Monday, December 14, 2009

Decisions for Medical Treatment - Risks vs. Benefits

In any decisions for medical treatments, unconventional treatments (such as “alternative” medicine), and even for choosing an exercise program, the two words you must keep in mind are “risks” and “benefits”. For such decisions, one should weigh the potential risks (or damages) against the potential benefits. Another way of look at it is weighing the risk of going with a treatment against the risk of not going with that treatment. Such decisions mean the difference between life and death in some situations.

Although your doctor knows this principle of weighing the potential risks with potential benefits when considering any medical intervention, or treatment, you should not rely on him to make the decision. Instead, you should ask him about the risks and benefits.

Examples of Questions to Ask:
  • What are the risks of this surgery? What are the side effects?
  • How will this treatment benefit me? What are the chances of this treatment in ridding the condition?
You should ask him such questions so that you can make an informed decision. You should not rely on the doctor to make the decision for you. Although your doctor is more knowledgeable in medicine, he probably does not have the exact same values as you and probably does not have the exact same risk tolerance as you. He may be more conservative than you and less willing to take risks in the quest to get rid of your illness. Or it may be the other way around where you are more conservative and your doctor is more tolerant of risks.

Although you have to keep in mind that you and your doctor most likely have differing risk tolerance levels, you must also humbly recognize that he has the medical knowledge, training, and expertise that you don’t have. The smart and wise patient is not one who acts like a know-it-all with his printouts of medical information (often from unreliable web sites. For a reliable medical information search, simply go to However, the wise patient is also not one who gullibly goes along with whatever the doctor recommends without understanding the risks vs. benefits himself, and weighing in his own risk tolerance and values. You must find the correct balance when making such decisions.

A thirty five year old man was informed by his doctor that he has a hyperactive pituitary gland from an abnormal growth pressing on it. This is probably why this man is a big man. Although the growth is benign, any further growth may consequently result in premature mortality. However, the proposed treatment by the doctor is opening the man’s head to surgically remove the abnormal growth. The risk to this surgery includes brain damage, blindness, and paralysis.

The doctor highly recommended this man to go through with the surgery, without asking the man’s history (such as the history of this man being oversized.) This man has been bigger than his peers since childhood. Therefore, chances are that he had this benign tumor pressing on his pituitary gland since he was a child. However, the doctor neglected to ask about this.

The man went to a few other endocrinologists and neurologists. One of the endocrinologists was actually a long time friend. This endocrinologist told him that he would not have his head opened up for this. Weighing the potential risk of paralysis and other severe disabilities (if he goes through with the surgery) vs. the risk of eventual premature death (which is actually lower considering that he probably had always had this growth since childhood), the man decided against surgery. He is alive and healthier than most people today.

It really depends on your value and how much risks you are willing to accept. If it was me, I would probably come to the same decision as this man (especially when I am more willing to accept the risk of death than the risk of disability.) However, you may not have the same value system as me and my doctors may not have the same risk values as me.

Summarizing simply, learn to weigh the risks and benefits after humbly being informed by doctors and by reliable medical research sources such as in order to make the right decisions according to your values and risk tolerance.

Disclaimer: Please consult your doctor before taking any advice from this blog.

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Copyright: © 2009. This document is the sole property of Amadeo Constanzo. You may use this article for free on your web site, blog, or other publication if and only if you include this entire copyright notice including the following links and statement. Other free teachings from Amadeo Constanzo can be found at and

Shu Chan 陳樹中 Terence Chan LIU