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December 19, 1980

The Compassionate Patient

JAMA. 1980;244(24):2755. doi:10.1001/jama.1980.03310240047026

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We hear a great deal about the compassionate physician, but hardly a word about the compassionate patient. This oversight is totally undeserved.

The compassionate patient is holistic. He views the physician as a whole person, replete with joys as well as anxieties that fluctuate with successes and failures of his therapy. He senses the physician's need for appreciation, gratitude, and approval. To satisfy this need, the compassionate patient praises the prescribed medication, even though it was never taken, or, worse still, it was ineffective. Such false feedbacks bolster the physician's self-confidence. Unfortunately, they also bolster the physician's confidence in what may be worthless drugs.

The compassionate patient faces a serious dilemma when he becomes involved in a randomized, prospective, double-blind comparative trial of a drug and a placebo. Should he praise at the risk of praising a placebo or should he disparage at the risk of disparaging the real thing?