Hold the goals-of-care conversation for care in the last days of life — OSCE

Candidate brief

You have eight minutes to open a goals-of-care conversation with the family in this scenario. Explore their understanding, hopes and worries; explain the clinical recommendation in plain language; address fear of abandonment; and agree next steps including documentation and support. [1][2]

Key teaching and communication objectives

Start with listening. Ask what the family already understands and what they are most afraid of. Name the clinical situation honestly without jargon. Make a clear recommendation grounded in the child's best interests rather than asking the parents to choose from an unsupported menu. [1]

Explain that limiting non-beneficial life support is not the same as stopping care. Symptom control, presence and dignity intensify. Invite questions, allow silence, and check back for understanding. If disagreement remains, explain second opinion and ethics pathways without threatening abandonment. [1][2]

Close with a concrete plan: who will do what by when, which treatments continue, which are limited, how symptoms will be treated, how siblings will be supported, and when you will meet again. [2]

Marking domains