Death Foretold: Prophecy and Prognosis in Medical Care

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This groundbreaking book explains prognosis from the perspective of doctors, examining why physicians are reluctant to predict the future, how doctors use prognosis, the symbolism it contains, and the emotional difficulties it involves. Drawing on his experiences as a doctor and sociologist, Nicholas Christakis interviewed scores of physicians and searched dozens of medical textbooks and medical school curricula for discussions of prognosis in an attempt to get to the core of this nebulous medical issue that, despite its importance, is only partially understood and rarely discussed.

"Highly recommended for everyone from patients wrestling with their personal prognosis to any medical practitioner touched by this bioethical dilemma."—Library Journal, starred review

"[T]he first full general discussion of prognosis ever written. . . . [A] manifesto for a form of prognosis that's equal parts prediction-an assessment of likely outcomes based on statistical averages-and prophecy, an intuition of what lies ahead."—Jeff Sharlet, Chicago Reader

"[S]ophisticated, extraordinarily well supported, and compelling. . . . [Christakis] argues forcefully that the profession must take responsibility for the current widespread avoidance of prognosis and change the present culture. This prophet is one whose advice we would do well to heed."—James Tulsky, M.D., New England Journal of Medicine

"....reveals that physicians frequently make errors in their prognosis & can convey an optimistic bias...also discusses how physicians can improve prognostication skills through careful clinical practice and education."

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Editorial Reviews

Journal of the American Medical Association
Death Foretold makes an important start in addressing the dearth of scholarship on the art, science, and mystery of prognosis. Although the author's purpose is to elucidate how physicians view and approach prognosis, the book should also appeal to patients interested in understanding how and why doctors too often fail to address the fundamental query, "Doctor, what will happen to me?"
Library Journal
In this important book on the issue of medical prognostication, Christakis explains that even though doctors commonly encounter situations that require a prognostic diagnosis, they feel poorly prepared, find it stressful, and believe that patients might judge them adversely in the face of prognostic errors. Drawing on his own knowledge of bioethics, his experience as a sociologist, and his work as a physician, Christakis has taken on the task of interviewing his colleagues, searching medical school curricula, gathering medical texts, and creating his own quantitative research to provide readers with a comprehensive consideration of this murky area of medical practice. This treatment takes us from a history of the social construction of prognosis, to an examination of the need for it, through the perils of accountability, and concludes with a "clarion call" for the duty of the healthcare industry (especially physicians) to find better ways to prognosticate. Highly recommended for everyone from patients wrestling with their personal prognosis to any medical practitioner touched by this bioethical dilemma. Especially suited for medical school libraries.--Rebecca Cress-Ingebo, Wright State Univ. Libs., Dayton Copyright 1999 Cahners Business Information.
Drawing on interviews, surveys, and his own experience as a physician, Christakis (medicine and sociology, U. of Chicago) examines how prognoses from the simplest to the direst are made, how often doctors err in making them, and the uncertainty with which they are pronounced and interpreted. He intends his account to be accessible both to doctors and to patients. Annotation c. Book News, Inc., Portland, OR (
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Product Details

  • ISBN-13: 9780226104713
  • Publisher: University of Chicago Press
  • Publication date: 4/1/2001
  • Edition description: 1
  • Pages: 374
  • Sales rank: 811,631
  • Product dimensions: 6.00 (w) x 9.00 (h) x 1.00 (d)

Meet the Author

Nicholas A. Christakis, M.D., Ph.D., is an associate professor of medicine and sociology at the University of Chicago.

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Table of Contents

1. Prognosis in Medicine
2. Making Use of Prognosis
3. Error and Accountability in Prognostication
4. Professional Norms Regarding Prognostication
5. Telling Patients Their Prognosis
6. The Self-Fulfilling Prophecy
7. The Ritualization of Optimism and Pessimism
8. A Duty to Prognosticate
Appendix 1: Original Sources of Data
Appendix 2: Detailed Survey Experiment Results
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