End of life, continued
======================

* Tom Koch

My brief Salon piece, “End of life, year after year after year,” 1 obviously touched a nerve with Dr. Wohlgemut. 2 However, his reply insists on a host of views that I do not hold. I do not suggest that Fred’s doctors should have been smarter, or that because physicians are indeed often “such poor predictors of mortality that we should abandon the task.” Nor do I doubt, or suggest to the contrary, that pressing on with aggressive therapies is sometimes inadvisable. However, Dr. Wohlgemut and I agree on an essential fact: Physician prognoses are imperfect indicators of longevity and should be understood as such. The tentative nature of prognoses results from the limits of our knowledge, the limits of our diagnostics and the natural variation (physically and socially) among patients. They surprise continually.

## Footnotes

*   **For the full letter, go to:** [www.cmaj.ca/cgi/eletters/182/4/412#311204](http://www.cmaj.ca/cgi/eletters/182/4/412#311204)

## REFERENCES

1.  1. Koch T. End of life, year after year after year. CMAJ 2009;181:868.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMDoiMTgxLzExLzg2OCI7czo0OiJhdG9tIjtzOjIyOiIvY21hai8xODIvOS85NDEuNC5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 

2.  2. Wohlgemut J. Going gentle. CMAJ 2010;182:412.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxODIvNC80MTIiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTgyLzkvOTQxLjQuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9)