A dilemma with a conflict of interest

[Eileen Dover]

Hi
For those of you who are not aware.. I work in cancer services based on hospital oncology wards. My job entails advising and assisting patients with the practicalities of their situation ie. housing, benefits, employment, debt etc. I am NOT involved in any aspect of dietry advice and indeed there is a dietian on site at each hospital.

When I first came to the job I kept my Veganism and Buddhism very much in the background and got the vibe that this is where it should remain. My 'quirkiness' is acknowledged and tolerated but the sensitivity of my role and the written codes of practice within that role clearly state that personal beliefs and religious opinions are not to be shared with patients.

I have adhered to this policy throughout but it has always raised a conflict of interest for me when patients arrive at their appointments armed with information they have picked up from the dietian or hospital publications.

Interestingly..in the three years that I have been in this post I have meant only one Vegan (that I know of , and I probably would know if it was more as we are a pretty vocal band arent we? ) and maybe two or three Veggies at most.

When I met the Vegan lady she was indeed VERY vocal about her diet. She had -previous to her diagnosis- been Veggie but had been cutting out diary for the two months since. She told me that she was dealing with her Chemotherapy very well and that her cancer had begun to shrink (not a rarity but not common place either). She rounded on me and wanted to know why I did not 'spread the word' and I explained my dilemma and begged her to 'spread the word' for me at all the clinics and sessions she attended. She told me that she had tried but everyone dismissed her as a 'hippy lunatic' and that what was needed was a professional doing it.

This was in my mind today as I sat with a client. His wife was flicking through a 'cookbook for cancer patients' and it caught my eye. I stopped her at one page and remarked that the Vegetarian recipe looked interesting and as I was Veggie I might try it. She remarked disgustedly that 'half the bloody book is Veggie stuff'. I then intimated that this may be because there is now evidence coming through that cancer can be linked to consumption of animal products and also the survival rate of existing cancer patients. Her husband seemed interested and asked me if he could read up about it. I mentioned The China Study and he told me he was going home to goggle it!

Now I am concerned that this could be seen as 'preaching' if he mentions it to his medical team ..or worse his dietian!!! I am aware of the subtle taboo operating around such discussion in medical circles and am worried that my professionalism will be questioned, my position is vunerable as it is.

Incidentially..I took a copy of the cookbook away to investigate the recipes and half the 'bloody book ' was not in fact Veggie. There were many Veggie recipes but even more fish recipes. But chicken, pork and beef featured very heavily too.

[harpy]

To a lay person (albeit a not completely unbiased one) this sounds quite reasonable - you weren't preaching about personal beliefs (e.g. about animal rights), and the client was keen to engage in a conversation about veg*nism. It's not as if you were forcing your opinions on them, you just gave them some information. Doesn't sound as if the patient will be complaining even if the wife wasn't so keen!

A friend who had cancer was advised by her doctors to lay off the dairy produce and (I think) meat so I would the medical team or dietician actually even disagree with you?

[Eileen Dover]

To a lay person (albeit a not completely unbiased one) this sounds quite reasonable - you weren't preaching about personal beliefs (e.g. about animal rights), and the client was keen to engage in a conversation about veg*nism. It's not as if you were forcing your opinions on them, you just gave them some information. Doesn't sound as if the patient will be complaining even if the wife wasn't so keen!

A friend who had cancer was advised by her doctors to lay off the dairy produce and (I think) meat so I would the medical team or dietician actually even disagree with you?

Yes, maybe I am just worrying unduly then? I did after all only signpost him without commenting on my own opinion, I did make sure of that. I do not think the dietician would agree to be honest judging by the information that she has given out to other patients. Personally she may agree, but professionally it would be a different matter.

It certainly seems that some of the cancer treatments such as Chemotherapy react badly to interaction with diary and it is often the case that patients will remove diary from their diet at this time, not based on medical advice but rather that their body rejects it. Some patients comment that even the sight of eggs or milk turns their stomachs at this time.

[harpy]

I would have thought so - it just sounds like a normal conversation and you couldn't very well have given him the brush-off when he asked where he could get more information. Also, they presumably understood what your role is and wouldn't have thought they were getting "official" advice from a dietician etc.

[misosoup]

A lot of people battling joint conditions such as Rheumatoid arthritis change to a vegan diet, so it's not unheard of in the medical profession.

It's a shame that had a non-vegan said this, there'd be no worry about it. I agree with Harpy. You mentioned this because it was a part of the conversation.