Open the goals-of-care conversation with an adolescent with relapsed cancer and the family — OSCE

OSCE communication and shared decision-making station: opening the goals-of-care and advance care planning conversation with a sixteen-year-old with relapsed cancer and the family, addressing the concurrent disease-directed and palliative care, the prognosis, the symptom control, the place of care, and the honest and hopeful communication in plain language.

osce communication and shared decision-making2 min readVerification in progress

Prompt

A sixteen-year-old boy with relapsed osteosarcoma and his parents are in clinic to discuss the next steps. The disease-directed options are limited and carry a heavy burden, and the family has read online that he will be abandoned if they choose comfort. They are frightened and do not understand what palliative care means or whether it means giving up. Open the goals-of-care conversation and build the integrated plan with them.

Candidate brief

You have eight minutes to open the goals-of-care and advance care planning conversation with a sixteen-year-old boy with relapsed osteosarcoma and his parents. The disease-directed options are limited and burdensome, and the family is frightened that palliative care means giving up. Use a structured, honest, empathic approach that reframes palliative care, explores the family's understanding and their hopes and worries, addresses the fear of abandonment, and builds a shared plan that integrates the disease-directed and the palliative care. [1][2]

Paediatrics Fellowship Pro

You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.

References2Show ledger

[1]Snaman JM, McCarthy S, Wiener L, et al. Pediatric Palliative Care in Oncology. J Clin Oncol, 2020.PMID 32023163
[2]Radbruch L, De Lima L, Knaul F, et al. Redefining Palliative Care-A New Consensus-Based Definition. J Pain Symptom Manage, 2020.PMID 32387576