Journal of palliative medicine
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The primary goals of this analysis were to explore the pros and cons of prognostic disclosure to patients and their families from the bereaved family's point of view. ⋯ Although prognostic disclosure to family members can contribute to psychological distress and hopelessness, at the same time, it has the potential to prepare them for the future both emotionally and practically, and also to make the time until the patient's death as meaningful as possible. It is useful for physicians to introduce pros and cons of prognostic disclosure to family members at the time of decision making, to understand the family members' psychological state, and to provide support considering pros and cons whether or not they disclosed prognosis.
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As attending physicians in acute care hospitals consult palliative care services earlier for patients with a life-threatening illness, the role of the palliative care consultant (PCC) may expand, especially when there is diagnostic uncertainty. ⋯ The diagnostic uncertainty that accompanies earlier palliative care consultation may hamper the PCC's ability to establish goals of care and the appropriateness of hospice palliative care unit admission. Attempts at resolving this diagnostic uncertainty may lead to an expanded role for the PCC, which ideally will occur in collaboration with the primary care team.