Word choice affects a patient's perception of illness and decision-making and is particularly important when discussing death. Researchers conducted a study to characterize the way death is discussed during family meetings between parents of critically ill infants and clinicians and to explore how discussion of death differs between family members and clinicians.

The longitudinal qualitative study was conducted at a single academic hospital. Families were approached about enrollment if their infant was younger than one year of age; had a diagnosed neurologic condition; was hospitalized in the ICU; and had a planned family meeting to discuss neurologic prognosis or starting life-sustaining treatment, not starting life-sustaining treatment, or stopping life-sustaining treatment.

A total of 68 family meetings involving 36 parents of 24 infants were recorded. Death was discussed in 33 (49%) of these meetings. The words die, death, dying, and stillborn were used a total of 32 times in 406 references to death (8%) and were present in 15 of the 33 family meetings that included discussion of death (45%). Family members used these words more often than clinicians (15% versus 5% total references to death). Four types of euphemisms used to reference death were identified: medical jargon, colloquialisms, pronouns and vague nouns, and survival framing. Medical jargon was the type of euphemism most used by clinicians, whereas family members most often used colloquialisms.

The authors note that the study was conducted in a single institution, and non-English speakers were excluded. More research is needed in other settings and with other patient populations, they conclude, adding that future studies should also explore how word choice affects shared decision-making and therapeutic alliance.