Hospice, a system for providing palliative care, is underused even for patients with advanced cancer. When physicians do talk about prognosis, they tend to be overly optimistic. This inability to relay unfavorable prognostic information results both from medicine's inherent prognostic uncertainty and from clinicians' fears that they will be perceived as 'giving up' if they talk about dying, thereby eliminating hope and depressing patients. However, studies have found that not only is this not necessarily the case, but failure to provide appropriate information about palliative care and prognosis can contribute to unnecessary pain and suffering.
Fewer physicians agree as to the clinical markers signaling the time to initiate discussions.
Before addressing various types of medical interventions with patients, Quill advises clinicians to discuss the relative weight placed by the patient on prolonging life as opposed to enhancing the quality of life. Helping patients achieve as good and meaningful a death as possible is part of what we do as physicians. This information is provided for educational purposes only. Please read the disclaimer .