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Communicating With Patients About Advanced Cancer
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To the Editor.—The key finding of the study by Dr Weeks and colleagues1 suggests that patients with colon cancer and lung cancer overestimate their likelihood of survival, compared with the estimates of the physicians who were more accurate. The authors suggest that this underestimation greatly undermines patients' ability to make informed decisions about their end-of-life care. In their Editorial, Dr Smith and Ms Swisher2 interpret this finding to mean that physicians should tell patients the truth about their condition and prognosis.
We agree with the principle of the importance of telling the truth in the patient-physician relationship. However, we have data to suggest that there are infringements on the patient's autonomy in the "one-size-fits-all" approach to telling the truth. We consecutively interviewed 100 patients from Memorial Sloan-Kettering Cancer Center, New York, NY, who were referred for consultation to our Pain and Palliative Care Service and who mostly presented with . . . [Full Text of this Article]
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