“How long do I have, Doc?” Ethical Issues in Prognostication for Older Adults

Alexander Smith, MD, MS, MPH

Making predictions is part of every domain of life, including health care, and when the prediction of healthcare outcomes influences the decisions that are made or the actions that are taken as a result of the prediction, these predictions take on ethical dimensions. We will begin with a brief historical overview, describing the waning of the importance of prognosis in medicine over time. This will lead to a description of the importance of prognosis in palliative care and geriatrics. We address ethical issues raised by the uncertainty inherent in prognosis, and issues in the communication of prognosis to patients. We will discuss the presenters work in this area, including a website for estimating prognosis for older adults (www.eprognosis.org and ePrognosis: Cancer Screening available for free in iTunes).
Alexander Smith, MD, MS, MPH
Associate Professor of Medicine, San Francisco VA Medical Center, University of California, San Francisco Division of Geriatrics
Recorded December 11, 2014


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