There’s a word in palliative medicine we talked about this 1st week of orientation called prognostication. It’s especially important in this field.  Doctor’s make prognoses all the time-  we tell people in clinic when we expect their infection will respond to antibiotic treatment, or when their rash will leave.  We guess when broken bones will heal and when pain from a muscle injury should dissipate.  However, when it comes to the time of death, doctor’s are a bit more nervous.  The thing is, just like all other things in life- most people WANT to know what we think.  Knowing helps with the preparation, and with coping.  It helps not just the patient, but the family too.  The problem is historically doctors haven’t done a good job of giving our prognosis on time of death.  This has to do with several things- from not wanting to communicate bad news, to not wanting to be wrong when guessing.

In my field of medicine, when everyday I am seeing people who are actively dying- it’s important to become good at prognostication.  It will be one of many uncomfortable things I’ll do this year. I’m to continually work on getting more accurate in predicting the time of people’s death.  The deep question then becomes ‘is there such thing as becoming too accurate?’  Hypothetically if doctor’s could develop a system with computers and genetics, etc that had no error rate- 100% correct, all the time, at telling people when they would die – – –  should we?

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