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Goals of Care: Family Conflict

Mediate a goals of care discussion with the healthcare proxy who is torn between his mother's wishes and his sister's demands.

  1. 1
    Briefing
  2. 2
    Simulation
  3. 3
    Feedback

How This Works

This is an interactive phone call simulation. You'll speak with David in a realistic clinical communication scenario.

1. Start Call

Click "Start Call" when you're ready. Speak naturally as you would on a real call.

2. Have the Conversation

10 minutes to complete the call. The AI responds in real-time to what you say.

3. Get Feedback

End the call when finished. You'll receive AI-powered feedback on your communication.

💡 Tip: Speak clearly and at a natural pace. If you need a moment to think, it's okay to pause briefly - just as you would in a real conversation.

Briefing Details

1. Learning: Mediating Family Conflict

Purpose of this Scenario

Goals of care conversations are often complicated by family dynamics. Disagreements can arise from differing interpretations of the patient's wishes, guilt, or long-standing family tensions. Your role as the physician is not to take sides, but to act as a neutral mediator, constantly redirecting the conversation back to one central question: "What would the patient have wanted?"

Key skills include:

  • Actively listening to and validating each family member's perspective and emotions.
  • Identifying the legal healthcare proxy.
  • Building consensus by appealing to shared love for the patient.
  • Depersonalizing the decision by focusing on honoring the patient's previously expressed wishes.

2. Scenario Briefing: The Conflicted Family

Your Objective

You are the ICU physician. Your goal is to lead a family meeting with David, the son of your 78-year-old patient who has suffered a devastating stroke. David is struggling because his sister, who is not present at this exact moment, disagrees strongly with him about the plan of care. You must help David navigate this conflict while focusing on his mother's likely wishes.

Patient & Family Background

Your patient is a 78-year-old woman who suffered a massive stroke. She is unresponsive with a grim prognosis for any meaningful neurologic recovery. Her son, David (the healthcare proxy), has been by her side and seems to understand the situation. However, his sister, Susan, just flew in from out of state and is overcome with guilt and grief, insisting that they "do everything."

Crucial Information: You will be speaking with David alone, but he will constantly bring up his sister's conflicting demands. Your challenge is to help him make a decision based on his mother's wishes, not his sister's guilt.

Key Medical Facts

  • Diagnosis: Massive ischemic stroke of the left middle cerebral artery.
  • Current Status: Unresponsive, on a ventilator (for airway protection), and receiving nutrition through a feeding tube.
  • Prognosis: Neurologists have confirmed she has virtually no chance of returning to a state where she could interact with her family or have any quality of life. She will likely remain in a vegetative state.

Learning Objectives

Optional prep details

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Optional Pre-Call Knowledge Check

Optional self-check before you start

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This scenario requires an account. Sign in to begin the simulation.

After completing this scenario, you will be able to:

  • Mediate a conflict between family members with differing views on goals of care.
  • Re-center a conversation on the patient's known wishes when family conflict arises.
  • Identify the roles and legal responsibilities of a designated healthcare proxy.

In a goals of care discussion, what is the primary legal and ethical responsibility of the designated healthcare proxy?

When family members are in conflict during a goals of care meeting, what is the most appropriate role for the physician?

A useful conflict resolution technique is 'reframing'. Which of the following best describes this technique in a family meeting?