Critically ill patients frequently have uncertain prognoses, but their families overwhelmingly wish that physicians would address prognostic uncertainty candidly, according to a new study out of the University of San Francisco Medical Center.

In face-to-face interviews with 179 surrogate decision-makers for patients in four separate intensive care units (ICUs), 87 % of caregivers indicated that they would want to be told of all prognostic estimates, even if the estimates were tentative. Most also indicated that they appreciated a physician’s candour in discussing uncertain outcomes as honest, rather than seeing it as a source of confusion or anxiety.

According to the study published in the American Thoracic Society (2009, January 5),

“they needed to begin to prepare for the chance that their loved one might die, and so begin the bereavement process … and want to have the opportunity to take care of unfinished personal business before their loved one dies. They need that chance to say their goodbyes, in case the patient does die.”

Although physicians often wish to shelter their patients and patient families from what might seem to be harsh realities, the human spirit is resilient and sheltering them often leads to unnecessary distress in the long run anyway.

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