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Ethicolegal
ethics
cultural competence
A 68-year-old woman with widely metastatic pancreatic adenocarcinoma, for whom palliative care is the primary focus, attends her regular oncology clinic appointment accompanied by her adult son and daughter. During the discussion about her declining functional status and potential future medical interventions, the oncologist broaches the topic of resuscitation preferences. When asked about a 'Do Not Resuscitate' (DNR) order, the patient, looking to her children, states softly, 'Whatever God wills,' while her son adds, 'We just want her to be comfortable and not suffer.' The daughter nods in agreement, maintaining eye contact with the physician but remaining silent. The family consistently avoids direct affirmation or denial regarding aggressive life-sustaining measures, often deferring with phrases like 'We trust the doctors to do what's best' or 'We need to pray on it.' The physician recognizes this as a potentially indirect communication style regarding end-of-life decisions in a healthcare context. Which of the following is the most appropriate next step for the physician to take in navigating this sensitive discussion?
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