An 86-Year-Old Man Is Admitted to the Intensive Care Unit

An 86-year-old man is admitted to the intensive care unit (ICU) because of multilobar pneumonia.  His ICU course was complicated by acute respiratory distress syndrome, which required him to be placed on mechanical ventilation.  He has been in the ICU for 3 days and has shown no progress despite broad spectrum antibiotic therapy.  He has also developed worsening acute kidney injury, third spacing of fluids, and persistent hypotension despite vasopressor support.  His other medical problems include stage 3 chronic kidney disease, congestive heart failure, coronary artery disease, cerebrovascular accident with mild residual right hemiparesis, and advanced prostate cancer.
The patient lives alone at home and has no advance directives on record.  He has 2 sons and 3 daughters who have arrived at the ICU and want to speak with the ICU physician.  A family meeting is arranged in an adjacent private conference room.  After every person is comfortably seated, everyone in the room, in turn, introduces themselves.  The family members look apprehensive.
Which of the following is the most appropriate response by the ICU physician?

A) Have you ever talked to your father about what his wishes would be if he became critically ill?
B) To make sure we are on the same page, can you share with me your understanding of your father's condition?
C) Your father is very sick.  We are doing everything we can to help his body recover from the infection.
D) I wish I could tell you that your father is going to pull through.
E) Some people want to hear about what I think may happen, while others do not want this information.  Which would you prefer?