Doctor-patient dilemmas in multiple sclerosis.

This paper is based on the second Jack Pritchard Memorial Lecture given at the Queen's University of Belfast (1). The author describes his own personal response to having multiple sclerosis (MS), and then examines the psycho-social aspects of the disease in a wider context. The distress caused by the emotional difficulties associated with MS is emphasised, and in particular the strain placed on the doctor-patient relationship at the time of diagnosis. The physician's ability to cope with the needs of MS families is explored, together with the importance of offering counselling. Also discussed is the ethical question of whether or not the patient should be told the complete truth. Patients with MS are seen as having a potential not only for helping each other, but also for being able to share in the management of their own health care.