Question

. Mrs. S., age 55, has chronic asthma. Even though she is very allergic to cat fur, she keeps two cats to whom she is very attached, and she smokes a pack of cigarettes a day. She also insists on getting emotionally involved in all family squabbles. Her family physician lectures her constantly on the fact

that all three factors complicate her asthma. He is reluctant to prescribe most asthma medicines because of the side effects, but most significantly because a change in S's lifestyle will do more good than any medication. After a year of unsuccessful patient education, he refuses to treat her any further unless she does her part and changes her lifestyle. He sends her a letter advising her to find another physician and makes it clear he will be available as needed until she does.

Is the physician ethical in refusing to treat the patient until she reforms her health habits? Is he blackmailing her or is he making a last desperate at- tempt to make her face her real problems? Is the patient capable of handling all the factors that complicate her asthma?

Answer 1

Mrs.S aged 55 years seems to enjoy the company of two cats and she is addicted to smoking and she involves emotionally in all family squabbles.This shows that she lacks love, encouragement in her life.Doctor is definitely not ethical when he is not treating her when she has to be treated.Being her family doctor its unethical to deal this way with her.Giving her tips regarding to solve her issues can help.

Ways to encourage quit smoking:

• Instead he can encouage her to stop smoking slowly .
• May be she can reduce by one cigar per day.This would help her to cut down on smoking gradually.

Ways to encourage handle pets:

• She can be encouraged to keep herself away from the pets, or ask someone else to handle her pets and she can visit them.
• Or she should be instructed to go for pets with no fur on them like rabbit etc.

Ways of overcoming stress:

• Teaching the techniques of stress is important.
• Deep breathing exercises can be taught to the patient to relieve stress.
• Music therapy ,meditation and prayer can help in relieving stress of Mrs.S
• Keeping informed to the family members not to reveal stress causing matters to Mrs.S is also important.

Other teachings which can be done are:

1. Encourage Mrs.S to jog every morning.It helps in reducing asthma.
2. Provide psychological support and reassure the clients
3. Encourage Mrs.S to follow the medications as per the prescription.

• All these measures the doctor can do to help the patient to recover from Chronic Asthma rather than ignoring her or leaving her alone with her sickness.