Better to prepare for the worst or to have hope?

I read an interesting article, When Doctors Steal Hope. It appeared in the New York Times on October 22, 2007. I thought it was a good read. I can see both sides of the issue from both the professional side and the personal side.

Is it better to be prepared for the worst and be happy that it didn’t come to be? Or is it better to know the best and worst, and be hit with the emotions that come with having an outcome that you hadn’t hoped for?

Ideally, the healthcare professionals would have time to sit down and explain everything, including helping you prepare for the worst outcome. This doesn’t always happen though, so how do we address this issue?

I’m wondering if this is also part of the problem with preparing people for palliative care. While in some illnesses, we know that there is no other outcome other than death, like ALS (Lou Gehrig’s disease), the diseases like cancer can have other outcomes. So, the issue of palliative care is not usually brought up until it becomes obvious that death is imminent – and even then this may not happen because then, death is considered to be a failure.

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