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A Piece of My Mind |

Assuming the Worst

Ann-Marie Rosland, MD, MS1
[+] Author Affiliations
1Division of General Internal Medicine, University of Michigan Medical School, Ann Arbor; and Ann Arbor VA Center for Clinical Management Research, Ann Arbor, Michigan
JAMA. 2015;313(22):2229-2230. doi:10.1001/jama.2015.2948.
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A year later, Jean still talks about the argument I had with her oncologist the day she was diagnosed with metastatic colon cancer. It was 11 o’clock that Friday night when the oncologist finally called me, and it didn’t take long for us to come to odds. I was arguing that Jean should be offered chemotherapy choices, but the oncologist was offering palliative care only. The main reason was Jean’s “functional status”:

“If you knew her, you’d realize that her functional status is great!” I had known her for a long time and he had just met her that day. I hoped that launching into a description of her many activities would clear up the situation.


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