, the patient/physician confidentiality bond has been broken because the patient's information was given to the family first and
not the patient.
I listed the IMSS patient rights on a separate post for future reference.
| Quote: | Originally posted by DavidE
Is this posed in form as to be a question?
Your local ministerio publico representing the state of B.C. would have the definitive answer to this if it is a question regarding the law.
|
|
|
|
toneart
Ultra Nomad
Posts: 4901
Registered: 7-23-2006
Member Is Offline
Mood: Skeptical
|
|
I cannot speak to Mexican law, but ethically, the doctor is doing a grave disservice to the patient. It is his diagnosis and it is his life!
Furthermore, you have stated that he is lucid and competent.
I cannot believe that the family would be prohibited by law. Why don't they disobey the doctor and tell the patient? If it is too delicate or
difficult for the family to do this, then they should prompt the patient to confrontationally grill the doctor to directly and fully reveal his
condition. I would also convince the patient to go elsewhere for a 2nd opinion/diagnosis.
You have not said whether the patient is a U.S. citizen, or if the family who U2Ud you live in Mexico.
If they have a home in the U.S., they should tell the patient and bring him/her there and seek the options available. If the condition has been
diagnosed as terminal, then get him enrolled into Hospice. That will provide the patient with palliative care; to gain the best possible quality of
life for the time remaining; to keep him pain free and comfortable, at home.
I am a Hospice Volunteer and can speak with full confidence as to what a wonderful organization it is. They are also very good at counseling the
family and even providing respite for the caregivers. After the passing, they also follow up with grief and/or spiritual consoling, if desired.
Medicare will pay for this.
If the patient prefers to remain and die in Mexico, then he can surely be accommodated there by a different doctor and loving, affordable caregivers.
We had a gringo resident, "Chicken John" in Mulege who chose to do just that. He kept a hotel room in town, with caregivers attending him until he
died peacefully. He was certainly no "chicken" when it came to bravely facing his impending death. He walked every afternoon and evening (right up to
the very end, until he was unable) to Scottie's El Candil Restaurant and sat at the bar taking large quantities of "medication". 
|
|
|
EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
|
|
Both family and patient in Mexico, and patient in a government run hospital. I am concurring with you 100%. | Quote: | Originally posted by toneart
I cannot speak to Mexican law, but ethically, the doctor is doing a grave disservice to the patient. It is his diagnosis and it is his life!
Furthermore, you have stated that he is lucid and competent.
I cannot believe that the family would be prohibited by law. Why don't they disobey the doctor and tell the patient? If it is too delicate or
difficult for the family to do this, then they should prompt the patient to confrontationally grill the doctor to directly and fully reveal his
condition. I would also convince the patient to go elsewhere for a 2nd opinion/diagnosis.
You have not said whether the patient is a U.S. citizen, or if the family who U2Ud you live in Mexico.
If they have a home in the U.S., they should tell the patient and bring him/her there and seek the options available. If the condition has been
diagnosed as terminal, then get him enrolled into Hospice. That will provide the patient with palliative care; to gain the best possible quality of
life for the time remaining; to keep him pain free and comfortable, at home.
I am a Hospice Volunteer and can speak with full confidence as to what a wonderful organization it is. They are also very good at counseling the
family and even providing respite for the caregivers. After the passing, they also follow up with grief and/or spiritual consoling, if desired.
Medicare will pay for this.
If the patient prefers to remain and die in Mexico, then he can surely be accommodated there by a different doctor and loving, affordable caregivers.
We had a gringo resident, "Chicken John" in Mulege who chose to do just that. He kept a hotel room in town, with caregivers attending him until he
died peacefully. He was certainly no "chicken" when it came to bravely facing his impending death. He walked every afternoon and evening (right up to
the very end, until he was unable) to Scottie's El Candil Restaurant and sat at the bar taking large quantities of "medication". |
[Edited on 9-26-2013 by EnsenadaDr]
|
|
|
Justbozo
Nomad
Posts: 139
Registered: 11-20-2012
Location: Lake Michigan/Bahia Concepcion
Member Is Offline
Mood: Got my little stone hut on the bay
|
|
Where is the "Like" button for the toneart posting!
People ask me what would I do if I had a heart attack on the beach in front of my house in Mulege. My reply is enjoy every last second of it!
I have watched too many people close to me pass with cancer...both full treatment and no treatment and Hospice. Believe me, Hospice is by far more
peaceful for ALL involved.
Inform the patient, it's THEIR life.
My 2 Centavos.
|
|
|
motoged
Elite Nomad
Posts: 6481
Registered: 7-31-2006
Location: Kamloops, BC
Member Is Offline
Mood: Gettin' Better
|
|
| Quote: | Originally posted by EnsenadaDr
... It's not easy to tell someone they are very sick or have a terminal illness. | Quote: |
Sure, it can be difficult for the doctor....but that is not a sufficient reason to withhold such information. Professionals in such positions of
trust and responsibility, I believe, have an ethical responsibility to be honest. There is an art to that....and doctors are practitioners of the
medical arts.  |
|
Don't believe everything you think....
|
|
|
Cypress
Elite Nomad
Posts: 7641
Registered: 3-12-2006
Location: on the bayou
Member Is Offline
Mood: undecided
|
|
My 87 yr. old mother has terminal cancer. The Hospice crew make it possible for us to keep her at home. She's lasted a year, but is slowly slipping
away. Without Hospice she would have to be in a nursing home.
|
|
|
DavidE
Ultra Nomad
Posts: 3814
Registered: 12-1-2003
Location: Baja California México
Member Is Offline
Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
|
|
Ensenada Dr. IMHO you are absolutely correct. This particular "doctor" should have a denuncia lodged against him through Sector Salud unless he or she
can come up with compelling evidence to the family that full revelation of severity of the affliction of the patient would cause needless harm,
physically or mentally. I know that Sector Salud can be rather rude to MD's that promulgate their own rules and code of ethics. The same applies to
IMSS. Whewee, an MD that threatens malicious reprisal should be castigated - to the hilt...
A Lot To See And A Lot To Do
|
|
|
DENNIS
Platinum Nomad
Posts: 29510
Registered: 9-2-2006
Location: Punta Banda
Member Is Offline
|
|
Jeeezo....this thread is about as "Baja" as catching a dose of clap at Anthony's.
"YOU CAN'T LITTER ALUMINUM"
|
|
|
EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
|
|
Yup that'll do it ya, fur sure!!
|
|
|
Ateo
Elite Nomad
Posts: 5901
Registered: 7-18-2011
Member Is Offline
|
|
I can't believe a Doctor would not inform their patient of a diagnoses. If I was gonna die I'd want to know so I could say my goodbyes, get stuff in
order, and attend a giant orgy. =)
|
|
|
EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
|
|
Both you and Dennis seem to be thinking along the same lines, but make sure you keep it in Baja, now!!
|
|
|
| Pages:
1
2
3 |
![[*]](images/xmbforum/default_icon.gif){kind=icon}
