There is a dialog between patient and provider that is often overlooked. A topic not normally discussed, and the source of frustration caused by boundaries that have already been set and later ignored.
Well-meaning people seeking to protect themselves and others have found that in order to identify a problem, one needs to perceive it in another. Once what we've determined to be a problem has been found to exist in another, we seek to remedy that problem by correcting its manifestations. Often the perception of the problem is based more upon identification with it; that is, the problem is magnified by the person who perceives it. It is much less florid in the world (and the people who own it), than it is in the mind of the person who tries to correct it.
Whether by written plan, dialog, discussion, or non-verbal communication a patient/provider relationship ought to be a dialectic, not a dictation - especially if a condition determined to be 'hopeless', or untreatable, such as a common addiction is being treated. In order to determine what the problem really is, and what exactly would be helpful, the patient needs to be trusted with the information he or she brings to the provider, including what he, or she knows to be true about the behavior and opinion of others. By relying upon what the patient has to say about him or herself, what might be considered a hopeless condition may actually be found to be a manifestation of hate, or enmity based upon the use of a label, or combination of labels providers have used. If a patient is expected to consent to treatment for a hopeless condition, then the provider has set up a fraudulent transaction, and a patient has a right to write his or her own plan for the doctors consideration and consent. [i]
Changing a plan can't be accomplished during treatment without disrupting the continuity of care and prior expectations. Once a service is established, a practitioner is involved in the delivery of standard practice. The treatment has been accepted by society at-large as a remedy that 'works', and there is no need for further discussion by the client other than to receive the treatment consented to in exchange for a fee. Even witchcraft can be accepted as a standard practice if there is faith in the community that supports it.
It is the standard of the community that builds confidence in a patient, and a person who has been 'treated', is accepted back into the community because the community standards have been met. But if someone is being treated for a hopeless condition, the grounds for treatment are meaningless, and whatever treatment might be used as an experimental practice, or research and development which is in and of itself considered to be unethical with human beings.
1. IMID Ltd, Bodywork 2014: Treating a condition at the source of the injury rather than discussing beliefs about it.
2. IMID Ltd, Medical Model 2014: The Medical Model (Describing the hopelessness of treating addictions of any kind)
3. IMID Ltd, Transpositions 2015: Establishing limits on evaluations and dependency.
4. IMID Ltd, Patients Bill of Rights 2014: A patient has the right to seek an alternative provider, a second opinion, or legal advocacy, etc.