Suggested responses to specific statements by the family
| Statements by the family . | Comments . | Suggested physician responses . |
|---|---|---|
| “My dad was always a fighter.” | Families want, and need to be assured that every appropriate effort has been made to restore the health of their loved one. | “Not all fights are meant to be won. Accepting this, but recognizing that your father was a fighter, the key question is, have we done everything we could to make it possible for him to win this fight? I can assure you we have.” |
| “My dad would want us to do everything.” | “Doing everything” should be understood as doing everything that is medically appropriate. There is no obligation to provide, at the demands of family members, treatments that are medially ineffective or lacking physiological benefit. | “I can assure you that we have done everything possible to make your father better. To make sure we have not missed anything, we consulted … and did the following studies … (briefly/succinctly list major problems and efforts made to address them). Although we are not able to make him better, we will do everything possible to make sure he is comfortable and does not suffer.” |
| “I am not ready to let my husband go.” | Expressions of anticipated grief or loss at this time are normal. An effective response is one that compassionately acknowledges the emotions the family is experiencing, while suggesting some things that might help them cope with their loss. | “When you love someone as you certainly do, the time will never feel right to let him go. But I do believe there are things you can hold on to, like memories of shared experiences; the pride you both enjoyed around your children or grandchildren; or your hope in seeing him in heaven (if they have that belief).” |
| “We know that things are hopeless, but we believe a miracle will occur.” | In responding to a family that has this belief, the goal is not to present arguments that intellectually overwhelm the family. Instead, through patient and respectful discussions, the family is provided with information and fresh perspectives that they can use to reshape their thinking and understanding of the current situation. This effort begins by attempting to understand the meaning and significance of a miracle to the family (see DeLisser36 and Feudtner37 ). | “Miracles can mean different things to different people. What does a miracle mean to you? What would a miracle look like?” |
| As a subsequent or follow-up question ask: | ||
| “Assuming that a miraculous healing might not occur, are there other things that you would like to hope for? |
| Statements by the family . | Comments . | Suggested physician responses . |
|---|---|---|
| “My dad was always a fighter.” | Families want, and need to be assured that every appropriate effort has been made to restore the health of their loved one. | “Not all fights are meant to be won. Accepting this, but recognizing that your father was a fighter, the key question is, have we done everything we could to make it possible for him to win this fight? I can assure you we have.” |
| “My dad would want us to do everything.” | “Doing everything” should be understood as doing everything that is medically appropriate. There is no obligation to provide, at the demands of family members, treatments that are medially ineffective or lacking physiological benefit. | “I can assure you that we have done everything possible to make your father better. To make sure we have not missed anything, we consulted … and did the following studies … (briefly/succinctly list major problems and efforts made to address them). Although we are not able to make him better, we will do everything possible to make sure he is comfortable and does not suffer.” |
| “I am not ready to let my husband go.” | Expressions of anticipated grief or loss at this time are normal. An effective response is one that compassionately acknowledges the emotions the family is experiencing, while suggesting some things that might help them cope with their loss. | “When you love someone as you certainly do, the time will never feel right to let him go. But I do believe there are things you can hold on to, like memories of shared experiences; the pride you both enjoyed around your children or grandchildren; or your hope in seeing him in heaven (if they have that belief).” |
| “We know that things are hopeless, but we believe a miracle will occur.” | In responding to a family that has this belief, the goal is not to present arguments that intellectually overwhelm the family. Instead, through patient and respectful discussions, the family is provided with information and fresh perspectives that they can use to reshape their thinking and understanding of the current situation. This effort begins by attempting to understand the meaning and significance of a miracle to the family (see DeLisser36 and Feudtner37 ). | “Miracles can mean different things to different people. What does a miracle mean to you? What would a miracle look like?” |
| As a subsequent or follow-up question ask: | ||
| “Assuming that a miraculous healing might not occur, are there other things that you would like to hope for? |