What strategies do you find helpful in advanced care planning with patients/families who are very "miracle" centered?

• Hope for the miracle yourself!
• Broaden: “Are there any other things you are hoping for?”
• Hope for the best, prepare for the worst: “I see how much you want a miracle. I wonder if we can talk about what we should do if this doesn’t happen.”
• Consider involving a religious leader if relevant.

I think it is important to first and foremost acknowledge their "Hope" and try to find out the 3 W's of their "miracle" wish:

WHAT: What do they mean by "miracle"? What is their past experience and what is the belief or faith behind it?

WHY: Why they think a "miracle" will happen now? Is it a convic...

I very much like Dr. @Dr. First Last's answer.

Hoping for a miracle in a poor prognosis patient by the family/patient does not give you much context, e.g., for some, a miracle would be making it to see their child's graduation in one or two months or a wedding, etc. For others, they mean I will go b...