This scenario presents a professional challenge due to the inherent complexity of advanced cellular therapies, the rapid evolution of evidence, and the ethical imperative to provide the most beneficial and least harmful treatment to patients with relapsed or refractory hematological malignancies. The physician must navigate a landscape where definitive, long-term data may be limited, and treatment decisions carry significant risks and potential benefits. Careful judgment is required to balance emerging evidence with established clinical practice and individual patient factors. The best professional practice involves a systematic and comprehensive evaluation of all available high-quality evidence, prioritizing randomized controlled trials (RCTs) and robust meta-analyses, while also considering well-designed observational studies and expert consensus guidelines when RCT data is scarce or inapplicable. This approach necessitates a critical appraisal of study design, patient populations, endpoints, and potential biases. The physician should then integrate this synthesized evidence with the patient’s specific clinical profile, including disease characteristics, performance status, comorbidities, and personal values, to construct a personalized treatment pathway. This aligns with ethical principles of beneficence and non-maleficence, ensuring that treatment decisions are informed by the best available scientific understanding and tailored to the individual’s needs and circumstances, thereby maximizing potential benefit while minimizing harm. An incorrect approach would be to solely rely on anecdotal evidence or the latest published case series without critically appraising their methodological rigor or generalizability. This fails to uphold the principle of evidence-based medicine, potentially exposing patients to unproven or suboptimal treatments based on limited or biased observations. Such a practice could lead to significant harm if the treatment is ineffective or carries unforeseen toxicities, violating the duty of care. Another professionally unacceptable approach is to exclusively adhere to older, established treatment protocols without considering newer, potentially superior evidence that has emerged. While established protocols provide a baseline of safety and efficacy, failing to incorporate advancements can result in patients not receiving the most effective or least toxic therapies available, thereby not fully acting in the patient’s best interest. This can be seen as a failure to stay current with medical knowledge and a missed opportunity to improve patient outcomes. Furthermore, making treatment decisions based primarily on the availability of a particular therapy within a specific institution, without a thorough external evidence review and consideration of alternative options, is ethically problematic. This prioritizes logistical convenience over optimal patient care and may lead to suboptimal treatment choices. The professional reasoning framework for such situations should involve a structured approach: first, conducting a thorough literature search using reputable databases and adhering to established guidelines for evidence synthesis (e.g., GRADE methodology). Second, critically appraising the quality and relevance of the identified evidence. Third, engaging in shared decision-making with the patient and their family, transparently discussing the evidence, potential benefits, risks, uncertainties, and alternatives. Fourth, formulating a personalized treatment plan that reflects the synthesized evidence and the patient’s unique circumstances and preferences. Finally, continuous monitoring of treatment response and toxicity, with a willingness to adapt the plan as new information or clinical changes arise.

Scenario Analysis: This scenario presents a professional challenge due to the inherent tension between a patient’s autonomy and the physician’s duty of care, particularly when a patient’s decision-making capacity is in question. The fellowship exit examination requires demonstrating a nuanced understanding of how to navigate such complex ethical and clinical situations, ensuring patient well-being while respecting their rights. The challenge lies in accurately assessing capacity, communicating effectively, and adhering to established medical and ethical guidelines without resorting to paternalism or abandoning the patient. Correct Approach Analysis: The best professional practice involves a comprehensive and systematic assessment of the patient’s decision-making capacity. This approach prioritizes understanding the patient’s specific condition and its impact on their ability to comprehend information, appreciate the consequences of their choices, and communicate a reasoned choice. It requires a thorough clinical evaluation, potentially involving consultation with specialists if capacity is borderline or complex. The physician must engage in open and empathetic communication, explaining the diagnosis, prognosis, and treatment options in a manner the patient can understand, and exploring the patient’s values and preferences. This approach aligns with the fundamental ethical principles of autonomy and beneficence, and is supported by general medical ethical guidelines that mandate capacity assessment before overriding a patient’s expressed wishes. It ensures that any decision made is in the patient’s best interest and respects their dignity. Incorrect Approaches Analysis: Proceeding with a treatment against the patient’s expressed wishes without a formal capacity assessment is ethically and regulatorily unacceptable. This approach disregards the principle of patient autonomy and risks violating the patient’s rights. It assumes a lack of capacity without due diligence, which can lead to unnecessary interventions and erode patient trust. Assuming the patient lacks capacity solely based on their diagnosis or a single instance of disagreement is a significant ethical failure. Capacity is not a global trait but is specific to the decision at hand. This approach is paternalistic and fails to uphold the patient’s right to self-determination. It also overlooks the possibility that the patient may have valid reasons for their refusal that are not immediately apparent. Delaying necessary medical intervention indefinitely due to a perceived lack of capacity without actively pursuing a capacity assessment and exploring alternative communication strategies is also professionally problematic. While caution is warranted, prolonged inaction can lead to deterioration of the patient’s condition, violating the physician’s duty of beneficence. This approach fails to balance the need for caution with the imperative to provide appropriate care. Professional Reasoning: Professionals should approach such situations by first recognizing the potential for conflict between patient autonomy and medical recommendations. The initial step is always to assess the patient’s decision-making capacity for the specific decision at hand. This involves understanding the patient’s condition, the nature of the decision, and the potential outcomes. If capacity is present, the patient’s wishes, even if contrary to medical advice, must be respected, with appropriate counseling and exploration of alternatives. If capacity is questionable or absent, a formal assessment process, potentially involving multidisciplinary input, should be initiated. Throughout this process, clear, empathetic, and patient-centered communication is paramount, ensuring the patient feels heard and understood, regardless of the outcome of the capacity assessment. Documentation of the assessment process and the rationale for decisions is crucial.

This scenario is professionally challenging due to the inherent complexity of diagnosing rare hematological disorders and the potential for misinterpretation of imaging findings, which can lead to delayed or incorrect treatment. The need for precise diagnostic reasoning, judicious imaging selection, and accurate interpretation requires a systematic, evidence-based approach that prioritizes patient safety and adherence to established clinical guidelines. The best professional practice involves a multi-modal diagnostic strategy that integrates clinical presentation, laboratory findings, and targeted imaging. This approach begins with a thorough clinical assessment and initial laboratory workup to narrow down the differential diagnosis. Subsequently, imaging modalities are selected based on the most likely underlying pathology, guided by established diagnostic pathways for suspected hematological malignancies or infiltrative processes. Interpretation of these images must be performed by experienced radiologists in conjunction with hematologists, cross-referencing findings with histopathology and molecular diagnostics where appropriate. This systematic integration ensures that imaging serves as a confirmatory or exclusionary tool within a comprehensive diagnostic framework, aligning with best practices in medical diagnostics and patient care. An incorrect approach would be to rely solely on a single imaging modality without considering the broader clinical context or differential diagnoses. This could lead to over-reliance on potentially non-specific findings or missing crucial information that other imaging techniques might reveal. Another professionally unacceptable approach is to proceed with invasive procedures or treatment based on preliminary or unconfirmed imaging interpretations without adequate correlation with other diagnostic data. This bypasses essential steps in diagnostic reasoning and can result in iatrogenic harm or inappropriate therapeutic interventions. Furthermore, selecting imaging based on availability or cost without considering diagnostic yield for the specific clinical suspicion is ethically questionable and professionally unsound, as it compromises the quality of care and patient outcomes. Professionals should employ a decision-making framework that emphasizes a hierarchical approach to diagnosis. This involves starting with the least invasive and most informative diagnostic steps, progressively escalating to more complex or invasive investigations only when necessary. Continuous critical evaluation of findings, consultation with multidisciplinary teams, and adherence to evidence-based guidelines are paramount. This ensures that diagnostic reasoning is robust, imaging selection is optimized for diagnostic yield, and interpretations are integrated into a coherent diagnostic and management plan.

Scenario Analysis: This scenario is professionally challenging because it requires a fellow to navigate the precise criteria for eligibility for a high-stakes exit examination. Misinterpreting these criteria can lead to significant professional setbacks, including delayed career progression and the need to repeat training or examination processes. The challenge lies in understanding the nuanced interplay between completed training, documented experience, and the specific objectives of the fellowship program as defined by the Nordic medical authorities overseeing hematology and cellular therapy. Careful judgment is required to ensure adherence to the established framework without overstepping or undershooting the defined requirements. Correct Approach Analysis: The best professional practice involves a thorough and direct review of the official documentation outlining the purpose and eligibility for the Comprehensive Nordic Medical Hematology and Cellular Therapy Fellowship Exit Examination. This documentation, established by the relevant Nordic medical regulatory bodies, will explicitly detail the criteria that a fellow must meet. This approach is correct because it relies on the authoritative source of truth, ensuring that all decisions are grounded in the established regulatory framework. Adhering strictly to these documented requirements guarantees that the fellow is meeting the objective standards set for program completion and professional certification within the Nordic region. Incorrect Approaches Analysis: Relying solely on informal discussions with peers or senior colleagues, without cross-referencing official guidelines, presents a significant risk. While peer advice can offer insights, it may be incomplete, outdated, or based on individual interpretations that do not align with the formal regulatory requirements. This approach fails to ensure compliance with the precise eligibility criteria, potentially leading to a fellow being deemed ineligible at a critical juncture. Assuming eligibility based on the successful completion of all fellowship rotations and coursework, without verifying specific examination prerequisites, is another flawed approach. While comprehensive training is a foundational element, the exit examination often has distinct, additional requirements such as specific case log submissions, supervisor attestations, or a minimum period of supervised practice post-fellowship, as stipulated by the Nordic authorities. Overlooking these specific mandates constitutes a failure to meet the full scope of eligibility. Interpreting the purpose of the examination as a general assessment of knowledge rather than a formal gateway to certification, and therefore believing that any demonstrable proficiency is sufficient, is also incorrect. The exit examination serves a defined regulatory purpose within the Nordic medical system, acting as a gatekeeper for advanced practice. A broad interpretation disregards the specific, often stringent, criteria established by the governing bodies to ensure a standardized level of competence for specialists in hematology and cellular therapy. Professional Reasoning: Professionals facing such situations should adopt a systematic approach. First, identify the authoritative source of information regarding the fellowship and its exit examination – this will be the official guidelines or regulations published by the relevant Nordic medical authority. Second, meticulously read and understand all stated requirements for eligibility, paying close attention to any nuances or specific documentation needed. Third, if any aspect remains unclear, seek clarification directly from the fellowship program administrators or the regulatory body itself, rather than relying on informal channels. Finally, ensure all personal documentation and experience align precisely with these verified requirements before proceeding with any application or assumption of eligibility.

The review process indicates a need to assess understanding of the fellowship’s blueprint, scoring, and retake policies, particularly in the context of a candidate who has not met the expected standards. This scenario is professionally challenging because it requires balancing the need for rigorous evaluation and maintaining high standards of medical practice with the ethical considerations of supporting a trainee’s development and providing fair opportunities. The fellowship program must adhere to its established policies to ensure consistency, fairness, and ultimately, patient safety. The best professional approach involves a thorough review of the candidate’s performance against the established blueprint and scoring criteria, followed by a formal discussion of the results and the specific areas requiring improvement. This approach is correct because it directly aligns with the principles of transparent and objective assessment, which are fundamental to any reputable fellowship program. Adherence to the blueprint ensures that evaluation is comprehensive and covers all essential competencies. Clear communication of results and specific feedback empowers the candidate to understand their deficiencies and develop a targeted remediation plan. This process upholds the ethical obligation to provide constructive feedback and support for professional growth while also ensuring that only those who meet the required standards progress, thereby safeguarding patient care. The fellowship’s retake policy, when applied after a clear and documented process of assessment and feedback, provides a structured pathway for remediation and re-evaluation. An incorrect approach would be to allow a retake without a clear, documented assessment of the initial failure against the blueprint and without providing specific, actionable feedback. This fails to uphold the integrity of the assessment process. The blueprint exists to define the expected standards, and bypassing a thorough review of performance against it undermines the validity of the entire evaluation. Furthermore, failing to provide specific feedback leaves the candidate without the necessary guidance to improve, making a subsequent attempt less likely to be successful and potentially leading to a cycle of repeated failures without genuine progress. This also raises ethical concerns about fairness and due process. Another incorrect approach would be to immediately dismiss the candidate without offering any opportunity for remediation or a retake, even if the policy allows for it under certain circumstances. While maintaining standards is crucial, a fellowship program also has a professional responsibility to support its trainees. A complete lack of recourse, especially if the initial assessment was not thoroughly communicated or if there were extenuating circumstances, can be seen as overly punitive and not in line with the developmental goals of a fellowship. This approach neglects the ethical imperative to provide opportunities for improvement and can be perceived as unfair. A final incorrect approach would be to modify the scoring or blueprint criteria retroactively to accommodate the candidate’s performance. This fundamentally compromises the integrity of the assessment process. The blueprint and scoring mechanisms are established to provide an objective and consistent measure of competency. Altering them after the fact to fit a particular outcome invalidates the entire evaluation system, erodes trust in the program, and sets a dangerous precedent for future assessments. It fails to uphold the principles of fairness and transparency, as it suggests that the standards are not fixed and can be manipulated. Professionals should approach such situations by first consulting the fellowship’s established policies regarding assessment, scoring, and retakes. They should then meticulously document the candidate’s performance against the blueprint. Following this, a transparent and constructive feedback session should be conducted, clearly outlining areas of deficiency and the rationale based on the blueprint. The decision regarding remediation and retakes should then be made in strict accordance with the documented policies, ensuring fairness and consistency for all candidates.

Scenario Analysis: Preparing for a high-stakes fellowship exit examination requires a strategic and comprehensive approach. The challenge lies in balancing the breadth of knowledge expected in a specialized field like Nordic Medical Hematology and Cellular Therapy with the need for efficient and effective study methods. Fellows must not only master complex scientific concepts but also understand the practical application and ethical considerations relevant to their practice, all within a defined timeline. The pressure to perform well can lead to suboptimal study habits if not managed carefully. Correct Approach Analysis: The best approach involves a structured, multi-modal preparation strategy that integrates foundational knowledge review with application-based learning and simulated exam conditions. This includes dedicating specific blocks of time for reviewing core textbooks and seminal research papers, actively engaging with case studies and clinical guidelines relevant to Nordic healthcare systems, and participating in mock examinations with peer feedback. This method is correct because it aligns with best practices in adult learning and professional development, ensuring a deep understanding of both theoretical principles and their practical, context-specific application. It addresses the need for comprehensive knowledge acquisition while also honing exam-taking skills and identifying areas requiring further attention, thereby maximizing preparedness and confidence. Incorrect Approaches Analysis: One incorrect approach focuses solely on memorizing facts from a single, comprehensive review book without engaging in active recall or application. This fails to develop critical thinking skills necessary for exam questions that require synthesis and problem-solving. It also neglects the importance of understanding the nuances of Nordic medical practice and ethical guidelines, which are crucial for a specialized fellowship. Another ineffective approach is to rely exclusively on attending lectures and passively absorbing information without independent study or practice. This method lacks the active engagement required for long-term retention and the development of analytical skills. It also fails to simulate the independent problem-solving demanded by an exit examination. A final suboptimal approach is to cram extensively in the final weeks before the exam, neglecting consistent, spaced learning throughout the fellowship. This leads to superficial understanding and increased stress, making it difficult to retain information or perform optimally under pressure. It also bypasses the opportunity to identify knowledge gaps early and address them systematically. Professional Reasoning: Professionals should approach exam preparation with a plan that prioritizes understanding over rote memorization. This involves identifying key learning objectives, allocating sufficient time for each topic, and employing active learning techniques. Regular self-assessment through practice questions and case discussions is vital for gauging progress and refining study strategies. Seeking feedback from mentors and peers can also provide valuable insights and support. The goal is to build a robust and integrated knowledge base that can be effectively applied in a clinical and examination setting.

This scenario presents a professional challenge due to the inherent complexity of integrating foundational biomedical sciences with clinical medicine in a fellowship exit examination. The difficulty lies in assessing a candidate’s ability to not just recall scientific facts, but to apply them judiciously in a clinical context, demonstrating critical thinking and ethical awareness. The fellowship’s focus on Nordic Medical Hematology and Cellular Therapy implies a need for understanding specific regional guidelines and best practices, which may differ from global standards. Careful judgment is required to differentiate between superficial knowledge and deep, integrated understanding that informs safe and effective patient care. The best approach involves a comprehensive evaluation of the candidate’s understanding of the underlying biological mechanisms of a specific hematological or cellular therapy condition and how this knowledge directly informs diagnostic strategies, treatment selection, and patient management. This includes assessing their ability to interpret complex scientific data (e.g., genomic profiles, cellular assays) and translate it into actionable clinical decisions, while also considering patient-specific factors and ethical implications. This approach is correct because it directly assesses the core competency of the fellowship: the integration of advanced biomedical science with clinical practice, ensuring the candidate can function as a competent and ethical specialist. It aligns with the principles of evidence-based medicine and the ethical obligation to provide patient-centered care, grounded in a thorough scientific understanding. An approach that focuses solely on the clinical presentation and management of a hematological disorder without delving into the underlying biomedical science fails to assess the fellowship’s core objective. This is ethically problematic as it suggests a superficial understanding that might lead to suboptimal treatment choices if the underlying pathology is not fully grasped. An approach that prioritizes the theoretical aspects of cellular therapy mechanisms without linking them to practical clinical application or patient outcomes is also flawed. While scientific understanding is crucial, its ultimate value in a clinical fellowship lies in its translation to patient benefit, making this approach incomplete and potentially less effective in preparing a physician for real-world practice. An approach that relies on memorization of treatment protocols without demonstrating an understanding of the scientific rationale behind them is insufficient. This can lead to rigid adherence to guidelines without the ability to adapt treatment in complex or atypical cases, potentially compromising patient safety and care quality. Professionals should employ a decision-making framework that prioritizes the integration of scientific knowledge with clinical application. This involves actively seeking to understand the “why” behind clinical decisions, constantly linking observed phenomena to underlying biological processes, and critically evaluating how scientific advancements can be ethically and effectively translated into improved patient care. This requires continuous learning, critical appraisal of evidence, and a commitment to patient well-being.

Scenario Analysis: This scenario presents a professional challenge due to the inherent tension between a patient’s autonomy and the physician’s duty of care, particularly when a patient’s decision-making capacity is in question. The fellowship exit examination requires demonstrating a nuanced understanding of how to navigate such complex ethical and legal situations, ensuring patient rights are upheld while also safeguarding their well-being. The challenge lies in accurately assessing capacity and responding appropriately without overstepping boundaries or abandoning the patient. Correct Approach Analysis: The best professional practice involves a systematic and documented assessment of the patient’s decision-making capacity. This approach prioritizes understanding the patient’s specific condition and its impact on their ability to comprehend the proposed treatment, appreciate the consequences of their choices, and communicate a reasoned decision. If capacity is found to be impaired, the next step is to involve the patient’s legally authorized representative or follow established protocols for surrogate decision-making, always in the patient’s best interest. This aligns with fundamental ethical principles of respect for autonomy and beneficence, and is supported by legal frameworks that mandate capacity assessment before proceeding with or withholding treatment. The process ensures that decisions are made with informed consent or, in its absence, with appropriate surrogate input, respecting the patient’s values and preferences as much as possible. Incorrect Approaches Analysis: Proceeding with treatment against a patient’s expressed wishes without a formal capacity assessment is a significant ethical and regulatory failure. It disregards the principle of patient autonomy and could constitute battery. Similarly, immediately assuming a patient lacks capacity based on a diagnosis alone, without a proper assessment, is discriminatory and violates their right to self-determination. This premature judgment can lead to unnecessary interventions or denial of desired care. Deciding to unilaterally override a patient’s decision without exploring the underlying reasons or involving appropriate support structures also fails to uphold ethical obligations. It bypasses the crucial steps of communication, understanding, and collaborative decision-making, potentially leading to a breakdown in the patient-physician relationship and a failure to act in the patient’s best interest by ignoring their expressed desires or values. Professional Reasoning: Professionals facing such situations should adopt a structured decision-making process. First, always assume capacity unless there is clear evidence to the contrary. Second, if capacity is questioned, conduct a thorough, documented assessment tailored to the specific decision at hand. This assessment should evaluate the patient’s ability to understand information, appreciate its relevance to their situation, reason through options, and communicate a choice. Third, if capacity is found to be impaired, identify and involve the appropriate surrogate decision-maker or follow institutional/legal guidelines for substitute decision-making, always prioritizing the patient’s known wishes and best interests. Fourth, maintain open communication with the patient and their representatives throughout the process, even when capacity is compromised.

This scenario presents a professional challenge due to the inherent complexity of managing patients with hematological malignancies, which often involve chronic conditions requiring long-term, multi-faceted care, alongside acute exacerbations and the need for proactive preventive strategies. The physician must balance immediate treatment needs with the patient’s overall well-being, quality of life, and adherence to established best practices, all within the framework of Nordic healthcare regulations and ethical guidelines for patient care. Careful judgment is required to integrate evidence-based protocols with individual patient circumstances. The best professional practice involves a comprehensive, individualized approach that integrates current evidence-based guidelines for acute management, chronic disease monitoring, and preventive interventions, while actively involving the patient in shared decision-making. This approach prioritizes the patient’s specific diagnosis, disease stage, comorbidities, and personal values. It ensures that treatment plans are not only clinically sound but also aligned with the patient’s goals and preferences, fostering adherence and improving outcomes. This aligns with the ethical principles of beneficence, non-maleficence, and patient autonomy, as well as the regulatory emphasis on providing high-quality, patient-centered care within the Nordic healthcare system. An approach that solely focuses on treating acute symptoms without adequately addressing the underlying chronic disease management or implementing appropriate preventive measures fails to provide holistic care. This can lead to suboptimal long-term outcomes, increased risk of complications, and a diminished quality of life for the patient. Ethically, it neglects the duty to provide comprehensive care and can be seen as a failure to uphold the principle of beneficence. Another unacceptable approach is to rigidly adhere to a single treatment protocol without considering the patient’s individual response, comorbidities, or evolving disease status. This can result in overtreatment or undertreatment, potentially causing harm and failing to optimize the patient’s care. It disregards the principle of individualized care and can lead to adverse events, violating the duty of non-maleficence. Furthermore, an approach that neglects patient education and shared decision-making, instead imposing a treatment plan without patient input, undermines patient autonomy. This can lead to poor adherence, patient dissatisfaction, and a breakdown in the therapeutic relationship. It fails to recognize the patient as an active participant in their own healthcare journey, which is a cornerstone of ethical medical practice. Professionals should employ a structured decision-making process that begins with a thorough assessment of the patient’s condition, including their acute needs, chronic disease status, and risk factors for complications. This should be followed by a review of the latest evidence-based guidelines relevant to their specific hematological condition. Crucially, this clinical information must be integrated with a detailed understanding of the patient’s personal circumstances, values, and preferences through open and honest communication. The resulting treatment plan should be a collaborative effort, ensuring it is both clinically appropriate and personally meaningful for the patient. Regular reassessment and adaptation of the plan based on patient response and new evidence are essential components of ongoing, high-quality care.

Scenario Analysis: This scenario presents a professional challenge due to the inherent conflict between a physician’s duty to provide comprehensive care and the patient’s right to autonomy, particularly when the patient’s decision-making capacity is in question. The physician must navigate complex ethical principles, including beneficence, non-maleficence, and respect for autonomy, while adhering to legal requirements for informed consent and capacity assessment. The urgency of the situation, coupled with the potential for serious harm if treatment is delayed or withheld, heightens the need for careful and ethically sound judgment. Correct Approach Analysis: The best professional practice involves a systematic and documented process to assess the patient’s capacity to make decisions about their treatment. This includes clearly explaining the proposed treatment, its risks, benefits, and alternatives in a manner the patient can understand, and then assessing their ability to comprehend this information, appreciate the consequences of their choices, and communicate a reasoned decision. If capacity is found to be lacking, the physician must then follow established protocols for decision-making by a surrogate or proxy, ensuring that the patient’s previously expressed wishes or best interests are prioritized. This approach upholds the principles of patient autonomy and beneficence while ensuring legal compliance with informed consent requirements. Incorrect Approaches Analysis: One incorrect approach involves proceeding with the treatment without a formal capacity assessment, assuming that the patient’s refusal is due to misunderstanding or fear. This violates the principle of respect for autonomy and could lead to the administration of treatment against a competent individual’s wishes, which is ethically and legally unacceptable. Another incorrect approach is to immediately override the patient’s refusal and proceed with treatment based solely on the physician’s judgment of what is medically best, without exploring the reasons for refusal or attempting to address any misunderstandings. This demonstrates a paternalistic attitude that disregards the patient’s right to self-determination. A further incorrect approach is to abandon the patient or withhold necessary treatment due to the patient’s refusal, without adequately exploring the underlying reasons for the refusal or involving a surrogate decision-maker if capacity is indeed lacking. This could be seen as a failure of the physician’s duty of care. Professional Reasoning: Professionals facing such a situation should employ a structured decision-making process. First, they must clearly identify the ethical and legal principles at play. Second, they should gather all relevant information about the patient’s condition and the proposed treatment. Third, they must engage in open and empathetic communication with the patient to understand their perspective and assess their capacity. If capacity is questionable, a formal assessment should be conducted, potentially involving other healthcare professionals. If the patient lacks capacity, the process of identifying and involving a surrogate decision-maker should be initiated, always prioritizing the patient’s best interests and known wishes. Documentation throughout this process is crucial.