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Medical Writings |

Hope for the Best, and Prepare for the Worst

Anthony L. Back, MD; Robert M. Arnold, MD; and Timothy E. Quill, MD
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From Veterans Administration Puget Sound Health Care System, University of Washington, Seattle, Washington; University of Pittsburgh, Pittsburgh, Pennsylvania; University of Rochester, Rochester, New York.

Acknowledgments: The authors thank Dr. Susan Block for her helpful suggestions about the role of ambivalence.

Grant Support: Drs. Back and Arnold are Faculty Scholars of the Project on Death in America. Dr. Arnold was also supported by the Greenwall Foundation, Ladies Hospital Aid Society of Western Pennsylvania, and the LAS Trust Foundation.

Requests for Single Reprints: Anthony Back, MD, Veterans Administration Puget Sound Health Care System, 1660 South Columbian Way S111, Seattle, WA 98108; e-mail, tonyback@u.washington.edu.

Current Author Addresses: Dr. Back: Veterans Administration Puget Sound Health Care System, 1660 South Columbian Way S111, Seattle, WA 98108.

Dr. Arnold: Section of Palliative Care and Medical Ethics, MUH 200 Lothrop Street 932, Pittsburgh, PA 15213.

Dr. Quill: Palliative Care Program, University of Rochester School of Medicine, Box 601, 601 Elmwood Avenue, Rochester, NY 14642.

Ann Intern Med. 2003;138(5):439-443. doi:10.7326/0003-4819-138-5-200303040-00028
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Mr. J., a 40-year-old father of two young children, has metastatic non–small-cell lung cancer that has not responded to two different chemotherapy regimens. His physician, Dr. B., explains that the cancer is progressing. Mr. J. says, “Isn't there something you can do? Please don't give up on me.” Dr. B. pauses and says, “Well, there is an experimental protocol we could try.”

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