I am writing in regard to the theoretical ethics scenario you wrote about in the journal of Pediatrics. As a 15 year old, the subscription belongs to my father, a pediatrician who works as a pediatric anesthesiologist at Nemours/A.I. duPont Hospital.
Another possible solution is to simply talk to the patient as if she is just that, the patient. Throughout the article, the patient was referred to in different ways. At the end of the second paragraph on page 65, the author refers to her as “the child.” However, in the beginning sentences of Drs Truog and Mancuso on page 66, the patient is referred to as a “young woman.” Although all of the authors came to the same conclusion, this issue goes back to how the patient is viewed in the doctors’ eyes.
The language that is used when talking to a patient is one of the most important components in the trust relationship between physician and patient. If my doctor came in and said something along the lines of “This is what I'm going to do...,” I'm going to feel talked at. Alternatively, if my doctor comes in and says “This is what I'm thinking, let's talk about it…,” then they would have successfully secured my trust. As for tone of voice, it should not be loud and commanding, but rather soft and confident. This also helps with diffusing the tension in the room for all parties involved.
Another overlooked component is body language. When the doctor is explaining their medical plan, they should be talking to me, not the authority figures in the room. The eye contact should also be mostly directed at the one who will be undergoing surgery, not the others. Also, when presenting their ideas, the doctor should not have crossed arms and be looking down upon the patient but rather open arms with a more welcoming stance.
Although the discussion hints upon these aspects, it fails to address them directly. Overall, I believe that with the correct body language, speech, and proper respect, these circumstances can be minimized and the patient will receive the care they need.
Potential Conflict of Interest: None declared