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CNN Today

Study: Doctors Overestimate Time Dying Patients Have to Live by Five Times

Aired February 18, 2000 - 1:39 p.m. ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

LOU WATERS, CNN ANCHOR: Doctors are facing scrutiny over a new report that finds many physicians are overestimating the amount of time their patients have to live.

CNN's Elizabeth Cohen explains how this greatly affects decisions regarding end-of-life care.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): Physicians dramatically overestimate the amount of time their terminally-ill patients have left to live, according to a new study. It showed that doctors generally predicted that their patients would live for four months after entering a hospice. In reality, the patients lived for only 24 days; that's a fivefold difference.

DR. NICHOLAS CHRISTAKIS, UNIV. OF CHICAGO MEDICAL CENTER: Doctors don't want to believe that their treatments and their interventions are not effective. They actually want to believe that the future is better than it really might be.

COHEN: Study author Dr. Nicholas Christakis calls this blind optimism, and it can lead to big problems for families. Take, for example, the child who wants to fly across the country before his parent dies.

CHRISTAKIS: So the family communicates to the child, you know, don't -- it's not time to fly in to see your parent yet, and the child doesn't come. And then the person dies the next day, let's say, or the next week, and the family misses the opportunity to say good-bye to the loved one because the prediction was not reliable.

UNIDENTIFIED MALE: Hi, Mary. How are you doing?

MARY STACK, HOSPICE ATLANTA: Good. How are you today?

UNIDENTIFIED MALE: All right.

COHEN: Mary Stack, a hospice social worker, knows well the problems that blind optimism can cause. Her friend Margaret (ph), at age 44, had cancer in both her breasts, her liver, her lungs and bones, but doctors still wanted to try and cure her, and they were afraid morphine would interfere with the treatment. STACK: She was flailing, she was moaning, she was writing in the bed, you know, just congested, couldn't breathe, and the nurse repeatedly asked the attending for morphine to relax her, and he said no.

COHEN: Stack says the physician predicted Margaret would live for months or even years. She died four days later.

(on camera): The University of Chicago study found that only 20 percent of doctors make accurate predictions about how long patients have to live. That inaccuracy is one reason the American Medical Association has started a special education program for doctors in end-of-life care.

DR. LINDA EMANUEL, AMERICAN MEDICAL ASSOCIATION: There's no question in my mind that it's a problem and that we do need to fix it.

COHEN: Dr. Emanuel says one reason for the problem is simple.

EMANUEL: I think it's part of the human condition: We are hard- wired to live, we are not hard-wired to die.

COHEN: And she says physicians are only human, fighting for life even in the face of all evidence that death is near.

Elizabeth Cohen, CNN, Atlanta.

(END VIDEOTAPE)

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