Abstract
We review briefly (1) the history of patient-physician relationship and its evolution
from a physician-centered to patient-centered model; (2) the impact of the McDonald
Criteria for Multiple Sclerosis (MS); (3) why it is important to tell patients of
their diagnosis; (4) how physicians should disclose the diagnosis to patients; (5)
dealing with suspected MS; and (6) prognosis and treatment. For the majority of clinically
definite MS patients we advocate disclosure, identify steps for physicians to communicate
the diagnosis and propose a framework to follow when revealing a diagnosis of MS.
Highlights
- We review the evolution of patient-centered medicine and the disclosure of diagnosis in MS.
- Third revision of McDonald diagnostic criteria accelerates confirmation of diagnosis.
- Patient's autonomy and availability of disease modifying treatments encourage early diagnosis.
- Communications techniques were identified to help physicians revealing a diagnosis of MS.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Multiple Sclerosis and Related DisordersAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer.The Oncologist. 2000; 5: 302-311
- Ethical Issues in Neurology.3rd ed. Lippincott Williams & Wilkins, Philadelphia2008
Brazier M. Medicine, Patients and The Law 1st ed. Penguin; 1987
- Survival and mortality rates among Danes with MS.The International MS Journal. 2006; 13: 66-71
- Social-psychological adjustment to multiple sclerosis: a longitudinal study.Social Science & Medicine. 1982; 16: 2129-2135
Buckman R, Kason Y. How to break bad news: a guide for health care professionals: JHU Press; 1992.
- Breaking bad news: why is it still so difficult?.British Medical Journal (Clinical research ed). 1984; 288: 1597
- Effect of early interferon treatment on conversion to definite multiple sclerosis: a randomised study.The Lancet. 2001; 357: 1576-1582
- Shifting the paradigm toward earlier treatment of multiple sclerosis with interferon beta.Clinical Therapeutics. 2009; 31: 1142-1157
Compston A, Confavreux Ch, Lassman H, McDonald I, Miller D, Noseworthy J, et al. McAlpine's multiple sclerosis; 2005 4th ed. UK
- Breaking bad news: a patient's perspective.The Oncologist. 2003; 8: 587-596
- To tell or not to tell the diagnosis of multiple sclerosis.The Lancet. 1985; 326: 27-28
- Communicating sad, bad, and difficult news in medicine.The Lancet. 2004; 363: 312-319
- Giving sad and bad news.The Lancet. 1993; 341: 476-478
- Telling your patient he/she has multiple sclerosis.Postgraduate Medical Journal. 1995; 71: 449-452
Freedman B. Offering truth: one ethical approach to the uninformed cancer patient. Archives of Internal Medicine. 1993;153(5):572.
- Radiologically isolated syndrome – incidental magnetic resonance imaging findings suggestive of multiple sclerosis, a systematic review.Multiple Sclerosis. 2012; (Jul 3. [Epub ahead of print])
- Delivering the diagnosis of MS - results of a survey among patients and neurologists.Acta Neurologica Scandinavica. 2003; 107: 363-368
Higgs R. On telling patients the truth. Moral dilemmas in modern medicine Oxford: OUP. 1985.
- Companion to bioethics.2nd ed. Blackwell, Oxford2006
- Delaying the diagnosis: truth-telling and multiple sclerosis.The Hastings Center Report. 1983; 13: 2-3
Lo B. Avoiding deception and nondisclosure. In Lo B. Resolving ethical dilemmas: a guide for clinicians, 4th ed. Baltimore: Lippincott Williams & Wilkinsons, 2009.
Maguire P, Fairbairn S, Fletcher C. Consultation skills of young doctors: II—Most young doctors are bad at giving information. British Medical Journal (Clinical research ed). 1996; 292(6535):1576.
- On “realization” in everyday life: the forecasting of bad news as a social relation.American Sociological Review. 1996; : 109-131
- Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis.Annals of Neurology. 2001; 50: 121-127
- SPIKE$: a six-step protocol for delivering bad news about the cost of medical care.Journal of Clinical Oncology. 2008; 26: 4200-4204
- Information needs of cancer patients in West Scotland: cross sectional survey of patients' views.Bmj. 1996; 313: 724-726
- The power of compassion: truth-telling among American doctors in the care of dying patients.Social Science & Medicine. 1993; 36: 249-264
- The value of diagnostic information to patients with suspected multiple sclerosis.Archives of Neurology. 1994; 51: 67
- What to tell cancer patients.JAMA: The Journal of the American Medical Association. 1961; 175: 1120
- Autonomy and trust in bioethics.Cambridge University Press, 2002
- Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria.Annals of Neurology. 2011; 69: 292-302
- Breaking bad news.JAMA: The Journal of the American Medical Association. 1996; 276: 496
- Beyond breaking bad news: how to help patients who suffer.Western Journal of Medicine. 1999; 171: 260
- Bad news from the patient’s perspective: an analysis of the written narratives of newly diagnosed cancer patients.Social Science & Medicine. 2002; 55: 721-732
- communicating the diagnosis of multiple sclerosis – a qualitative study.Multiple Sclerosis. 2007; 13: 763-769
- Communication and neurology – bad news and how to break them.Acta Neurologica Scandinavica. 2011; 124: 5-11
- Truth-telling and patient diagnoses.Journal of Medical Ethics. 2001; 27: 192
- Modifi cation of MRI criteria for multiple sclerosis in patients with clinically isolated syndromes.Journal of Neurology, Neurosurgery, and Psychiatry. 2006; 77: 43
- MRI criteria for multiple sclerosis in patients presenting with clinically isolated syndromes: a multicentre retrospective study.Lancet Neurology. 2007; 6: 677-686
- Breaking bad news.American Family Physician. 2001; 64: 1975
Article info
Publication history
Published online: February 04, 2013
Accepted:
December 26,
2012
Received in revised form:
December 20,
2012
Received:
October 22,
2012
Identification
Copyright
© 2013 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
