Today in class we participated in a bit of role playing. Some students were assigned a heart transplant patient candidate they had to advocate for and others sat on a review board to decide whether or not the patient actually received the transplant. Each patient was different, different values, past medical history and outlook. It was interesting to listen to how the advocates stood up for their patient. A few gave the straight facts and left nothing out. Some led with the positives and closed with the negatives, while others put the negatives upfront but used research statistics to make those negatives aspects of the patient’s life seem less of a problem.
One patient was receiving his second transplant and another had an issue with drugs. The first patient’s advocates said that the chances of rejecting a heart from the same autoimmune complication as before was a very rare occurrence. The second group omitted the drug use fact from their presentation, possibly purposefully. The truth came out when a board member asked for the patient’s drug history. This poses the question of whether to be forthcoming with the truth, or withhold deleterious information and hope it is not brought up later in the hearing.
These various strategies demonstrate how far doctors may go to stand behind their patient when proceeding with treatment. I believe each patient deserves the extra mile given by their treating physician. The physician needs to treat everyone equally though. If treating their patient, who may not benefit as much from a procedure, withholds that treatment from another, more viable patient, it could lead to the harm of two patients instead of one.
One personal advocacy story I have experienced is having the UCLA Mobile Clinic face shutdown due to local complaints. Here we have an established UCLA organization trying to benefit the lives of the underserved population in Los Angeles, and community members try to shut it down. Luckily, we reached a compromise but it makes me sick hearing people not care about the well-being of others. You need to stand up for what you believe in and always believe in your patients, no matter what.