Intended for healthcare professionals

Observations Patient Partnership

When doctors and patients disagree

BMJ 2014; 349 doi: (Published 10 September 2014) Cite this as: BMJ 2014;349:g5567
  1. Tessa Richards, senior editor/patient partnership, The BMJ
  1. trichards{at}

In the internet age, doctors will inevitably be placed in situations where they don’t necessarily know best

Although we don’t know the nature of the communication between doctors and the family in the Ashya King case,1 the ensuing media coverage has thrown a light on the much wider issue of how communications are conducted between the medical profession and patients and their families.

Decisions about treatment and best management should be shared and take account of the concerns and perspectives of patients and their carers.2 It’s not easy. Doctors daily debate what constitutes best practice and how to apply it to the patient in front of them.3 They also struggle to find the time, or lack the skill or motivation, to listen to patients, elicit essential information from them, and fully understand what matters to them.

Patients and their families are often frustrated by this. Most “get” that there are constraints under which doctors and public health systems work. But when the stakes are high, patients will, and surely have the right to, explore every possible option; and …

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