This post was originally published on this site
The magazine’s Ethicist columnist on whether it’s appropriate to offer an unsolicited medical diagnosis.
When our neighbor died a few months ago, his companion was grief-stricken. Although she lives separately in a rural town an hour away, they spoke every day. We knew her hardly at all, but she asked us to keep an eye on the now-vacant home, which she will eventually inherit.
Now she comes periodically to sort through our neighbor’s possessions and prepare the house for sale. In doing so, it has become apparent that he was a hoarder, and she has turned to us again — for help in understanding the value of many of his things and for physical help with the sorting of them. She is overwhelmed. Her movements are slow, her decisions are hesitant and her stamina is limited.
I happen to be a retired neurologist. Over the course of many days spent helping and observing her, I’ve become convinced she has Parkinson’s disease. I concluded that much of the slowness and hesitancy we initially attributed to her shock and emotional fatigue is, instead, a result of her as-yet-undiagnosed neurological illness. With the passage of time, I am increasingly confident of my observations.
There’s been no occasion to mention my professional background, and I’m now uncertain about whether I should tell her about it and my clinical impressions. Her disease, at its current stage, is likely to be successfully managed with oral medication. However, it is neither obvious that she will have access to skilled neurological care nor that she will be willing to seek it. And a new diagnosis of Parkinson’s, without prompt treatment, on top of her recent loss and the challenges that have followed, may further overwhelm her. My wife is in favor of my informing her, because treatment would benefit her quality of life. I’m hesitant, as there has been no invitation to become more involved in her personal life, and I cannot provide her with a supportive doctor-patient relationship. What would you recommend? — Name Withheld
From the Ethicist:
You offer two reasons for not saying anything. One is that she hasn’t asked for your involvement in her personal life. Given that she knows nothing of your qualifications, though, she has had no cause to. The second is that the information might bring her distress without any benefit. But as a former professional in the field, you’re in a position to reduce that risk by advising her how to access the necessary care. Treatment that could help alleviate her symptoms would be the best outcome. Surely you would want to know if you had a treatable medical condition.
I wonder whether you’re worried that if you tell her what you’ve noticed, you’ll be drawn into her life in demanding ways. After all, you’ve probably spent a lot more time in your neighbor’s house than you had expected. But you can draw a clear boundary here: You’re not her doctor and you’re not going to be her doctor. You happen to be qualified to give her some medical counsel that could lead to treatment and substantially improve her ability to function. You’re not offering to be her Virgil through the underworld of neurological care.