As a hospitalist, I often end up taking care of patients who are clearly near the end of their lives. Usually I don’t know them well. I don’t know what they’ve been through. I wonder what their regular doctors have been telling them, if anything, about their chances of survival. Too often, I’m the one discussing end of life issues that should have been addressed three months ago.
After reading the article linked below, I have a bit more understanding of the situation. A sample:
“Cancers vary in prognosis. Cancers vary in their response to treatment. This begs the question: In the absence of perfect information, what should the oncologist tell the patient? Should the oncologist reveal the median survival only? If so, why? What normative ethics say only the central tendencies of a distribution be disclosed? Should the oncologist give a whiff of hope that the patient could be an outlier? Should the oncologist mention the short left and not long right tail and stress the imminence of death so that the patient can die gracefully? What is the truth? Is it the median, the long tail of optimism or the short tail of pessimism? If all three are truths which truth should be mentioned first and which truth should be mentioned last?”