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American Journal of Bioethics.

What’s in a Name? The Ethical Importance of Respecting a Patient’s “Unexplained” Medical Concerns

In the first-year clinical skills course medical students take here at the Loyola University Chicago Stritch School of Medicine, one of the key aspects of the medical interview that students learn is the patient’s perspective of their illness. In addition to documenting the patient’s main concerns, history of present illness and past medical history (a curious redundancy), we stress with our students that they should always ask what the patient thinks is going on. Documenting the patient’s perspective is important because it emphasizes the patient’s own interpretation of what is happening to him or her. This conveys not only respect and concern, but it may reveal something important that the clinician may otherwise miss. Thus, the patient perspective emerges as a key part of the interview. Yet, as Diane O’Leary (2018) states in this month’s target article, the majority of clinical complaints are due to “medically unexplained symptoms” or MUS. Such symptoms lack a biological explanation. Her article focuses on a subset of MUSs that have primarily psychosocial origins.

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Volume 18, Issue 5
May 2018