And some said they didn’t believe physicians could ever accurately predict survival. However, such skepticism about physicians’ accuracy would result in a random distribution of interpretations rather than in the systematic optimism observed here, Dr. Zier and his colleagues noted.
The findings of this study show that "clinicians who communicate with surrogate decision makers in the care of incapacitated patients should be aware of the diverse causes for discordance about prognosis." Unrealistic optimism may not be benign; it can lead to treatment decisions that do not reflect the true values of the patient but that instead serve the surrogate decision maker’s impulse toward self-protection, they added.
This study was supported by the National Heart, Lung, and Blood Institute, the Greenwall Foundation, and the University of California, Berkeley–University of California, San Francisco, Joint Medical Program.