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Chest. 2009 Jun;135(6):1643-1647. doi: 10.1378/chest.08-2805.

A practical approach to the family that expects a miracle.

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Department of Medicine, Pulmonary, Allergy and Critical Care Division, University of Pennsylvania School of Medicine. Electronic address:


When a patient is extremely ill and/or dying, and the family expects a miraculous recovery, this situation can be very challenging to physicians, particularly when there is certainty that the miracle will occur through divine intervention. A practical approach is therefore provided to clinicians for engaging families that anticipate the miraculous healing of a sick patient. This strategy involves exploring the meaning and significance of a miracle, providing a balanced, nonargumentative response and negotiation of patient-centered compromises, while conveying respect for patient spirituality and practicing good medicine. Such an approach, tailored to the specifics of each family, can be effective in helping a family come to a place of acceptance about the impending death of their loved one.

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