Doctor-patient relationship – an idealised concept? (1)

The concept enunciated in the essay entitled Doctor-patient relationship1 is good but is based on an idealised assessment of the behaviour of doctors and patient. It may have worked in the situation described because of the eminence of the institution.

What would be the proper behaviour in situation such as those described below?I have based my query on personal experiences.

1. A person well known to you suffer a head injury. He has been admitted to another private hospital where surgery has been recommended. The relatives approach you. Your study of the case record and the findings of tests carried out convince you that surgery is absolutely useless and recovery is unlikely. You now realise that surgery has been advised not to benefit the patient but to extract fees. What do you do?
2. A friend suffers from an illness such as lower respiratory infection and her condition is not very serious. She shows you the prescription given to her. You find it irrational. Multiple antibiotics in non-therapeutic doses, a cortico-steroid preparation and three vitamin preparations have been ordered. Will you offer any comment to the patient?
3. Someone you know very well has been advised a rather complex operation such as total replacement of the knee. The surgeon concerned, whom you know very well, has never undergone any training in such surgery. Will you allow the patient to undergo the operation?
4. A specialist in a particular branch of surgeru, notorious for his avarice, has advised your friend an operation not within his province of expertise. The literature is full of opinions questioning the role of this form of surgery (say hysterectomy) in such patients. Do you interfere?