Medical Should medical staff stop when you tell them to?

[GettingBetter]

Being chronically ill, I have obviously had a heck ton of medical procedures done. And it's common knowledge that majority of Dr's aren't the most compassionate. I had PTSD before my medical escapades from sexual/childhood abuse, but that made it worse.

It's only been recently that I've discovered that I should not have been treated the way I was. This came from other Dr's telling me this- I mentioned things in passing and they were horrified that I was treated as such, which made me realise the significance of what I've been through.

This brings me to my question, is: Should doctors stop procedures when you tell them to? There are so many "Just a few more minutes...," "We're almost done...." This is harmless, perhaps, for someone in pain during a procedure, but could be really damaging for someone like me with PTSD.

It struck me when I was having pelvic pain and Dr's wanted to do an ultrasound right then and there. Knowing that you need a full bladder, I told them it wouldn't work because they just did a urine sample. They tried to do it anyway and couldn't see anything, because duh, science. So I was laying there on the verge of hyperventilating and bursting into tears from anxiety because I was being held down with someone pulling my clothes down, digging something into my pelvis, in a dark room. I told her to stop, that I'd come back to do the procedure properly, but she wouldn't get off. Needless to say, last time I went there.

Resolution: Went somewhere else for an ultrasound and the technician was an absolute sweetheart. I was properly prepared, she respected my needs, and I got the imaging results I needed.

 

[FragileGlass]

I can attest to the compassionate part of doctors, I work with them, I promise you, you want the detached seemingly uncompassionate one. They’re cold and clinical. It’s means they’re in the game of solving a problem not wrestling with an emotion over the problem.

As far as investigative procedures, if you present to an ER, the uncompassionate doctor needs a reason to admit, pursue or release you. Unless you’re a doctor yourself and know otherwise, trust in the process that they just want answers before the admit or release you.

I’ve had patients present who felt that it was overreaching for certain scans, and I’ve had to wrestle those patients into compliance, only to be opening up an emergency surgery room shortly because that patient is in crisis.

If it’s a routine visit, sure, you can state your discomfort absolutely, if it’s acute. Let the professionals take care of the puzzle while stating your discomfort always. You do matter at the end of the day.

 

[Justmehere]

It’s your body. Even if it’s a medical emergency, you have the right to refuse care. In fact, you even have the right to refuse life saving care. That doesn’t mean a surgeon can simply stop a surgery after cutting someone open... but what you describe isn’t that kind of situation at all.

The doctor should have stopped the routine non emergent ultrasound when you said no.

I’m glad you found a much better clinic for your medical care.

 

[ilian]

I don't have any firsthand experience with medical trauma and/or mistreatment, but just based on my personal morals, I think it depends on the situation. Informed consent is also definitely a thing that applies in a lot of medical situations. In the specific situation that you described, I absolutely think that the person doing your ultrasound should have stopped. I understand the doctors still wanting to try an ultrasound, but they should have stopped either entirely or just to give you a moment based on how distressed it sounds like you were. If it's an emergency, it might not be possible to get a patient's informed consent, but it doesn't sound like that applies to your situation. Ultimately, I think that as long as it is possible for you to participate in decision making, informed consent still applies. If you refuse or delay treatment, that's your decision.

I'm sorry to hear that you went through that, and I'm glad that you were able to find someone else who was better suited to your needs.

 

[Suzetig]

I think it’s a tricky one, sometimes it really is a case of just one more minute and it’s done, whereas staring again is another 15 minutes of discomfort etc.

I also think the level of intimacy really matters too - someone doing an internal exam had better listen to me when I say stop. In fact, I’ve found a specialist clinic for people who have experienced sexual violence to do my smear tests and internal exams who really really get my need for complete control in those situations. Control over my body is a huge issue for me and my gp surgery, as good as they are, just don’t get it.

 

[scout86]

I’ve had to wrestle those patients into compliance

This is exactly the reason I avoid the medical profession as best I can. One person trying to wrestle me? They are probably going to lose the fight, unless I'm REALLY sick, and I'll be out the door. I was subjected to enough of that kind of treatment as a kid. The advantage of being an adult is you can say FU and leave. They may be doctors, but they aren't the boss of me. I'd literally rather die than be subjected to that kind of treatment.

 

[gealach]

In school, and in my working life, there's a lot of training and conversations around informed consent. Everyone has the right to information, and the right to say "yes" to treatments.

No one ever brought up the issue of informed refusal (I've never heard that phrase anywhere else, so maybe I coined it?). Everyone has the right to information, and the right to say "no" to treatments, even when we as practitioners disagree with that decision. For some reason, we in the medical profession seem to almost take it personally when we know what a patient needs medically, and they refuse anyway. We seem to think that information should always lead to consent.

I think the medical profession needs to start exploring, and become more comfortable with, the idea of informed refusal. And of course, we need to inform our patients, and respect the patient's decision. After all, it's their emergency, not ours.

 

[Chris-duck]

I think it gets dicier when the consent is given then taken away mid procedure. I'd always stop obviously but in some cases it's unsafe to not finish what's started. Obviously that's the persons choice and I'd just explain new risks of not continuing and admittedly everyone I've ever dealt with has just needed to chill for a bit and are good to go again. But I get the frustration for both sides. In my training we were taught to treat everyone as if they had a history of trauma (went to a very trauma focused university tbf) cos it's unlikely everyone that does have trauma is gonna wanna disclose it to everyone they see. I'd say my gynae ward time definitely had the most chat about consent and the associated stuff with that.

Summary, yeah they should stop. But sometimes there's risks to that which the healthcare people are more aware of at the time. Should still stop, a lot of people just need a break more than wanting to walk out mid procedure so it works.

 

[ben1982]

My mother had Munchausen Syndrome by Proxy. Sadly i was her proxy for most of my childhood. My mother was the grand architect behind my suffering. Sadly she used the medical staff to do most of the worst traumatic abuse. Forcing medical treatment on me that i loudly and violently protested against. Medical treatment that i didn't needed in the first place. I'm a 36 year grown man now. But in my nightmares i will always stay a 7 year old boy. Desperately trying to fight off the doctors who are hurting me while holding me down. Desperately trying to tell them that i'm not really sick. But non of them ever listens to me. Meanwhile my twisted mother is enjoying every second of it.
Maybe something the medical professionals should consider. That some mental wounds that are caused by a traumatic experience like this. Can possibly be more harmful than the wounds they are trying to heal. And some of them will never heal.
I understand my situation is extremely rare. And that they just wanted to help me. But still.

 

[scout86]

I think it gets dicier when the consent is given then taken away mid procedure.

You know, it's kind of like sex, isn't it? I hadn't really thought of that, until you said this. But, yeah, "no" ought to mean know, when ever it's said.

 

[Chris-duck]

I'm on my phone so it doesn't let me quote but @scout86 i didn't mean by that quote that I wouldn't stop. I always would, it's just stopping mid procedure can add health risks for the other person. Whereas stopping mid sex has no effect on anyone. So I would stop, give the person a break, ask if they feel able to continue and go by that answer. But I'd also at that point need to make them aware of the new risks of stopping half way. It's still their decision. I wouldn't force anybody.

 

[scout86]

i didn't mean by that quote that I wouldn't stop.

I took it to mean that you'd stop, don't worry. (Kind of made me wish there were more people like you in the business!) And, you made a good point, that sometimes stopping is dangerous. Communication is really important.