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Doctor withholding diagnosis

twm May 25th, 2021

Do some doctors or health networks still refuse to diagnose people with BPD or refuse to inform patients or treat them when they think that is the case? There is lots of published literature documenting this practice, and it has been discouraged more recently based on legal and ethical arguments but I wonder if it still happens. They list various reasons for doing this but they all serve to protect the doctors and providers more than the patient. Does anyone know?

2
RarelyCharlie May 25th, 2021

@twm Here in the UK, the British Medical Association advises:

"…the doctor should withhold from the patient any information the release of which would cause serious harm to the mental or physical health of the patient."

The American Medical Association advises:

"Except in emergency situations in which a patient is incapable of making an informed decision, withholding information without the patient’s knowledge or consent is ethically unacceptable."

So yes, in circumstances where there's a risk to the patient, doctors in both the UK and the US might decide not to inform the patient. BPD is sometimes associated with a risk of suicide, so that could be a factor in the decision.

I think refusing to diagnose at all is different. BPD can be difficult to diagnose, and I suppose for that reason doctors often refuse to make a definite diagnosis of BPD. They might talk about suspected BPD, or BPD traits, in order to avoid sounding too definite.

I think refusing to treat is different again. A doctor who doesn't have the skills to treat BPD should not attempt to provide treatment, and should instead refer the patient to someone else who has the right skills. So yes, in a case like that the doctor would refuse to treat.

Charlie

1 reply
StarlitSky4762 May 25th, 2021

@RarelyCharlie this is a really thoughtful reply thank you!

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