When should prognostic discussions occur to support decision-making?

• A. Early and repeated discussions to support decision-making.
• B. Only when the patient requests them.
• C. Early and repeated discussions to support informed decisions and alignment with patient values.
• D. Only for legal documentation.

Answer: (C)

Prognostic discussions should be an ongoing, proactive conversation started early in the illness and revisited as the situation changes. This approach supports decision-making by helping patients understand likely outcomes, compare treatment options, and see how those options align with their values and goals. Beginning these talks early gives time to absorb information, ask questions, and reflect on what matters most, while revisiting them as prognosis shifts keeps decisions aligned with evolving preferences. It’s about guiding care to fit the individual’s wishes, not waiting for a request or focusing on legal documentation. Repeated conversations also support advance care planning and prevent surprises later.