Do you think doctors should predict the life expectancy of terminal patients?

Hi Obe, I personally think that some doctors are too blunt, and they force their opinions on the patients. If there is no way the patient can survive for three months, then the doctor can reasonably advise the family and the patient. If there is a likelihood of surviving a year, then the doctor should keep his mouth shut or just say a year or more. Most patients cannot accept that they are going to die within a year, and some patients cannot accept that they will live in pain for one whole year. I think it is more important to give hope to the patients.

Personally, i think it is the doctors' job to inform patient's of their diagnosis truthfully based on their opinion, and their opinion are definitely based on workup [bloodwork, x-ray, ct scan, etc.] and usually they also confer or ask opinions from other doctor colleagues and scientific clinical journals. Based on these results and definite diagnosis and prognosis, the doctor then inform the patient first or sometimes the family beforehand, and this is done so as to prepare the patient, as well as the family, mentally and physically. The option of the patient on the other hand is to get a second opinion if he/she does not concur with her/his terminal diagnosis or accept the situation and a consultation for hospice could be on the way. Hospice consultation is an important option as this kind of care/treatment aims on keeping the patient as comfortable as he/she can be, without pain or with less pain which i think is a better option for the patient, as well as the family. Shutting up or concealing the truth is not the doctors' best option for dealing with terminal patients as this would mean a defiance of medical ethics. Honestly, hope should be given to patient if there is still a cure, but in cases of terminal or endstage disease, the best option is face the facts and hope for a miracle.

Doctors, unfortunately, with all the workup done to rule out certain diseases tends to err based on diagnosis/prognosis, so i think in cases especially one with endstage/terminal illness, an option is to seek a second opinion or even third, fourth or fifth opinion until there is certainty on the what the patient is really going through. personally, doctors are only trying to do their job, and obviously with what they have [workup, bloodwork, radiographic studies, etc.], they give their honest opinion based on their judgment.

Hi scheng1, I agree that doctors should not personalize the statistic and say "you" only have so much amount of time left, however, we cannot generalize and say all patients will feel better being given the statistics. Yes, many will look at the positive and place themselves in the 10%. But it all depends on the person. Many will also look at the negative and give up feeling that they are part of the 90%. It really is a tough situation for doctors. All they can do is provide what information they have to the patient and be ready to give the patient whatever help they can, but it is up to the patient to interpret the diagnosis themselves.

Hi Tinkerick, if the doctors just quote from the statistics, many patients will feel more positive. Even if the statistics show that only 10% of the patients for a given cancer will survive to five years and above, the patients will feel comforted. They will not think of themselves as the 90% who will die within five years. They will think of themselves as the ones who will live to five years and more. i think that is a better approach. Most of us do not feel that the statistics apply to us, unless these are good indicators. It is bad of a doctor to personalize the statistics, and say that a patient has only a year to live.

Hi Jaiho, while it is true that many patients will ask the doctors about the prognosis, it is also true that they ask for the sake of hearing positive news. Most people do not think that they will die so soon, especially when the morphine masks their pain. They want to hear that others can survive to ripe, old age. They are not ready to hear that they will die in a year. Over here, many doctors offer such information, and they are quite blunt in telling the patients. However, many older and experienced doctors are more reserved in that they offer hope. They also share their experience of certain seemingly miraculous healing.

Partly may be because of what you said but most cases doctors offered also such information - but for me the buttom line is doctor can predict but not sure because it is only prediction - if God said it is not prediction... surely. see you around

Hi, i agree with you completely. Since the doctors are always wrong with it comes to life expectancy, they should just keep their mouths shut. If patients want to know, then they should just print out the general statistics for the patients. Even if just 5% of the patients can survive for three years and more, it is more comforting than hearing that he has just a year to live.

Hello my friend the topic mentioned only if the doctor can predict the expectancy of the patients - yes because, doctor can predict according to his/her finding but not 100% accurate, only God can tell whether die or life... even terminal ill. see you around

Hi Karljohnson and Visavis, actually that is a common practice in the medical field. It seems that doctors like to tell people that they can live for one year, or two years. Sometimes they tell the family members, but they also tell the patients directly. I think it is very demoralizing to hear that we have only a year or two, or that the doctors have given up on us. Just hope that we never get terminal illness.

Hi Lipstick2009, most of the times doctors talk as if they are the authority in the lifespan of a patient. Most young doctors are more tactless. They are better at treating the physical symptoms, and they sometimes forget that the next patient could be their own beloved family member. Many older and more experienced doctors are more tactful in dealing with the emotions of the patients. The younger doctors in the public hospitals are more fond of predicting the remaining days. It seems that is the current trend in my country.

Hi 06MLam, yes, I agree the doctors have a duty to tell the truth. However, I do not agree that doctors should speculate on the life expectancy of the patients. The doctors can and should list the options available to the patients, in term of treatment methods, cost and government subsidies or assistance. But they should never speculate on the actual life expectancy. The best they can do is to show the statistics. The statistic is a general outcome, and people do not personalize the statistics. For example, if you tell a smoker that half of the smokers die of lung cancer, he will not feel offended. He likes to think of himself as the other half who do not die of lung cancer. It is different from telling him that he will die of lung cancer. In this case, it is very insulting, as we have personalize the figure.

Hi Lsdshrooms, I think it is even worse for a doctor to ask patients. It is better for a doctor to give general statistics. Even if the statistics shows that only 10% can survive a year or more, most patients will try to defy the odds. Much better than telling them that they have a year to live. Over here, some terminal patients waste their time in the casino. They say that doctors have told them they have a year to live, so they feel that money is no longer important. They waste so much time and money there, instead of finding ways to prolong their lifespan.

Hi Katieh, I think the experience of the doctor in charge is a deciding factor. Many patients who are older do not doubt the words of the younger and inexperienced doctors. They accept whatever the doctors say. I think those doctors have to bear in mind that not all patients want to know the truth. Some of them want the doctors to say comforting words, such as "you will defy the odds." It is very cruel to tell someone that he has just a year to live, when the patient expects himself to live for another three years.

Hi Mr47ali, I have noticed that the more experienced the doctor, the less likely he will speculate on the life expectancy. Those doctors who are younger and less experienced are mostly in public hospitals. They are the ones who tell a patient that he has only a year or less to live. It is very tactless, and not accurate too. Even statistics show that some patients can defy the odds, and live for longer term, or cured completely. If the doctors just say that only 10% survive to five years, that is more comforting than telling someone he has only a year to live.

Hi Chiyosan, actually I think most patients want to hear positive news even when they ask the doctors how long they can live. If the doctors say that the patient has at most a year, that will definitely crash the spirit of the patients. If the doctors say that some can survive above five years, that gives hope to the patients. I think it is better for doctors to provide general statistics, instead of personalize the bad news.

Hi Visavis, I think doctors should not even try to predict. If they just give the statistics, most patients will try to beat the odd. Many of us do not personalize the information we read in the newspaper. For example, even if we know that 1 in 4 persons will get heart attack, we will not think that we belong to one of these potential heart attack patients. If the doctors would just say 30% die in the first year, 40% die in the second year, and the rest survived more than two years, most people will think that they belong to the last category. it is better than telling people that they will die within 2 years.