Uncertainty, fear and whistling happy tunes

Abstract

Uncertainty in medical practice is ineradicable, despite great scientific advances over the last century. Uncertainty provokes fear, not just in patients but also in doctors. Patients cope with their fear by seeking the advice and reassurance of doctors; doctors, on the other hand, cope by denial and self-deception. But today, in this scientific, truth-seeking age doctors are encouraged to share their uncertainty with patients in order to ‘empower’ patients and improve doctor–patient relations. While in theory doctors might agree with this approach, in practice they continue to deny it and instead whistle happy tunes—deceiving both themselves and their patients. A disclosure of uncertainty requires an acknowledgement of uncertainty and, in practice, the ability of doctors to acknowledge and to tolerate uncertainty is limited.