In Reply We thank Drs Barot and Yu for their comments regarding the complex factors contributing to goals-of-care conversations. They are correct that in our study1 we were not able to quantify discussions hospital chaplains may have had with families outside of conferences that included clinicians. The primary observation remains that clinicians rarely discussed spiritual concerns with families of critically ill patients, even when families seemed to raise such concerns.
Ernecoff NC, Curlin FA, White DB. Spiritual Care Providers and Goals-of-Care Discussions—Reply. JAMA Intern Med. 2016;176(2):279. doi:10.1001/jamainternmed.2015.7893