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Discussing prognosis and communicating risk 

Discussing prognosis and communicating risk

Chapter:
Discussing prognosis and communicating risk
Author(s):

Phyllis N. Butow

, Martin H.N. Tattersall

, and Martin Stockler

DOI:
10.1093/med/9780198736134.003.0013
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date: 22 August 2017

Understanding and communicating about risk and prognosis are difficult for doctor and patient alike, and yet are critical to enabling patient autonomy and informed consent. Most guidelines, legal frameworks, and doctors emphasize the right to disclosure, but suggest sensitivity in responding to patient preferences and needs. Most patients want to know their prognosis, but there is diversity of preferences between and within patients over time. In reality, discussions of prognoses are often avoided, and are not recorded. We suggest openly negotiating prognostic discussions, giving information clearly and honestly when desired, providing best case, worst case, and typical scenarios, using strategies to maintain hope, and recording the discussion and its outcome. Role play is a very effective method for developing skills in this area.

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