“But that is your opinion”: the dark side of postmodern pain medicine creating a postmodern patient autonomy

Abstract

Jan M Keppel Hesselink,1 Michael E Schatman2,3 1Institute for Neuropathic Pain, Bosch en Duin, the Netherlands; 2Boston Pain Care, Research and Network Development Waltham, MA, USA; 3Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA “But that is your opinion”, our patients tell us. They make this remark following our explanations that if they want natural remedies for their sleep disorders, cannabis oil is not the best choice, and that L-theanine is probably a better choice. We point out the various problems one can face when using cannabis oil regularly for treating sleep disorders and explain that although we may prescribe medical cannabis for certain conditions, we do not do so for sleep disorders due to the fact that cannabis might not be the first choice for this indication.1 Patients shrug their shoulders and say, “That again is your opinion, a friend of mine is using cannabis oil and is very happy with it”. End of discussion. They want prescriptions/authorizations for cannabis oil. What are we to do? Are we obliged to correct what we believe is erroneous thinking or do we emphasize respect for patient autonomy and allow what we perceive to constitute irrationality dominate our clinical judgment and decision making?&nbsp