Withholding Tragic Knowledge May Lead to a Tragic Death: A Palliative Care Perspective

Excerpt

I read with interest the article by Suri et al. [1] on the harms and benefits of sharing “tragic knowledge” with patients. However, I want to clarify that there have been no good studies to indicate that unrealistically optimistic patients benefit at the end of life. In fact, a study looking at patients with advanced cancer found that those who were overly optimistic were more likely to receive aggressive treatments and die while on a ventilator—all without survival benefit [2]. Studies that have pointed to the psychological benefits of unrealistic optimism in cancer patients are flawed because they are overwhelmingly cross-sectional in their design and do not take into account the emotional distress of patients and families when death is imminent. …