Intended for healthcare professionals

Reviews Personal view

Gloomy prognoses keep lawyers happy but are bad for patients

BMJ 2006; 332 doi: (Published 15 June 2006) Cite this as: BMJ 2006;332:1459
  1. Richard Lawson, general practitioner (
  1. Congresbury, Somerset

    Last year my sister had a massive subarachnoid haemorrhage, resulting in her being in a coma for four months. She has made a miraculous recovery and is now living in her own home with some support. Throughout the course of her illness her surgical treatment could not be faulted, apart from the inevitable time spent waiting.

    We are giving gloomy prognoses to keep ourselves out of court

    The aneurysm was embolised, the tracheotomy and gastrostomy tubes were duly inserted, and a shunt was fitted when she began to develop hydrocephaly. Technically the work was faultless, but at every stage a bleak prognosis was given. Initially, there was much sucking of teeth and shaking of heads among the doctors as we viewed the large areas of black on the computed tomography scans; and at the end, before the shunt was inserted to relieve increasing intracranial pressure, we …

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