Should Doctors Offer Overall Prognosis to Patients who are Not Terminally Ill?

Dr. Alexander Smith is a proponent of offering to discuss overall prognosis with patients even if they’re not terminally ill. Researchers say this could be beneficial to anyone who has less than 10 years to live or has reached 85 years old. The average life expectancy for an 85-year-old is six years. Giving an overall prognosis can help patients get their affairs in order and focus more on the quality of the life they have left rather than toiling with medications and procedures in an attempt to prolong life.

Opponents to this idea say that patients don’t want to hear such grim news, and that there is no way to accurately predict life expectancy anyways. A small minority of patients prefer not to know their overall prognosis. Dr. Smith only proposes presenting the option to discuss this with patients, and the prognosis would not be forced upon anyone.

Dr. Smith also says that several geriatric calculators can reasonably predict life expectancies that are based on factors such as age, cognitive abilities, and sometimes lab test results. One index can accurately predict mortality within 4 years about 75% of the time.

See Paula Span, The Unspoken Diagnosis: Old Age, New York Times, Dec. 29, 2011.

Special thanks to Jim Hillhouse (WealthCounsel) for bringing this article to my attention.