Monterey Bay Forum

Medical Diagnosis: You go to a doctor. He/She says that you have a diagnosis of cancer. You say, what do I do …? The doctor suggests various treatments. Here, diagnosis is the flip side of treatment. Nobody BUYS or WANTS a diagnosis of cancer. If a person has cancer then treatment may involve radiation, surgery or chemotherapy or a combination of all three. All these treatments have significant medical side effects. None of these should be undertaken lightly.

Psychiatric/psychology diagnosis: Parents are concerned about mental and emotional development of their child. They take their child to a doctor — this one is a psychologist and / or psychiatrist. The parents want maximum services to address the concerns they see in the development of their child. So long as the services don’t hurt the child why not maximize them? That is the parents point of view.

Does the doctor conservatively diagnose or? Most of the treatments offerred for children with a diagnosis of autism do not have substantial side effects as in cancer. No lose of hair or feeling lousy because of radiation. So why not maximize treatment to assist the child? Why not “err” and offer maximum kinds of treatment?

Ethics: I say that it is best to do as accurate a diagnosis as possible and not “err” in order to maximize services. Better to incrementally come back and add necessary services rather than overload at the beginning.

This is an ethical dilemma. Does the MD give out drugs that are not necessary but the patient came all that way, waited an hour and expects to get “something”? Does the psychologist diagnose Autistic Disorder 299.0 and not PDD-NOS knowing that one will probably maximize all possible services and the other may not?

Another issue is who pays. If the patient pays for it akin to buying groceries then he may decide that some services are crucial and others can wait. If the “government” is paying the tab — how does that affect decisions?