operations,therisksthatyouwantandaccept.Youhave
complete autonomy.
The neurosurgeon at my hospital in Boston showed
elements of both these types of roles. He was the
paternalisticdoctor:surgerywasmyfather’sbestchoice,
heinsisted,andmyfatherneededtohaveitnow.Butmy
fatherpushedhimtotrytobetheinformativedoctor,to
go over the details and the options. So the surgeon
switched,butthedescriptionsonlyincreasedmyfather’s
fears,fueledmorequestions, andmadehimevenmore
uncertainabout what he preferred. The surgeondidn’t
know what to do with him.
Intruth,neithertypeisquitewhatpeopledesire.Wewant
informationandcontrol,butwealsowantguidance.The
Emanuels described a third type of doctor-patient
relationship,which they called“interpretive.” Herethe
doctor’sroleistohelppatientsdeterminewhattheywant.
Interpretivedoctorsask,“Whatismostimportanttoyou?
What areyour worries?” Then,when they knowyour
answers,theytellyouabouttheredpillandthebluepill
and which one would most help you achieve your
priorities.
Expertshavecometocallthisshareddecisionmaking.It
seemedtousmedicalstudentsanicewaytoworkwith
patients as physicians. But it seemed almost entirely
theoretical.Certainly,to thelargermedicalcommunity,
theideathatmostdoctorswouldplaythiskindofrolefor
patients seemed far-fetched at the time. (Surgeons?
“Interpretive?”Ha!)Ididn’thearclinicianstalkaboutthe
idea again and largely forgot about it.The choices in
trainingseemedtobebetweenthemorepaternalisticstyle