Scenario Analysis: This scenario presents a professional challenge rooted in the ethical imperative to balance the pursuit of knowledge through research with the immediate needs and well-being of vulnerable populations receiving humanitarian rehabilitation services. The tension lies in the potential for research activities, even those intended for quality improvement, to inadvertently disrupt established care pathways, create undue burden on participants, or compromise data integrity if not meticulously planned and executed. The expectation for research translation adds another layer of complexity, requiring a proactive approach to ensure findings are not only generated but also effectively disseminated and implemented to benefit future beneficiaries. Careful judgment is required to navigate these competing demands ethically and effectively. Correct Approach Analysis: The best professional practice involves a systematic and ethical approach to integrating research and quality improvement initiatives. This begins with a thorough review of existing data and literature to identify specific, actionable areas for improvement or knowledge gaps within the humanitarian rehabilitation and assistive tech context. Subsequently, a pilot study or a phased implementation of a quality improvement initiative, designed with clear research objectives and robust ethical oversight, should be undertaken. This approach prioritizes participant safety and data integrity by starting small, allowing for iterative refinement based on preliminary findings. Crucially, it includes a pre-defined plan for data analysis and dissemination, ensuring that any insights gained are translated into improved practices or new assistive technologies. This aligns with ethical research principles that emphasize minimizing harm, maximizing benefit, and ensuring scientific rigor, as well as the professional responsibility to contribute to the advancement of the field. Incorrect Approaches Analysis: One incorrect approach involves immediately launching a large-scale, complex research project without prior pilot testing or a clear quality improvement objective. This risks significant resource misallocation, potential disruption to ongoing services, and the generation of unreliable data due to inadequate foundational work. It fails to adhere to the principle of proportionality in research, potentially exposing participants to unnecessary risks without a clear benefit. Another unacceptable approach is to solely focus on data collection for a research study without a concurrent plan for quality improvement or immediate translation of findings. This prioritizes the research output over the practical application and benefit to the target population, neglecting the core purpose of humanitarian rehabilitation. It also fails to meet the expectation of research translation, potentially leading to valuable data remaining unused and unapplied. A third flawed approach is to implement changes based on anecdotal evidence or preliminary observations without a structured research or quality improvement framework. While well-intentioned, this lacks the rigor necessary to ensure the changes are truly effective, sustainable, or generalizable. It bypasses essential ethical considerations such as informed consent for research-like activities and robust data analysis, potentially leading to unintended negative consequences. Professional Reasoning: Professionals in humanitarian rehabilitation and assistive technology must adopt a decision-making process that prioritizes ethical conduct, evidence-based practice, and a commitment to continuous improvement. This involves: 1) Identifying a clear need or knowledge gap that aligns with the mission of humanitarian aid and the advancement of assistive technology. 2) Designing interventions or research protocols that are ethically sound, with robust participant protection and informed consent processes. 3) Employing a phased approach, starting with pilot studies or quality improvement initiatives to refine methodologies and assess feasibility before scaling up. 4) Establishing clear metrics for success and a plan for data analysis and dissemination. 5) Actively seeking opportunities to translate research findings into practical applications and policy recommendations to ensure lasting impact.

Scenario Analysis: This scenario presents a professional challenge related to the integrity of the certification process and the equitable application of its policies. The core dilemma lies in balancing the desire to support a dedicated individual with the imperative to uphold the established rules governing board certification, particularly concerning retake policies and their impact on blueprint weighting. The professional must navigate potential perceptions of bias or unfairness while ensuring the credibility of the certification. Correct Approach Analysis: The best professional practice involves a transparent and consistent application of the established retake policy, as outlined by the Critical Humanitarian Rehabilitation and Assistive Tech Board Certification guidelines. This approach prioritizes fairness and the integrity of the certification process. It acknowledges that while the individual’s dedication is commendable, the established policies regarding retakes, blueprint weighting, and scoring are designed to ensure a standardized and objective assessment for all candidates. Adhering to these policies, even when it presents a difficult personal situation, reinforces the credibility of the board and its commitment to rigorous standards. The policy itself, by defining retake limits and scoring adjustments, implicitly addresses the weighting of content areas and the overall scoring mechanism for subsequent attempts. Incorrect Approaches Analysis: One incorrect approach would be to grant an exception to the retake policy based on the individual’s perceived dedication or the circumstances of their initial failure. This failure to adhere to established policy undermines the fairness of the certification process. It creates a precedent that could lead to future requests for exceptions, eroding the standardization that the blueprint weighting and scoring are designed to maintain. Such an action could be perceived as preferential treatment, damaging the reputation of the board and potentially leading to challenges regarding the validity of the certification. Another incorrect approach would be to significantly alter the scoring or blueprint weighting for the individual’s retake without a formal, board-approved mechanism for such adjustments. The blueprint weighting and scoring are integral to the certification’s design, ensuring that all candidates are assessed against the same defined knowledge domains. Deviating from this without explicit policy allows for subjective interpretation and introduces bias. It fails to uphold the principle of equal opportunity and could lead to questions about the rigor and objectivity of the assessment. A further incorrect approach would be to dismiss the individual’s concerns about the retake policy and simply reiterate the rules without offering any supportive guidance within the bounds of the policy. While adherence to policy is crucial, a professional approach also involves empathy and a willingness to explain the rationale behind the policies, including how retake limitations and scoring are integrated with the overall blueprint weighting. This approach, while technically compliant, lacks the professional courtesy and transparency expected in such situations. Professional Reasoning: Professionals faced with such situations should first consult the official documentation for the Critical Humanitarian Rehabilitation and Assistive Tech Board Certification, specifically focusing on the sections detailing examination retake policies, scoring methodologies, and blueprint weighting. They should then assess the situation against these established guidelines, looking for any provisions for exceptions or appeals. If no such provisions exist or if the situation does not meet the criteria for an exception, the professional’s duty is to uphold the policy consistently. Communication should be clear, empathetic, and focused on explaining the rationale behind the policy, rather than simply stating the rule. If there is ambiguity in the policy, seeking clarification from the board’s governing body is the appropriate next step before making a decision.

This scenario presents a professional challenge due to the inherent conflict between a client’s expressed wishes and the potential for harm or exploitation, particularly when the client may have diminished capacity or be subject to undue influence. Navigating this requires a delicate balance of respecting autonomy while upholding ethical obligations to protect vulnerable individuals. Careful judgment is required to ensure the client’s best interests are served without infringing upon their rights. The best professional approach involves a thorough, objective assessment of the client’s capacity to make informed decisions regarding the assistive technology. This includes understanding the client’s understanding of the technology’s benefits, risks, and alternatives, as well as their ability to communicate their decision. If capacity is deemed present, the professional should proceed with the client’s wishes, ensuring they are fully informed and have explored all available options. This aligns with the ethical principle of client autonomy and the regulatory framework that emphasizes informed consent and client-centered care. The professional’s role is to facilitate informed decision-making, not to impose their own judgment on what constitutes the “best” technology, provided the client has the capacity to choose. An incorrect approach would be to unilaterally decide that a different assistive technology is superior and proceed with that without the client’s informed consent, even if the professional believes it is for the client’s benefit. This disregards the client’s autonomy and the principle of informed consent, potentially leading to a breach of trust and professional misconduct. Another incorrect approach is to dismiss the client’s preference outright due to a perceived lack of sophistication or a belief that the professional knows better. This is paternalistic and fails to acknowledge the client’s right to self-determination. Finally, proceeding with a technology that the client has not fully understood or consented to, even if it seems technologically advanced, violates the core ethical tenet of ensuring the client is an active and informed participant in their rehabilitation and assistive technology choices. Professionals should employ a decision-making framework that prioritizes understanding the client’s goals and preferences, assessing their capacity to make decisions, providing clear and understandable information about all available options, and respecting their informed choices. When capacity is in question, a structured assessment process should be initiated, potentially involving other professionals or family members, to ensure the client’s rights are protected while their well-being is paramount.

Scenario Analysis: This scenario presents a professional challenge because it requires balancing the immediate needs of a vulnerable population with the long-term integrity and purpose of a certification program. The pressure to demonstrate impact and secure funding can create a temptation to broaden eligibility criteria beyond the established scope, potentially compromising the certification’s credibility and the quality of services it aims to ensure. Careful judgment is required to uphold the certification’s standards while remaining responsive to humanitarian needs. Correct Approach Analysis: The best professional practice involves a rigorous and transparent process for evaluating any proposed expansion of eligibility. This includes a thorough review of the proposed changes against the original purpose and objectives of the Critical Humanitarian Rehabilitation and Assistive Tech Board Certification. It necessitates gathering evidence to demonstrate that any new applicant groups would possess the necessary foundational knowledge, skills, and ethical understanding to meet the certification’s standards and effectively contribute to humanitarian rehabilitation and assistive technology. This approach ensures that the certification remains a reliable indicator of competence and upholds its commitment to quality and safety for the populations it serves, aligning with the ethical imperative to act in the best interests of beneficiaries and maintain professional integrity. Incorrect Approaches Analysis: Expanding eligibility based solely on the urgency of a humanitarian crisis without a formal assessment of the applicants’ qualifications would undermine the certification’s purpose. This approach risks admitting individuals who may lack the specialized knowledge or ethical grounding required for critical humanitarian rehabilitation and assistive technology, potentially leading to suboptimal or even harmful interventions. It fails to uphold the principle of competence and due diligence inherent in professional certification. Approving eligibility based on the potential for increased funding or organizational visibility, without a clear alignment with the certification’s core mission and standards, is ethically unsound. This prioritizes external benefits over the quality and integrity of the certification, potentially diluting its value and misleading the public about the expertise of certified individuals. It represents a conflict of interest and a failure to adhere to the certification’s stated objectives. Allowing a committee member to unilaterally decide on eligibility based on personal acquaintance or perceived need, without a standardized evaluation process, introduces bias and inconsistency. This bypasses established governance and assessment procedures, compromising fairness and the objective measurement of qualifications. It violates principles of good governance and professional accountability. Professional Reasoning: Professionals facing such dilemmas should first consult the official documentation outlining the purpose, scope, and eligibility criteria of the certification. They should then engage in a structured decision-making process that involves: 1) clearly defining the problem and its potential impacts; 2) identifying relevant ethical principles and regulatory requirements; 3) exploring all available options and their consequences; 4) consulting with relevant stakeholders and ethical review boards if necessary; and 5) making a decision that is justifiable, transparent, and aligned with the highest professional standards and the certification’s mandate.

This scenario presents a professional challenge due to the inherent tension between immediate humanitarian needs and the long-term sustainability and ethical implications of resource allocation in a global health context. The need for rapid intervention in a crisis zone often clashes with the principles of equitable distribution, informed consent, and the potential for unintended consequences of technological deployment. Careful judgment is required to balance these competing demands. The best professional approach involves prioritizing the immediate safety and well-being of the affected population while simultaneously initiating a process for informed consent and community engagement regarding the assistive technology. This means deploying the technology in a way that addresses critical needs, such as mobility for injured individuals, but also immediately beginning dialogue with community leaders and potential recipients about the technology’s purpose, benefits, risks, and maintenance. This approach aligns with core humanitarian principles of humanity, neutrality, impartiality, and independence, as well as ethical guidelines for technology deployment in vulnerable populations, which emphasize dignity, autonomy, and the avoidance of harm. It also respects the principle of “do no harm” by ensuring that the introduction of new technology does not inadvertently create new dependencies or exacerbate existing inequalities without proper consideration. An incorrect approach would be to deploy the assistive technology without any attempt at informed consent or community consultation, solely based on the perceived immediate need. This fails to respect the autonomy of the recipients and risks imposing solutions that may not be culturally appropriate, sustainable, or desired by the community in the long run. It could lead to resentment, underutilization, or even misuse of the technology, violating ethical principles of respect for persons and beneficence. Another incorrect approach would be to delay the deployment of the assistive technology until a comprehensive, long-term sustainability plan and full community consensus are achieved, even if this means prolonging the suffering of individuals who could immediately benefit. While long-term planning is crucial, an absolute delay in the face of acute need can be seen as a failure to act impartially and provide assistance where it is most urgently required, potentially violating the principle of humanity. A third incorrect approach would be to prioritize the introduction of the most advanced or expensive assistive technology available, assuming it is inherently superior, without adequately assessing the local context, maintenance capacity, or the specific needs of the beneficiaries. This approach risks creating unsustainable systems, diverting limited resources from more appropriate solutions, and potentially causing harm through the introduction of technology that cannot be properly supported or utilized, thus failing to adhere to principles of efficiency and appropriateness in humanitarian aid. Professionals should employ a decision-making framework that begins with a rapid needs assessment, followed by an immediate intervention that addresses critical needs while simultaneously initiating a participatory process for long-term integration and sustainability. This involves continuous dialogue with affected communities, local stakeholders, and relevant experts to ensure that interventions are culturally sensitive, ethically sound, and ultimately empowering for the beneficiaries.

This scenario presents a professional challenge because it requires balancing the candidate’s immediate needs and perceived urgency with the ethical obligation to provide accurate and comprehensive guidance regarding preparation for a rigorous certification. The pressure to “help” quickly can lead to shortcuts that ultimately disadvantage the candidate. Careful judgment is required to ensure that the advice given is both helpful and ethically sound, adhering to professional standards. The best approach involves a structured and resource-oriented response. This entails acknowledging the candidate’s request, validating their enthusiasm, and then immediately directing them to the official, comprehensive preparation resources. This includes providing links to the official syllabus, recommended reading lists, past examination papers (if available), and any official study guides or webinars. Crucially, it also involves recommending a realistic timeline based on the breadth and depth of the material, suggesting a phased approach to studying that allows for thorough understanding and retention. This aligns with the ethical duty of care to ensure candidates are adequately prepared and understand the commitment involved, preventing them from entering the examination underprepared due to insufficient or misleading advice. It also upholds the integrity of the certification process. Providing a superficial overview or focusing solely on “tips and tricks” without emphasizing foundational knowledge is professionally unacceptable. This approach fails to equip the candidate with the necessary depth of understanding required for the Critical Humanitarian Rehabilitation and Assistive Tech Board Certification. It risks creating a false sense of preparedness, leading to potential failure and wasted resources for the candidate, and undermines the credibility of the certification. Ethically, it breaches the duty to provide accurate and complete information. Offering to “personally coach” the candidate through the material without referencing official resources or a structured timeline is also professionally unsound. While well-intentioned, this can lead to subjective interpretations of the syllabus, potential biases in the information provided, and an informal structure that may not cover all essential areas. It also raises concerns about conflicts of interest and the potential for providing advice that is not aligned with the certification’s stated objectives and standards. This approach bypasses the established and validated preparation pathways. Suggesting that the candidate can “cram” the material in a short period by focusing only on high-yield topics is a significant ethical and professional failing. This approach directly contradicts the nature of a board certification, which is designed to assess comprehensive knowledge and practical application. It encourages a superficial engagement with the subject matter, which is unlikely to lead to genuine understanding or the ability to apply knowledge in real-world humanitarian rehabilitation and assistive technology contexts. This advice is misleading and sets the candidate up for failure, violating the principle of providing honest and accurate guidance. The professional decision-making process for similar situations should involve: 1) Active listening to understand the candidate’s needs and concerns. 2) Prioritizing ethical obligations to provide accurate, comprehensive, and unbiased information. 3) Consulting official certification guidelines and resources to ensure advice is aligned with established standards. 4) Recommending a structured and realistic preparation plan that emphasizes deep learning over superficial memorization. 5) Managing candidate expectations regarding the time and effort required for successful certification.

This scenario presents a significant ethical and logistical challenge, requiring careful consideration of humanitarian principles, resource allocation, and the specific needs of vulnerable populations in a disaster setting. The core difficulty lies in balancing the immediate, life-saving requirements of a field hospital with the longer-term, sustainable needs of the affected community, all within the constraints of a rapidly evolving and potentially chaotic environment. Professional judgment is paramount to ensure that decisions are not only effective but also ethically sound and aligned with humanitarian best practices. The best approach involves prioritizing the immediate establishment of essential WASH (Water, Sanitation, and Hygiene) infrastructure that directly supports the field hospital’s operational capacity and patient safety. This includes ensuring a safe and reliable water source for medical use, adequate sanitation facilities for patients and staff to prevent disease transmission, and basic hygiene supplies. This approach is correct because it directly addresses the most critical immediate risks to health and safety within the operational zone of the field hospital. It aligns with the Sphere Minimum Standards in Humanitarian Response, which emphasize the critical link between WASH and health outcomes, particularly in emergency settings where disease outbreaks are a significant threat. Ethically, it upholds the principle of “do no harm” by proactively mitigating the risk of waterborne diseases within the very facility designed to heal. An incorrect approach would be to focus solely on the medical equipment and supplies for the field hospital, neglecting the foundational WASH infrastructure. This is ethically problematic as it creates an environment where the hospital itself can become a source of infection, undermining its primary purpose. It fails to meet humanitarian standards that recognize WASH as a prerequisite for effective healthcare delivery. Another incorrect approach would be to prioritize the construction of extensive community WASH facilities before the field hospital is fully operational and its immediate WASH needs are met. While community well-being is crucial, the immediate health and safety of patients and staff within the field hospital must take precedence in the initial emergency response phase. Delaying critical WASH for the hospital could lead to outbreaks within its walls, compromising patient care and potentially spreading disease further. Finally, an approach that solely focuses on procuring advanced medical technology without considering the necessary supporting infrastructure, including WASH and a functional supply chain for consumables, is also flawed. This overlooks the interconnectedness of humanitarian response elements. A field hospital cannot function effectively without clean water, sanitation, and a reliable supply of basic necessities, regardless of the sophistication of its medical equipment. Professionals should employ a decision-making process that begins with a rapid needs assessment, prioritizing life-saving interventions. This involves identifying the most immediate threats to health and safety, such as lack of clean water and sanitation. Next, they should consult relevant humanitarian standards and guidelines (e.g., Sphere) to inform their decisions. Resource allocation should then be guided by these priorities, ensuring that essential infrastructure, like WASH for the field hospital, is established concurrently with or prior to the deployment of advanced medical capabilities. Continuous monitoring and adaptation based on the evolving situation and community needs are also critical components of effective humanitarian response.

Scenario Analysis: This scenario presents a significant ethical and professional challenge due to the inherent vulnerability of the population, the limited resources, and the potential for conflicting priorities. Ensuring the nutritional well-being and protection of mothers and children in a displacement setting requires navigating complex logistical, cultural, and ethical considerations. The professional must balance immediate needs with long-term sustainability and the rights of the individuals served, all while operating within a framework of humanitarian principles and potentially limited regulatory oversight specific to emergency contexts. Correct Approach Analysis: The best professional approach involves a comprehensive needs assessment that prioritizes the most vulnerable groups, specifically pregnant and lactating women and children under five, for targeted nutritional interventions. This approach is correct because it aligns with established humanitarian principles of prioritizing need and ensuring the most vulnerable receive essential support. It also reflects best practices in maternal-child health in emergency settings, which emphasize early identification of malnutrition and provision of appropriate therapeutic and supplementary feeding. Furthermore, integrating protection concerns, such as ensuring safe access to feeding sites and addressing gender-based violence risks, is crucial for holistic care and aligns with international humanitarian law and ethical guidelines for protecting displaced populations. Incorrect Approaches Analysis: One incorrect approach would be to distribute general food aid equally to all displaced individuals without specific consideration for the heightened nutritional requirements of pregnant and lactating women and young children. This fails to address the specific physiological needs of these groups, potentially leading to continued or worsening malnutrition in these critical populations, and neglects the principle of prioritizing need based on vulnerability. Another incorrect approach would be to focus solely on immediate food distribution and overlook the underlying causes of malnutrition and protection risks. This might involve providing food without assessing water, sanitation, and hygiene (WASH) conditions, which are critical for nutrient absorption and preventing disease, or failing to establish mechanisms for reporting and responding to protection concerns like exploitation or abuse. This approach is ethically flawed as it provides an incomplete solution and fails to uphold the right to a safe and healthy environment. A third incorrect approach would be to implement a one-size-fits-all feeding program that does not account for cultural dietary preferences or local food availability. This can lead to low uptake of the provided food, waste of resources, and may not effectively meet the nutritional needs of the target population. It also fails to respect the dignity and autonomy of the displaced individuals by not involving them in the design of the interventions. Professional Reasoning: Professionals in this field should employ a decision-making process that begins with a rapid, yet thorough, needs assessment. This assessment should disaggregate data by age, sex, and vulnerability status to identify specific needs. Following the assessment, interventions should be designed based on evidence-based guidelines for nutrition and protection in emergencies, prioritizing the most vulnerable. Continuous monitoring and evaluation are essential to adapt interventions as the situation evolves and to ensure accountability to the affected population. Collaboration with local communities, other humanitarian actors, and relevant authorities is also critical for effective and ethical programming.

The monitoring system demonstrates a critical lapse in security protocols, revealing a potential breach that could compromise the safety of personnel and sensitive humanitarian aid. This scenario is professionally challenging because it pits the immediate need for operational continuity and aid delivery against the paramount duty of care owed to staff and the ethical imperative to maintain security in an austere, high-risk environment. The tension lies in balancing risk mitigation with mission objectives, requiring a nuanced judgment that prioritizes human safety. The best professional approach involves immediately halting non-essential operations in the affected area and initiating a comprehensive security review. This includes a thorough investigation of the monitoring system anomaly, a reassessment of physical security measures, and a review of communication protocols. Simultaneously, staff wellbeing must be actively addressed through clear, transparent communication about the situation, provision of psychological support resources, and ensuring all personnel are aware of and adhere to updated security procedures. This approach is correct because it directly addresses the identified security threat, fulfills the duty of care by prioritizing staff safety and mental health, and aligns with the ethical principles of humanitarian work which mandate the protection of those delivering aid. It proactively mitigates further risk and demonstrates responsible stewardship of resources and personnel. An approach that involves downplaying the anomaly and continuing operations with minor adjustments fails to adequately address the potential security breach. This neglects the duty of care by exposing staff to unknown risks and violates ethical obligations to ensure a safe working environment. It prioritizes mission expediency over fundamental safety, which is unacceptable in austere settings. Another incorrect approach would be to withdraw all personnel immediately without a proper assessment or communication plan. While seemingly prioritizing safety, this can cause significant disruption to aid delivery, potentially harming beneficiaries who rely on the assistance. It also fails to address the root cause of the security lapse and may create panic among staff without providing clear guidance or support. This approach is reactive rather than proactive and can be detrimental to both mission effectiveness and staff morale. Finally, an approach that focuses solely on technical fixes to the monitoring system without considering the broader security implications or staff wellbeing is insufficient. While technical issues may be part of the problem, the security of personnel in an austere mission is multifaceted and requires a holistic assessment that includes physical security, operational procedures, and psychological support. Professionals should employ a decision-making framework that begins with a rapid risk assessment of any identified threat. This should be followed by a clear communication strategy to inform relevant stakeholders, including staff, about the situation and the steps being taken. Prioritizing the safety and wellbeing of personnel is a non-negotiable ethical and regulatory requirement. Implementing robust security protocols, providing necessary support, and conducting thorough post-incident reviews are crucial for maintaining operational integrity and upholding humanitarian principles.

This scenario presents a professional challenge due to the inherent conflict between a client’s expressed wishes and the clinician’s assessment of their best interests, particularly when the client’s capacity to make informed decisions is in question. Navigating this requires a delicate balance of respecting autonomy while ensuring safety and well-being, adhering to professional ethical codes and relevant legal frameworks governing client capacity and decision-making. The approach that represents best professional practice involves a thorough, documented assessment of the client’s capacity to understand the information relevant to their rehabilitation goals and the assistive technology options, and to appreciate the consequences of their choices. This assessment should be conducted by a qualified professional, ideally one with expertise in cognitive assessment or capacity evaluation. If capacity is found to be present, the client’s informed decision should be respected, even if it differs from the clinician’s initial recommendation. If capacity is deemed lacking, the process shifts to involving appropriate surrogate decision-makers or advocating for the client’s best interests within legal and ethical guidelines, which may include seeking a formal guardianship or conservatorship if necessary and appropriate. This aligns with the ethical principles of autonomy, beneficence, and non-maleficence, and is supported by professional guidelines that emphasize client-centered care and the legal requirements for assessing and supporting decision-making capacity. An approach that involves overriding the client’s stated preference without a formal, documented assessment of capacity is ethically problematic. It undermines the principle of autonomy and can lead to a breakdown of trust. Similarly, proceeding with a plan that the client has explicitly rejected, even if the clinician believes it is for their own good, without exploring the reasons for rejection and re-evaluating capacity, constitutes a failure to respect the client’s agency and can be seen as paternalistic. Lastly, abandoning the client or ceasing to provide services solely because of a disagreement over the rehabilitation plan, without exploring alternative solutions or seeking further consultation, would be a dereliction of professional duty and a failure to uphold the commitment to client care. Professionals should employ a structured decision-making process that begins with understanding the client’s perspective and stated wishes. This is followed by an objective assessment of the client’s capacity to make the specific decision at hand, utilizing validated tools and professional judgment. If capacity is confirmed, the client’s informed choice is paramount. If capacity is questioned, a systematic process of re-assessment, seeking collateral information, and involving relevant parties (family, legal counsel, ethics committees) should be initiated to determine the appropriate course of action that balances the client’s rights and well-being.