Doctors’ diversity dilemmas
In a multicultural society as the Netherlands have become in daily reality, doctors in hospitals face new dilemmas. Dutch law tells them to give their diagnosis – even when fatal – to the patient unless this patient has explicitly told the doctor that he or she doesn’t want to be informed. A doctor can only withhold information in case that telling the truth would be harmful to the patient. In Dutch hospitals patients are openly informed about the diagnosis of cancer and other possibly fatal diseases.
However, family members of patients whose origin lies in Southern Europe or the Middle East frequently ask doctors not to tell the diagnosis to their father or mother ‘since it would discourage them completely’. Situations like these are doctors’ diversity dilemmas. Now what does the doctor do? Can he take into account cultural differences and consider it harmful to tell the patient the truth based on culture?
Examples are known that cultural differences are used by the family as a means for other, not very noble purposes to leave the patient ignorant. On the other side examples are also known that harm was done by telling.
We discussed several doctors’ diversity dilemmas thoroughly with a group of medics yesterday and came to the conclusion that there is no ‘one size fits all’ solution. We need doctors who are able to make their decision based on the particular ‘multicultural’ situation they are in.
Doctors should also be able and willing to explain their considerations for the decisions made, be transparant about it. The probability that they make the right decision without exception is low, but they can always show their considerations and explain why they decided what they did. This competence will not come to them automatically: this is why the study of doctors’ diversity dilemmas has become a vital part of doctors’ training.