You are the physician caring for Mrs. Miller, who has been declared brain dead and would be an excellent organ donor. When you ask her husband and son for consent, they strongly object. What would you do?

Where answers to this question lose points

Our scorer marks every answer on three parts. For each of the 115 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 point48 of 115
• Content: covering what the question needs29 of 115

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

• Ethics
• Patient care

How to structure your answer

1. Ask questions (25 seconds). Open by saying you would ask Mr. Miller and his son why they object and what they understand about brain death and organ donation. The answer explores possible religious or cultural beliefs, misconceptions, and difficulty processing their loss before deciding how to respond.
2. Who is affected (20 seconds). Mrs. Miller comes first, with respect for her dignity after death central to the answer. Her husband and son face profound grief, potential recipients could lose a lifesaving opportunity, and the healthcare team's approach could affect public trust in organ donation.
3. The conflict (20 seconds). The conflict is between the opportunity to save other patients' lives through organ donation and respecting the family's grief and objections. The answer recognizes that pursuing donation too forcefully could deepen their distress and damage trust in the medical system.
4. Options (40 seconds). The answer considers a private, compassionate discussion that addresses misconceptions and explains donation's potential benefits, while recognizing that persuasion can become pressure. It contrasts accepting continued refusal, which loses a chance to help recipients, with forcing the issue, which risks additional trauma and damaged trust.
5. Choose (30 seconds). The answer chooses to listen, explain brain death and donation accurately, and discuss potential benefits without pressuring the family. If their objection persists, it would respect their decision because forcing the issue could compound their grief and undermine trust.
6. What next (20 seconds). The answer would document the conversations and the family's reasons for refusing donation. It would also ensure access to grief counseling and spiritual support if desired, maintaining compassionate care for the family even when donation does not proceed.

Example answer from Confetto

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

I recognize this is an incredibly sensitive situation that requires balancing the potential to save multiple lives through organ donation with the profound grief and wishes of Mrs. Miller's family. My first priority would be to acknowledge their loss and provide space for their emotional response.

I believe the key is to understand why the family is objecting. I would work with the healthcare team to arrange a quiet, private conversation with Mr. Miller and his son to listen to their concerns. Perhaps they have religious or cultural beliefs about organ donation, or maybe they're struggling with the suddenness of their loss and aren't ready to make this decision. I would ensure they have accurate information about brain death and what organ donation entails, as misconceptions are common.

I think it's important to share, compassionately, how organ donation can bring meaning to their loss and help other families avoid similar grief. I would mention that many donor families find comfort in knowing their loved one helped save others. However, I would be careful not to pressure them, as this could damage trust and cause additional trauma.

If the family maintains their objection after these discussions, I would respect their decision while documenting our conversations and their reasoning. While it's disappointing to lose the opportunity to help other patients, I believe forcing the issue against the family's wishes could harm public trust in the medical system and potentially discourage others from considering organ donation in the future.

Throughout this process, I would ensure the family has access to grief counseling and spiritual support if desired. This situation reminds me that in medicine, we must balance clinical opportunities with human emotions and family dynamics, always maintaining respect for both the deceased and their loved ones.

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

Keep going

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