This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Patient-Physician Relationship/ Care  • Patient-Physician Communication  • End-of-life Care/ Palliative Medicine  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In their Perspectives on Care at the Close of Life article, Drs Lamont and Christakis¹ discussed the complexities of delivering prognostic information to patients with terminal illnesses. There is one addition that I find particularly helpful in dealing with these situations. I explain to patients that there are different types of "averages." In the case in cancer survival, where numbers vary widely and in a nonnormal way, I explain that statisticians use a different type of measure, the median, and then explain that half of patients can be expected to live longer than this time, while the other half will not. Initially, I related this information to provide patients hope about surviving longer than the stated prognosis while still being completely truthful. However, after having patients die much sooner than expert prognostications had predicted, relatives have told to me that, had we not had that specific discussion . . . [Full Text of this Article]

Gary N. Fox, MD
Toledo, Ohio

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Complexities in Prognostication in Advanced Cancer: "To Help Them Live Their Lives the Way They Want to"
Elizabeth B. Lamont and Nicholas A. Christakis
JAMA. 2003;290(1):98-104.
ABSTRACT | FULL TEXT