Clinical forecasting: Towards a sociology of prognosis

Much of our understanding of prognosis in clinical settings comes from end-of-life situations but prognostication is also a concern in chronic illnesses. Parents of children living with seizures wonder what the future holds: will the child outgrow their seizures, or will they remain a part of their child's life? Based on video recordings of clinic consultations between pediatric neurologists and families, we examine how clinicians convey a child's prognosis. We find that neurologists mainly communicate the prognosis indirectly through the goals they set for the child, the time frame of attaining these goals, and the uncertainties they highlight regarding the attainability of the goals. By modulating goals and erring on the side of optimism, clinicians maintain a collaborative relationship even if the prognosis turns increasingly dire.