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Books, Journals, New Media
October 28, 1998


Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(16):1403-1404. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-16-jbk1028

In Reply.—I agree with Dr Kennedy that the term terminal seems impersonal, but it is truthful. I do not use terminal unless a patient asks me specifically, but I have always preferred to say, "You have a disease that cannot be cured with medicines." However, it is important to emphasize that data for populations do apply to individuals. If 95 of 100 patients with advanced pancreatic cancer will be dead within 1 year, then the patient should know that. If all that the patient hears is "You have pancreatic cancer" and "Some people do well, after all, not everyone is the same," they have not been given decent information.