
Bamboozled by Patients?
Key Takeaways
- Early-career psychiatry residents often default to nonprescribing controlled substances, equating “playing it safe” with minimizing harm.
- A strict refusal framework may inadvertently increase harm by withholding potentially beneficial treatment for pain or anxiety.
A recent essay by Michael W. Kahn, MD, explores whether psychiatrists are going too far in denying patients’ requests for drugs. When first year psychiatry residents were asked how they would react to a request from a patient for narcotic painkillers or antianxiety medications, the general consensus was that they would do no harm by playing it safe and would not provide the requested drug.
A recent
Dr Kahn examines whether this is the right approach. He argues that doing no harm may occasionally require being fooled by a patient. He cautions that “. . . the harm of missing a chance to help often greatly exceeds the harm of prescribing under false pretenses.”
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