This month on our blog we manage the topic of the moral judge in the relationship between doctor-patient throughout many different points of view, discovering how this could be influenced by non-verbal language and how technical rationality isn’t enough in real life to help the doctor facing complex situations.
Those articles were published by authors from many countries that work in health environments different from our and therefore a question rise spontaneously: those observations are valid also for the Italian health system?
We of ISTUD Foundation had find out that in our research projects the theme of moral judge came both from physicians and from patients, reverberate like a constant independent from the observed disease, the age and the geographic position. In a study about chronic asthma, now in publication, we followed also the negative influence that moral judge had on the doctor-patient relationship and on the efficacy of care.
To understand better what we mean with moral judge, we have choose for you two fragments from our narrations, one written by a paediatrician involved in the care of a person with chronic asthma and one written by a patient that lives with Immune Thrombocytopenia.
Leggings and drugs
[…] The patient appears like a girl with an appropriate attitude for her age, a bit affected. High society. A mother very flashy, apparently a bit concerned, absolutely not empathic. The father a philanderer but more tender with the daughter. Parents diveded, but in good relations. […] I explain that wasn’t normal that a kid of 11 years old suddently had a dyspnoeic episode so serious to deserve even an oxygen treatment. […] During the communication of the results of the appreciation the girl was always very calm and she had apparently accepted the exam and the therapies. The family appeared too much calm. She approved the proposes, diagnostic-therapeutic without specific questions. […] During the next visits the girl continued to be dyspnoeic, with symptoms apparently refractory to any therapies. […] I thought that everyone was making fun of me. Particularly, I was sure that the girl, left alone for many hours, didn’t make any of the prescribed therapies. […] From the relation with the patient and his family I’m learning that a sunny familiar environment it’s fuel for the healing. Sometime lower social environments assure a stronger familiar control and heat.
My Experience with ITP
[…] Everything started because I was full of bruises and very very tired. My physician thought that I just won’t work. I wanted to underline that for 5 consecutive years I’ve always won the production prize for absence of diseases at 105×100 I’m absolutely not an idler. Then the same day I’ve change physician, thanks to my husband that was sick of that story. When undressed he saw my bruises he sent me urgently to make blood analysis and after he confided to me that he was thinking that was leukemia. Analysis done, recovered and platelet urgency at 4000. After a couple of days the diagnosis auto-immune thrombocytopenia. […]
