Is it better to steal hope or give false hope?

This is a difficult question.

Often times, doctors find themselves faced with a distraught family who desperately wants to know what the prognosis is for their loved one. And the doctor may not know yet. It can take days for a doctor to know what the real prognosis is. So often times, the doctors find it easier to give the worse case scenario. They figure it is better to set expectations low, to brace people for the worst, and if the patient improves, everyone will be happy.

But as the blog from todays nytimes.com states, this isn't neccessarily the best answer http://well.blogs.nytimes.com/2007/10/22/when-doctors-steal-hope/. The family featured in the blog was given a terrible prognosis when their grandmother came in to the emergency room having a stroke. When the grandmother recovered, they felt like they couldn't be upset about the vitality she has lost because they felt they needed to be grateful that she survived. "But because the doctor initially said the woman would die, they feel like they are no longer entitled to grieve for her lost vibrancy — after all, she’s alive. And their premature grief has come with a cost, stealing away precious emotional energy they now need to help with a long recovery."

The better answer is for doctors to spend more time with the patients' families and offer the full range of possibilities of prognosis. Take the time to discuss what could happen and listen to the fmialies questions. Don't be afraid to express and explain uncertainty.

All of this, of course, requires something in short supply in most hospitals and that is time. But that little extra bit of time means everything in the world to the patients and families who have been given the greatest gift: hope in appropriate measure.

Dr. Jerome Groopman has written two enlightening books on the topic of doctors and how they interact with their patients: The Anatomy of Hope and most recently How Doctors Think. Both should be required reading for doctors.