Shades of Grey

I’ve always held the belief that people have the right, and should be, informed of all medical information pertaining to their health.

However, a recent experience at the lab has called this assumption into question.

On our first ELISA plate testing for Chagas disease we hit a strong positive corresponding to a middle aged women. My first reaction was, “we need to let this lady know!” However, Manuel (the MD/PhD I work with) put forward a few ideas that made me less sure.

1) The woman is from the Orient, middle of the rainforest, and it is very likely she has no idea what Chagas disease is or what it does. Her almost certainly limited knowledge of human physiology and disease processes would severely limit the effective transfer of information about her condition and thus…

2) …We would be scaring her immensely and giving great cause for additional worry concerning a chronic, relatively untreatable disease, of which she may never suffer from end-stage symptoms (only around 40% of infected individuals develop chronic symptoms) and that at best we could only offer limited symptomatic relief.

3) Financially, and this point is really frustrating, she is not likely to be able to afford any treatment herself and getting the state to pay for it here is almost hopeless. We may be able to help her, but we don’t have the funds to assist everyone we diagnose with the disease. Our research is ultimately aimed at reducing transmission, not initiating a widespread treatment program.

So, in conclusion, are we really acting in the woman’s best interests by informing her that she has Chagas disease? I for one am not so sure anymore and am open to the possibility that sometimes, in very difficult cases with multiple issues factoring in, not telling the individual may allow them a better quality of life.