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Jul 11, 2008

Patient Autonomy

I just watched an episode of the original Star Trek, because I am a total nerd and am not afraid to share that with you, and HOLY COW. Check out this exchange between Dr. McCoy and an alien lady who is super pregnant (clearly evident by her flowing dress):

McCOY
(tries to touch Alien Lady's belly)

ALIEN LADY
(slaps him)
Don't touch me!

McCOY
(touches her again)

ALIEN LADY
(slaps him again)
I said don't touch me!

McCOY
(slaps Alien Lady across the face)
I'll touch you wherever my medical judgement says I should!

ALIEN LADY
(shocked beyond protest)

McCOY
(touches her belly)
Just as I thought. The baby could come anytime...

ALIEN LADY
How do you know?

McCOY
BECAUSE I'M A DOCTOR, THAT'S HOW!

So that's how it's done. I never saw interactions like that in all those videos of patient encounters during the entire first two years of medical school. Hm. Maybe it's because standardized patients already know that the students are playing the role of doctor so they don't need to be slapped into submission. I guess I'll have to work up some arm strength for August!

5 Readers rock!:

Xavier Emmanuelle said...

Um, yeah... I would generally consider touching people when they obviously don't want to be touched to be a Bad Thing.

That star trek space doctor guy must have missed those "how not to be a jerk to your patients" lectures!

Dragonfly said...

Good grief. I bet that Alien Lady wanted a midwife and a homebirth for the next one.

Pennsy said...

Sounds like Bones forgot the prime directive. Slapping hysterical dames around doesn't exactly sound like his or Gene Roddenberry's finest hour.

Understandable though. With Kirk slutting his way through the universe, the old country doctor didn't get to touch many females anywhere.

And you know how irresistible pregnant bellies can be...

Peace,
Pennsy

The Shrink said...

Medics can indeed be rather directive and assertive.

I know a few surgeons who still treat surgical patients as nuisances they have to interact with as a tiresome part of dealiung with the lump/burst/broken bit.

One once told a group of us, as students, "There's my way, and the wrong way!"

James said...

That's awesome. I remember that episode - I rewatched the entire series before starting residency. McCoy expresses what is today considered to be a fairly paternalistic/misogynistic view toward medicine. An element of that attitude still permeates the profession today. Are doctors supposed to serve the patient according to the patient's wishes or according to what the doctor believes is medically in the patient's best interest? It's a great question - not easily answerable.