DEATH FORETOLD
Prophecy and Prognosis in Medical Care
Nicholas Christakis
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University of Chicago Press, 1999
328 pp
ISBN 0-226-10470-2
RRP $US 30. £21
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This book is about “the use physicians make of prognosis, the symbolism it contains, and the practical and emotional difficulties
it involves.” Christakis believes that “cogent and compassionate prognostication … could decrease the prevalence of bad deaths in our society.” How true!
Successive chapters describe the decline in the use of prognosis with the increasing availability of therapies, how prognoses are
used in contemporary medicine, the inaccuracy of prognostication, the stresses involved, and the “ritualization of optimism”. The final chapter argues that individual physicians and the profession
as a whole have a duty to prognosticate.
To people who work in palliative care, this book brings no surprises. The discussion of the origins and perpetuation of some of the
rituals makes for interesting reading, and clearly calls for a change to the way physicians are taught and practice. For the sake of their patients.
Roger Woodruff
Director of Palliative Care, Austin Health, Melbourne, Australia
(May 2004)
Author Information
Nicholas Christakis is Associate Professor of Medicine and Sociology at the University of Chicago, USA.
Table of Contents
1. Prognosis in Medicine 1
2. Making use of Prognosis 30
3. Error and Accountability in Prognostication 64
4. Professional Norms regarding Prognostication 84
5. Telling Patients their Prognosis 107
6. The Self-fulfilling Prophecy 135
7. The Ritualisation of Optimism and Pessimism 163
8. A Duty to Prognosticate 179
Appendix
Bibliography
Index
