Guidelines for Discussing Uncertain Prognoses with Patients

Clinicians can help patients with uncertain prognoses enjoy the time they have left and make better decisions by working to alleviate their anxiety about the uncertainty, write the physician authors who developed guidelines for addressing the uncertainty of prognosis with patients, published June 27, 2013, in the New England Journal of Medicine. Observing that uncertainty is an inevitable part of making prognoses, the authors make three suggestions for helping patients understand and cope with their prognoses. First, physicians should acknowledge that, much like the weather, it is difficult to make a specific prediction. Next, they should respond to patients’ emotional reactions to uncertainty, acknowledging that it can be difficult not to know what to expect, and address patients’ concerns about the future. Finally, physicians must help patients focus on living in the present so that patients and their family members do not dwell on an uncertain future while they can still use their time.