Family meeting
Formal Definition
A structured clinical discussion involving the patient's family members (and/or surrogate decision-makers), the attending physician, and often multidisciplinary team members (nursing, social work, chaplaincy), to discuss goals of care, prognosis, treatment options, and end-of-life decision-making; requires preparation, a private setting, and sufficient time to allow for questions and emotional processing.
How It's Used on the Ward
Family meeting or family discussion or family conference — gathering the family in a quiet room to talk about a seriously ill patient's prognosis and what they would want done if things go badly.
Example
"Family meeting: daughter and son of 82-year-old with metastatic lung cancer, now hypoxic and declining on 100% O2. Sitting with the attending, bedside nurse, social worker. Attending presents prognosis — cancer is not curable, ICU transfer would mean being on machines but not getting better. Asks what their mother told them about what she would want. Family decides on comfort measures only."
Clinical Context
SPIKES framework adapted for family meetings: Setting (private room, no interruptions, all key people present), Perception (what does the family understand?), Invitation (are they ready for a serious conversation?), Knowledge (deliver prognosis clearly), Empathy (acknowledge emotion), Strategy/Summary (next steps). Preparation: review case, know prognosis, have recommendation ready, coordinate multidisciplinary team. Common errors: having the meeting in the hallway, delivering prognosis in medical jargon, being vague about time frames, not asking about patient's stated wishes. Document: who was present, what was discussed, what decisions were made.