ArticleTheoretical medicine and bioethics2009
The self-fulfilling prophecy in intensive care.
Article in Theoretical medicine and bioethics, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
57 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Part 3: Ethics: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation · 2025Guideline
- Predicting neurological outcome in adult patients with cardiac arrest: systematic review and meta-analysis of prediction model performance.Critical care (London, England) · 2022Pooled it
- Clinical Predictive Models of Sudden Cardiac Arrest: A Survey of the Current Science and Analysis of Model Performances.Journal of the American Heart Association · 2020Pooled it
- Good Outcome Following Attempted Resuscitation Score and Clinical Frailty Scale for Estimating Long-Term Mortality: An Ancillary Study of the CLEAR Randomized Clinical Trial.JAMA network open · 2025Trial
- One termination of resuscitation rule to guide them all?Resuscitation plus · 2026Article
- From frailty-driven to frailty-informed care in the age of wearable AI.Communications medicine · 2026Review
- Intensive care admissions in older adults: are we moving from ageism to ableism?European geriatric medicine · 2026Article
- Expectations before periacetabular osteotomy and relation to post-operative outcomes and satisfaction.Journal of hip preservation surgery · 2026Article
- When facts are not fixed: rethinking shared decision making at the margins of neonatal viability.BMC medical ethics · 2026Article
- Artificial Intelligence, Informatics, and Pain in Aging.Clinics in geriatric medicine · 2026Review
- Article
- The ethics of blood stewardship and quantitative futility assessments to predict certain death in neurotrauma patients.Frontiers in medicine · 2026Review
- Article
- External multicenter validation of the eSAH score for predicting outcomes after subarachnoid hemorrhage.Scientific reports · 2025Article
- Feedback loops in intensive care unit prognostic models: an under-recognised threat to clinical validity.The Lancet. Digital health · 2025Review
- Navigating parental disagreement: ethical analysis and a proposed approach.Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- Can an accurate model be bad?Patterns (New York, N.Y.) · 2025Article
- Traumatic Brain Injury as an Independent Predictor of Futility in the Early Resuscitation of Patients in Hemorrhagic Shock.Journal of clinical medicine · 2024Review
- Indian Society of Critical Care Medicine and Indian Association of Palliative Care Expert Consensus and Position Statements for End-of-life and Palliative Care in the Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Disorders of Consciousness Rehabilitation: Ethical Dimensions and Epistemic Dilemmas.Physical medicine and rehabilitation clinics of North America · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Predictions of poor prognosis for critically ill patients may become self-fulfilling if life-sustaining treatment or resuscitation is subsequently withheld on the basis of that prediction. This paper outlines the epistemic and normative problems raised by self-fulfilling prophecies (SFPs) in intensive care. Where predictions affect outcome, it can be extremely difficult to ascertain the mortality rate for patients if all treatment were provided. SFPs may lead to an increase in mortality for cohorts of patients predicted to have poor prognosis, they may lead doctors to feel causally responsible for the deaths of their patients, and they may compromise honest communication with patients and families about prognosis. However, I argue that the self-fulfilling prophecy is inevitable when life-sustaining treatment is withheld or withdrawn in the face of uncertainty. SFPs do not necessarily make treatment limitation decisions problematic. To minimize the effects of SFPs, it is essential to carefully collect and appraise evidence about prognosis. Doctors need to be honest with themselves and with patients and their families about uncertainty and the limits of knowledge.
Indexed as
Identifiers
19943193What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.