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When a family says ‘it was always going to happen’, what are they claiming?

"It was always going to happen." I hear the sentence most weeks at work. Sometimes from a daughter, sometimes from a doctor, sometimes from me.

I've started to think it means very different things in different mouths:

  • Medical inevitability. Given the disease as it was when he arrived, nothing anyone did would have changed the outcome.
  • Fate. It was true all along that he would die on that Tuesday, and so it could not have been otherwise.
  • Hindsight. Now that it has happened, it cannot un-happen.

The first is a claim about what would have happened under other treatment, and it is sometimes false. The second is the old argument about future truth fixing the future. The third is trivially true and comforts nobody once you say it out loud.

My question for people who think about this: is it a problem that we let these blur together? The blur seems to be what makes the sentence comforting. But I've also watched families discover months later that the first reading wasn't true, and the comfort turned into something much worse.

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5 answers

  1. Nadia Haddad

    Fellow

    Elin, I hear it constantly in palliative care too. My rule for myself is to say the first version only when I'm sure it's true, and to say it as the first version: "There was nothing more the treatment could have done." When I'm not sure, I don't borrow the sound of fate to cover the gap. Families can tell the difference later, even when they can't in the moment.

    Helpful · 3
  2. Alistair Gow

    Fellow

    "It was always going to happen" is very often said to protect the doctor rather than the family; I heard it plenty at the surgery. It closes the conversation. Logically it's a counterfactual claim, that under any treatment we could have given the outcome would be the same, and counterfactuals are exactly the claims that need evidence. The fatalist wording makes it sound like a claim that needs none.

  3. Titilayo Adeyemi

    Fellow

    An angle from Yoruba thought, where this sentence would be heard against the idea of orí, the destiny a person is understood to have chosen before birth. On most readings I trust, that destiny is not a fixed script: character, effort and the right ritual acts can modify how it unfolds, and philosophers here argue a great deal about how far. So "it was always going to happen" in a Yoruba mouth is usually not bare fatalism. It's closer to "this was within what was given to him", which leaves room for asking whether someone failed him.

    Helpful · 1
  4. Elin Hedqvist

    Fellow

    Titilayo, that's a helpful complication, and it's close to what I'd like the sentence to mean: room for consolation without closing the question of whether anything went wrong. Alistair's point stings, because I think he's right about who it protects.

    Helpful · 2
  5. Bilal Rashid

    Fellow

    I often hear the Muslim version, "it was written", and I'd make the same distinction Elin does. In Islamic theology, belief in divine decree has never cancelled the doctor's duty of care or the family's right to ask hard questions. It is a consolation about the meaning of what happened, not a verdict on whether the treatment was right. When people use it to stop an inquiry, they're using it against its own tradition.

    Helpful · 3