Believe it or not, there are such instances.
Peter Ubel tells us of one, in a sad case of end-stage metastatic lung cancer. While observing a patient and his wife arguing about his cigarette use, Dr. Ubel realizes that in this instance, it’s quality of life that matters.
So, instead of watching them fight, he encourages them to see the bigger picture: “My duty as a physician is to improve my patients’ lives. And if I can do that by sharing my perspective with them, however strange or uncomfortable it may sound, then that is what I must do. Even if it means encouraging them to smoke.”
Wise words.
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{ 6 comments }
So, when the wife gets lung cancer too, that will be OK as well?
Some docs can be fanatics on the smoking issue. All through the ages top quality clinicains have shown open-mindedness to recognizing that the infinite variety of human situations exceed the capacity of the current set of rules to reliably guide clinical action.
I too have given patients my blessing to smoke, always with the understanding that I wasn’t saying it isn’t dangerous.
The positive benefit of nicotine for some psychiatric patients has long been noted.
My friend went back to smoking after diagnosed with metastatic cancer–but he did it outside for his wife’s comfort.
Is the wife your patient? To whom do you owe your duty?
The Happy Hospitalist : what do you think is the incremental absolute risk to the wife of lung cancer if he continues to smoke?
This is a common way to fight the symptoms when all other treatment alternatives have failed.
Nicotine is a powerful drug with many uses, but it will kill you. But if your death is impending anyway, why not partake of the benefits if needed?
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