A family requests aggressive, life-sustaining treatment for a terminally ill elderly relative, despite a medical consensus that palliative care is the most compassionate option. How do you approach this discussion with the family?

Where answers to this question lose points

Our scorer marks every answer on three parts. For each of the 49 applicants who finished this question on Confetto, we took their first scored answer and counted the part that scored lowest.

• Structure: a clear order and a clear point25 of 49

Confetto data as of November 8, 2026. A part is shown only when 20 or more applicants share it. Answers where two parts tied are not counted toward either. We never show anyone's answers or details.

What this question tests

• Communication
• Patient care
• Medical ethics

How to structure your answer

1. Ask questions (25 seconds). Open by saying you would ask the family what they understand about the illness, what they hope aggressive treatment will achieve, and what the patient would have wanted. The answer explores their perspective privately and sensitively before explaining the medical situation or recommending a direction.
2. Who is affected (20 seconds). Put the terminally ill patient first, focusing on potential suffering, comfort, dignity, and previously expressed wishes. Then describe the family's grief, hopes, and possible cultural or religious beliefs, alongside the medical team's responsibility to explain the prognosis and provide compassionate guidance.
3. The conflict (20 seconds). The conflict is between the family's wish to continue life-sustaining treatment and the medical team's concern that this would prolong suffering rather than benefit the patient. The answer tries to respect the family's emotions while keeping the patient's interests and wishes central.
4. Options (40 seconds). The answer contrasts continued aggressive treatment, which may add suffering without changing the terminal prognosis, with palliative care, which prioritizes comfort but may feel like giving up to the family. It also suggests additional support if disagreement persists, recognizing that the family may need more time to process the situation.
5. Choose (30 seconds). The answer favors guiding the family toward palliative care because the medical consensus is that comfort, dignity, and quality time best serve the patient. It makes that recommendation through listening, clear explanations, and discussion of the patient's wishes rather than dismissing the family's request.
6. What next (20 seconds). If the family remains insistent, the answer proposes involving a chaplain, social worker, or ethics committee for additional support and perspective. It also commits to ongoing compassionate guidance, giving the family time to absorb the information rather than expecting one conversation to resolve everything.

Example answer from Confetto

Example answer from Confetto. Not a real applicant's answer.

My immediate thought is that this family is likely struggling with grief and the difficulty of letting go, which makes this an emotionally charged situation requiring tremendous sensitivity. I recognize that behind their request for aggressive treatment is probably love, fear, and perhaps cultural or religious beliefs about end-of-life care that I need to understand and respect.

I would start by asking to meet with the family in a private, comfortable setting where we can have an uninterrupted conversation. My first priority would be listening - I'd ask them to share what their loved one meant to them and what they're hoping to achieve with continued aggressive care. I believe understanding their perspective is crucial before I can effectively communicate the medical reality.

I would then gently explore their understanding of the current medical situation. Sometimes families haven't fully grasped the severity of the condition or what "aggressive treatment" actually entails in terms of potential suffering. I'd explain in clear, compassionate language what the medical team sees happening and what we anticipate will occur with different treatment approaches.

What matters most to me is ensuring this family feels heard and supported while also advocating for what's truly in the patient's best interest. I would emphasize that palliative care isn't about giving up - it's about focusing on comfort, dignity, and quality time together. I'd ask if they know what their loved one would have wanted in this situation, as that can sometimes help families process their decision.

If they remain insistent on aggressive care, I wouldn't dismiss their feelings. Instead, I'd suggest involving a chaplain, social worker, or ethics committee to provide additional support and perspective. I believe families need time to process this information, and my role is to provide ongoing compassionate guidance while respecting their autonomy in this incredibly difficult decision.

Use it for its structure. Interviewers can tell a memorized script, so tell your own story.

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