Physician training lends much to developing a steely resolve amidst life-and-death scenarios. In the face of their patients’ panic, physicians must be calm, in control, and decisive. However, keeping such a stoic image intact can prove to be more challenging when dealing with a family member.
Ideally and ethically, they shouldn’t have to. Since 1803, Percival’s Medical Ethics has advocated the separation for a doctor’s profession and their personal lives. The lack of healthcare practitioners, unavailability of specialists, and preference of patients don’t give practitioners many choices to avoid treating family members.
In 2001, a study by Chen, et al. entitled “Role conflicts of physicians and their family members: rules but no rulebook” was published through the National Center for Biotechnology Information. The research approached this phenomenon by identifying the factors that plagued physicians when treating family members. Aptly, it was named the ‘Physician-Family Member’ dilemma.
What we can gather from the study is that doctors consider two internal images they feel they must live up to and a third external concept they feel obliged to keep.
First, the ‘Devoted Family Member’. Physicians gain renown for their professional skill, not so much for their familial involvement. The study revealed that majority of participating physicians preferred the role of ‘family member’ during times of medical crises. Reportedly, many felt compelled to intervene in family medical affairs and felt guilty when they refused requests to do so.
The second internal image is the ‘Ideal Physician’. Participants were chairs of academic departments of family medicine from various institutions. Following years of practice as senior family physicians, they still feel conflicted when dealing with family members. This is attributed to the fact that they know that unaffected objectivity is the ideal approach – and yet they cannot emotionally distance themselves from loved ones.
The third image is external and relates more to society’s expectations of them, especially that of family. The study finds that patients demand an unreasonably high level of attention from physician-family members. Professional courtesy was often removed in favor of excessive situational control, emotional comforting, and casual demands for more service.
Seventeen years later, the study still proves to be relevant as the situation has apparently changed very little in the medical field. While ‘time-honored ethical precepts’ remain vital foundations in many physicians’ practices, there is still that consideration when it comes to family members. Therefore, it is advised that doctors undergoing the same should develop strategies to avoid this dilemma. This is different at a personal and professional level and each is ultimately responsible for adapting and adjusting to the push and pull of these factors.
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