Goals of Care Discussion

In this scenario, a daughter brings her elderly father to the hospital because of respiratory distress. The patient has a history of advanced lung cancer, appears frail and very ill, and is in the emergency department requiring BIPAP for respiratory support. The learner must take the role of the emergency room physician and engage the patient’s daughter in a goals of care discussion. During the discussion, the daughter exhibits a number of emotional reactions and transitions from very anxious to comforted as the learner successfully empathizes with her using good communication skills.

Learning Objectives

– Assess the family’s understanding of the patient’s medical condition
– Deliver bad news with empathy to the patient and family
– Engage the family with a goals of care discussion and make recommendations in line with the values they expressed