Poor communication is a common source of problems such as misunderstanding, ignorance, lack of cooperation, suspicion, mistrust, and, if the outcome is perceived as suboptimal, litigation. Effective communication is crucial for several reasons.
• Gaining the patient's confidence. Chance, rather than choice, brings the injured patient to the ophthalmologist: the patient's trust is not automatic, it must be earned.
3 "Every human being of adult years and sound mind has a right to determine what shall be done with his own body; and a surgeon who performs an operation without his patient's consent, commits an assault, for which he is liable in damages" (Justice Benjamin Cardozo, Court of Appeals of New York; Schloendorff vs. The Society of the New York Hospital, 211 N.Y. 125; 105 N.E. 92 (1914).
• Establishing and maintaining a partnership. Patient and ophthalmologist must cooperate throughout the entire treatment and follow-up period. The process can last several years, and loss of cooperation reduces the chance of success.
• Making the patient understand and endorse the objective of treatment. Restoring the eye's anatomy to as close to normal as possible is all a physician can attempt.
A physician should not promise functional recovery but make the patient understand that restoring the anatomy is conditio sine qua non to improve vision.
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