Re:

To the editor:

Lisa Rosenbaum advises patients to 'let fear guide early breast cancer decisions' (NY Times, 8/27/15) but I think it needs to be emphasized how subjective fear is and, also, how inter-subjective it is.  The degree of fear a patient feels will be influenced by the physician's attitude and the push to intervene is often conveyed implicitly or explicitly.  Living with uncertainty can be very anxiety provoking, especially in relation to one's health.  But informed consent requires the physician to make explicit his uncertainty (based on the best available evidence) about the long term benefits of a suggested intervention. In this way, the authoritative position of the physician is tempered by humility and expresses respect for the patient's autonomy and right to be fully informed about reasonable - even opposing - options.



Respectfully


Larry S. Sandberg MD