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. 2020 Apr 1;3(4):e201945. doi: 10.1001/jamanetworkopen.2020.1945

Table 1. Intensivist Responses to the Question “What do you think is most likely to happen?”.

Response type Quotation
Direct (28 words, 12 s) “I think the most likely thing, which doesn’t mean it’s the certain thing, I think the most likely thing is that he’s not going to survive this hospitalization.”
Indirect by describing other patients (17 words, 8 s) “Many people like your father that we’ve cared for, they do not survive this type of illness.”
Indirect by describing physiological condition (133 words, 45 s) “What I’m very concerned about is given the amount of oxygen that he requires on the mechanical ventilator… I mean, if his oxygen requirements continue to go up and up and up and the antibiotics don’t kick in, ...given his age... given his medical history, there is certainly a possibility that ultimately we may get to a point where the mechanical ventilator is not able to deliver the amount of oxygen required for him to keep his organs going. And these are just things that... we are not there yet; however, every single day, I’m going to be reassessing him, so I’m really concerned that he might not... we might not be able to deliver the amount of support to keep his organs alive and they may just continue to shut down.”
Redirection (148 words, 52 s) “So, some of it is... and you know... in no way do we need to make any decisions today, but there is a likelihood that there is a significant possibility that we’ll be in a place where we might have to have some tough conversations and make some tough decisions, okay? And some of that goes to... you know... our job, since he can’t speak for himself since you’re his next of kin... his closest family member, is to try and make the decision that he would make if he could speak for himself, which is oftentimes hard because that’s not always the decision that we want to make as the loved one, you know? My experience is we want to hold on, but the question isn’t that. The question is would he want that? And some of that centers around what did he consider quality of life?”