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June 14, 1995

Denial in the Medical Interview-Reply

Author Affiliations

Medical College of Pennsylvania Pittsburgh
University of Pennsylvania Philadelphia

JAMA. 1995;273(22):1735-1736. doi:10.1001/jama.1995.03520460016012

In Reply.  —We completely agree with Dr Moon that physicians exhibit denial and that self-knowledge in this area benefits the medical encounter. As we discussed in example number 3, which illustrates collusion in denial between a patient and a physician, "Denial does not necessarily 'belong' exclusively to either party." Can physicians learn to recognize and cope with their own denial, as Dr Moon advises? One method is to start by becoming aware of one's own blind spots, such as revulsion toward child abuse or domestic violence; this may be an important step for the physician toward avoiding denial when having to deal with these problems in the clinical setting.We believe that there is also a cognitive aspect to denial: "When faced with a choice, a rational decision-maker will prefer the prospect that offers the highest expected utility."1 Physicians are less likely to deny or avoid a clinical problem

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