Published on: April 11, 2022

How decisions are made and patients cared for are often guided by the Golden Rule: Treat patients as we would want to be treated in similar circumstances.  But when patients’ lived experiences and outlooks deviate substantively from our own, we stop being a reliable barometer of their needs, values, and goals, writes Dr Harvey Max Chochinov, in the Journal of Palliative Medicine.

In his guest editorial titled ‘The Platinum Rule: A New Standard for Person-Centred Care’ Dr Chochinov writes, “So long as the patient’s values and priorities align with our own, we can infer their needs based on how we would want to be treated in their situation, not so when our  worldview  and  lived  experience  deviates  from theirs.”

Unconscious bias can influence the way we process patient information, affecting our behaviour, interactions, and decision making. Rather than feeling that they have been heard, distorted compassion can result in patients feeling devalued, misunderstood, and further demoralised at the very hands of those who are meant to help.

Dr Chochinov adds that not all patient preferences can or should be accommodated, especially when they are driven by nihilistic self-loathing (I don’t want anything), or motivated by expectations that exceed any objective reality (I want everything). Even then, it is important to understand their wishes, and what approaches might provide them with optimal comfort and reassurance.

Read the Editorial by Dr Harvey Chochinov, published in Journal of Palliative Medicine: ‘The Platinum Rule: A New Standard for Person-Centred Care

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