TERMINAL ILLNESS: Most Doctors Avoid Truthful Prognosis
Most physicians fail to give terminally ill patients a straight answer about their life expectancy, according to a new survey presented at the annual scientific meeting of the American Society for Clinical Oncology. Researchers surveyed 258 doctors caring for 326 cancer patients in five Chicago hospices and found that most tend to be overly optimistic about the life expectancy of terminally ill patients or refuse to offer an estimate, the AP/Washington Times reports. Forty percent of physicians said they would give an inaccurate estimate, and three-quarters of those physicians said that they would "sugarcoat" the prognosis, giving patients a longer life expectancy estimate than they really believe. Only one-third were willing to give patients "their best guess." The remainder indicated that they would "paint a picture even more grim than necessary." Dr. Elizabeth Lamont of the University of Chicago said that doctors' dishonesty is "probably well-intentioned," fearing that the truth may "harm patients ... by becoming a self-fulfilling prophecy." Despite doctors' good intentions, study co-author Dr. Nicholas Christakis argued that honesty is the best medicine. He noted that many patients "die in pain, institutionalized and broke" due to poor prognostic information. "Part of the reason we die badly is because we don't see death coming and we don't plan accordingly," he said (5/21).
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