This scenario presents a professional challenge due to the inherent conflict between a patient’s expressed wishes and the clinician’s perceived best medical interest, particularly in the context of complex congenital heart disease where long-term management and potential future complications are significant considerations. The advanced practice standards in Adult Congenital Cardiology demand a nuanced approach that balances patient autonomy with the clinician’s duty of care, requiring careful ethical deliberation and adherence to established guidelines for shared decision-making. The correct approach involves a comprehensive and empathetic discussion with the patient, exploring the underlying reasons for their decision, providing detailed information about the risks and benefits of both continuing current management and pursuing surgical intervention, and involving a multidisciplinary team. This approach respects patient autonomy while ensuring informed consent and adherence to the principle of beneficence. It aligns with ethical principles of shared decision-making, which are paramount in managing chronic and complex conditions like adult congenital heart disease, and reflects the professional obligation to empower patients to make choices aligned with their values and understanding, even when those choices differ from the clinician’s initial recommendation. This is further supported by professional guidelines emphasizing patient-centered care and the importance of understanding patient preferences and life goals. An incorrect approach would be to proceed with the surgical intervention against the patient’s explicit, informed refusal. This disregards the fundamental ethical principle of patient autonomy and the right to refuse medical treatment, even if the clinician believes it is in the patient’s best interest. Such an action would constitute a serious breach of professional conduct and could have legal ramifications. Another incorrect approach would be to dismiss the patient’s concerns and simply reiterate the medical recommendation without actively seeking to understand their perspective or addressing their fears. This fails to uphold the principle of shared decision-making and can erode patient trust, potentially leading to non-adherence to future treatment plans. It neglects the professional responsibility to engage in a therapeutic dialogue that acknowledges and respects the patient’s lived experience and values. Finally, an incorrect approach would be to unilaterally decide on the patient’s behalf without further consultation or attempting to bridge the gap in understanding. This paternalistic stance undermines the patient’s role in their own healthcare and is contrary to modern ethical standards that prioritize collaborative decision-making between patient and clinician. Professionals should employ a decision-making process that begins with active listening and empathetic inquiry to understand the patient’s perspective. This should be followed by a clear, jargon-free explanation of the medical situation, including all available treatment options, their associated risks, benefits, and uncertainties. Crucially, this information must be tailored to the patient’s level of understanding and their personal values and goals. Involving a multidisciplinary team, including ethicists if necessary, can provide additional support and perspectives. The ultimate goal is to reach a shared decision that the patient feels confident in, even if it requires compromise or further exploration of alternatives.

This scenario is professionally challenging because it requires balancing the integrity of the examination process with empathy for a candidate facing significant personal hardship. The examination board must uphold the established policies for blueprint weighting, scoring, and retake policies to ensure fairness and standardization for all candidates. However, ignoring the candidate’s circumstances entirely could be perceived as lacking compassion and potentially lead to a perception of an overly rigid system. The core tension lies in maintaining objective standards while acknowledging individual human factors. The best professional approach involves a thorough review of the examination board’s established policies regarding exceptional circumstances and retake eligibility. This approach prioritizes adherence to the documented framework that governs the examination’s integrity. It requires the candidate to formally apply for consideration of their circumstances, providing necessary documentation. The board then objectively assesses this application against pre-defined criteria for deferral or special consideration, ensuring consistency and fairness for all candidates. This aligns with ethical principles of impartiality and due process, as well as the regulatory requirement to maintain a standardized and valid assessment process. An incorrect approach would be to grant an immediate retake without a formal review process. This undermines the established retake policies and scoring mechanisms, potentially creating a precedent for preferential treatment and compromising the overall fairness of the examination. It fails to uphold the regulatory framework that dictates how candidates progress and are assessed. Another incorrect approach is to dismiss the candidate’s request outright without any consideration or explanation. While upholding policy is crucial, a complete lack of empathy or a refusal to engage with the candidate’s situation can lead to reputational damage for the examination board and may not align with broader professional ethical expectations of considerate conduct. This approach neglects the importance of clear communication and a structured process for handling exceptional cases. Finally, an incorrect approach would be to arbitrarily adjust the scoring or weighting of the examination for this specific candidate. This directly violates the blueprint weighting and scoring policies, introducing subjective bias and invalidating the assessment’s standardization. It compromises the integrity of the examination results and is ethically indefensible. Professionals should approach such situations by first understanding the established policies and procedures. They should then engage with the candidate through the designated channels, requesting formal documentation of the exceptional circumstances. A structured, objective assessment against pre-defined criteria is paramount. Transparency in the decision-making process and clear communication of the outcome, along with any available recourse, are essential components of professional conduct.

Scenario Analysis: This scenario presents a professional challenge due to the inherent conflict between a patient’s expressed wishes and the clinician’s assessment of the most appropriate diagnostic pathway for a complex congenital heart condition. The ethical imperative to respect patient autonomy must be balanced with the duty of beneficence and non-maleficence, ensuring the patient receives the best possible care to prevent harm and promote well-being. The clinician must navigate this delicate balance while adhering to professional standards of diagnostic reasoning and imaging selection. Correct Approach Analysis: The best professional practice involves a thorough, shared decision-making process. This approach prioritizes open communication with the patient and their family, explaining the rationale behind the recommended imaging modality (e.g., cardiac MRI for detailed anatomical assessment and functional evaluation in complex adult congenital heart disease) and its benefits in guiding management. It involves actively listening to the patient’s concerns, addressing their fears or misconceptions about the procedure, and exploring alternative options if feasible, while clearly articulating the potential risks of delaying or choosing a less optimal diagnostic pathway. This aligns with ethical principles of informed consent and patient-centered care, ensuring the patient understands the implications of their choices and feels empowered in the decision-making process. Professional guidelines emphasize the importance of patient education and shared decision-making in all aspects of healthcare, particularly in complex specialties like adult congenital cardiology. Incorrect Approaches Analysis: One incorrect approach involves overriding the patient’s expressed preference for a less invasive imaging technique without a robust discussion of the diagnostic limitations and potential consequences. This fails to uphold the principle of patient autonomy and can erode trust. While the clinician may believe the alternative is superior, the failure to engage in a shared decision-making process, explain the risks of suboptimal imaging, and explore the patient’s reasoning for their preference is ethically problematic. Another incorrect approach is to proceed with the patient’s preferred, but diagnostically suboptimal, imaging modality without clearly documenting the discussion about its limitations and the potential risks of incomplete information. This could lead to delayed or incorrect diagnosis and management, potentially causing harm. It also fails to meet the professional standard of ensuring the patient is fully informed about the trade-offs involved in their choice. A further incorrect approach is to dismiss the patient’s concerns and insist on the clinician’s preferred imaging without adequate explanation or exploration of the patient’s perspective. This demonstrates a lack of respect for patient autonomy and can lead to patient dissatisfaction and non-adherence to treatment plans. It neglects the ethical duty to involve the patient in decisions about their own health. Professional Reasoning: Professionals should employ a framework that begins with a comprehensive assessment of the patient’s clinical condition and the diagnostic question. This is followed by an open and empathetic dialogue with the patient, where the clinician explains the diagnostic options, their respective benefits, risks, and limitations, tailored to the patient’s understanding. The clinician should actively listen to the patient’s values, preferences, and concerns, and collaboratively explore the best course of action. Documentation of this shared decision-making process is crucial.

Scenario Analysis: This scenario presents a professional challenge due to the inherent conflict between a patient’s expressed wishes, which may be influenced by their current acute condition and potentially limited understanding of long-term implications, and the clinician’s ethical and professional duty to provide evidence-based care that promotes the patient’s best interests and long-term well-being. The clinician must navigate the complexities of informed consent, patient autonomy, and the principle of beneficence, all within the framework of European guidelines for adult congenital heart disease management. Correct Approach Analysis: The best professional practice involves a multi-faceted approach that prioritizes shared decision-making while ensuring the patient receives comprehensive, evidence-based information. This includes clearly explaining the risks and benefits of both surgical intervention and conservative management, tailored to the patient’s specific condition and prognosis. It requires engaging the patient in a dialogue about their values and goals, and involving their family or designated support persons with the patient’s consent. Crucially, it necessitates a thorough assessment of the patient’s capacity to make such a decision, potentially involving a formal capacity assessment if there are doubts. This approach aligns with European Society of Cardiology (ESC) guidelines on adult congenital heart disease, which emphasize patient-centered care, shared decision-making, and the importance of a multidisciplinary team in complex cases. It upholds the ethical principles of autonomy (respecting the patient’s right to choose) and beneficence (acting in the patient’s best interest) by ensuring the decision is informed and aligned with their values. Incorrect Approaches Analysis: One incorrect approach involves immediately deferring to the patient’s stated preference for non-intervention without a thorough exploration of the underlying reasons, the potential long-term consequences, or an assessment of their decision-making capacity. This fails to uphold the clinician’s duty of beneficence and may lead to suboptimal outcomes if the patient’s preference is not fully informed or is based on a misunderstanding of their condition. It also risks violating the principles of shared decision-making by not actively engaging the patient in understanding the evidence. Another incorrect approach is to proceed with the more aggressive surgical intervention solely based on the clinician’s interpretation of the evidence, overriding the patient’s expressed concerns and desire for a less invasive path. This disregards patient autonomy and can lead to a breakdown in the therapeutic relationship, potentially causing distress and mistrust. It fails to acknowledge the patient’s values and goals, which are integral to effective shared decision-making. A third incorrect approach is to delay the decision-making process indefinitely, citing the patient’s acute condition, without actively seeking to clarify the patient’s wishes, assess their capacity, or initiate a structured discussion about treatment options. This can lead to a missed opportunity for timely intervention, potentially worsening the patient’s condition and increasing future risks, while also failing to respect the patient’s right to participate in their care. Professional Reasoning: Professionals should adopt a structured decision-making process that begins with a comprehensive understanding of the patient’s clinical status and prognosis. This is followed by an open and empathetic discussion about all available evidence-based treatment options, including their respective risks, benefits, and uncertainties. The clinician must then assess the patient’s capacity to make an informed decision, engaging in a dialogue that explores the patient’s values, preferences, and goals. If capacity is questionable, a formal assessment should be sought. The involvement of a multidisciplinary team, including nurses, psychologists, and ethicists if necessary, can provide valuable support and diverse perspectives. The ultimate decision should be a collaborative one, reflecting both the best available evidence and the patient’s informed choices, documented thoroughly.

Scenario Analysis: This scenario is professionally challenging because it pits the desire to advance a colleague’s career and potentially improve patient care through their expertise against the strict requirements of a licensure examination designed to ensure a baseline standard of competence across the entire European region. The conflict arises from the potential for personal relationships or perceived exceptional talent to influence judgment regarding formal qualifications, which could undermine the integrity and purpose of the licensure process. Careful judgment is required to uphold the examination’s standards while acknowledging professional relationships. Correct Approach Analysis: The best professional practice involves rigorously adhering to the stated eligibility criteria for the Advanced Pan-Europe Adult Congenital Cardiology Licensure Examination. This approach prioritizes the integrity of the examination and the assurance of a standardized level of expertise for all licensed practitioners. The purpose of the examination is to objectively assess a candidate’s knowledge and skills against a defined pan-European standard, ensuring patient safety and consistent quality of care. Eligibility requirements, such as specific training pathways, documented experience, and potentially prior certifications, are established to guarantee that candidates possess the foundational competencies necessary to undertake advanced study and practice. Upholding these criteria, even for a highly respected colleague, is ethically mandated to maintain public trust and the credibility of the licensure process. It ensures that all candidates are evaluated on the same objective benchmarks, preventing any perception of favoritism or undue influence. Incorrect Approaches Analysis: One incorrect approach involves advocating for a waiver of specific eligibility requirements based on the colleague’s perceived exceptional talent and extensive experience. This fails to recognize that licensure examinations are not merely about recognizing existing expertise but about verifying that this expertise meets a defined, standardized pan-European benchmark. Allowing waivers based on subjective assessment undermines the purpose of the examination, which is to create a uniform standard for all practitioners. It also creates an unfair advantage for the individual and could set a precedent for future exceptions, eroding the examination’s credibility. Ethically, this approach compromises the principle of fairness and equal opportunity for all candidates. Another incorrect approach is to suggest that the colleague’s existing national certifications are sufficient, implying they should be automatically recognized without meeting the pan-European eligibility criteria. While national certifications are important, the Advanced Pan-Europe Licensure Examination is designed to establish a supra-national standard. Its purpose is to ensure a consistent level of advanced competency across diverse healthcare systems within Europe. Relying solely on national qualifications without fulfilling the pan-European eligibility requirements bypasses the examination’s intended function of harmonizing advanced adult congenital cardiology practice. This approach neglects the specific objectives of the pan-European licensure. A further incorrect approach involves encouraging the colleague to pursue a less rigorous or alternative pathway that might exist outside the formal examination structure, without ensuring it aligns with the spirit and letter of the pan-European licensure’s purpose. This could involve suggesting informal mentorship or a modified training program that does not demonstrably meet the advanced competencies assessed by the examination. Such an approach circumvents the established process and fails to provide the objective assurance of competence that the licensure examination is designed to deliver. It prioritizes expediency over the rigorous validation of advanced skills and knowledge required for pan-European practice. Professional Reasoning: Professionals should approach situations involving licensure requirements with a commitment to transparency, fairness, and adherence to established regulations. The decision-making process should involve: 1) Clearly understanding the purpose and specific eligibility criteria of the licensure examination. 2) Objectively assessing whether the candidate meets all stated requirements without bias. 3) Recognizing the ethical imperative to uphold the integrity of the examination process for the benefit of patients and the profession. 4) If advocating for a candidate, ensuring that any proposed exceptions or alternative pathways are fully compliant with the spirit and letter of the regulatory framework and do not compromise the examination’s standards. 5) Prioritizing objective assessment over personal relationships or subjective evaluations of talent.

Scenario Analysis: This scenario presents a professional challenge due to the inherent conflict between a candidate’s perceived readiness and the rigorous, evidence-based requirements for licensure in a specialized medical field. The pressure to pass, coupled with the desire to expedite the process, can lead to ethically questionable shortcuts. Careful judgment is required to balance professional integrity, patient safety, and the candidate’s aspirations. Correct Approach Analysis: The best professional practice involves a structured, evidence-based approach to preparation that aligns with established guidelines for adult congenital cardiology licensure. This includes meticulously reviewing the official syllabus, engaging with recommended study materials, participating in accredited review courses, and undertaking practice examinations that accurately simulate the licensure exam’s format and difficulty. The timeline should be realistic, allowing for thorough comprehension and retention of complex material, typically spanning several months, rather than weeks. This approach is correct because it directly addresses the core competencies and knowledge domains assessed by the Advanced Pan-Europe Adult Congenital Cardiology Licensure Examination, ensuring the candidate is adequately prepared to practice safely and effectively. Adherence to recommended preparation resources and timelines is an implicit ethical obligation to future patients and the profession, as it minimizes the risk of unqualified individuals entering practice. Incorrect Approaches Analysis: One incorrect approach involves relying solely on anecdotal advice from peers and a condensed, last-minute cramming strategy. This is professionally unacceptable because it bypasses the structured curriculum and recommended resources, potentially leading to gaps in knowledge and superficial understanding. It disregards the complexity of adult congenital cardiology and the thoroughness expected for licensure, risking inadequate preparation and potential harm to patients. Another incorrect approach is to focus exclusively on memorizing past examination questions without understanding the underlying principles. This is ethically flawed as it prioritizes passing the exam through rote learning rather than developing the deep conceptual understanding and clinical reasoning skills essential for competent practice. It fails to equip the candidate with the ability to apply knowledge to novel clinical situations, which is a cornerstone of responsible medical practice. A further incorrect approach is to assume that prior experience in a related field automatically translates to readiness for this specific, advanced licensure, and therefore to undertake minimal preparation. This is professionally unsound because adult congenital cardiology is a highly specialized discipline with unique knowledge and skill requirements that may not be fully covered by general cardiology or pediatric training. It underestimates the specific demands of the examination and the ethical imperative to demonstrate mastery of the defined scope of practice. Professional Reasoning: Professionals should approach licensure preparation with a mindset of continuous learning and a commitment to meeting established standards. This involves proactively seeking out official guidance on examination content and recommended resources, developing a realistic study plan that allows for deep learning rather than superficial memorization, and engaging in self-assessment through practice examinations. The decision-making process should prioritize patient safety and professional integrity above expediency, ensuring that licensure is a true indicator of competence.

This scenario presents a significant ethical challenge because it pits the immediate medical needs of a vulnerable patient against the established protocols and the potential for long-term harm if those protocols are bypassed without due diligence. The professional challenge lies in balancing the physician’s duty of care to the individual patient with the responsibility to uphold institutional policies designed for patient safety and resource allocation, all within the framework of European medical ethics and relevant national legislation governing patient consent and access to experimental treatments. Careful judgment is required to navigate the complex interplay of patient autonomy, beneficence, non-maleficence, and justice. The best professional approach involves a thorough, documented discussion with the patient and their legal guardian regarding the experimental nature of the treatment, its potential benefits and risks, and the availability of alternative, established therapies. This approach prioritizes informed consent, a cornerstone of European medical ethics and patient rights legislation. It acknowledges the patient’s autonomy while ensuring they understand the implications of choosing an unproven treatment. Furthermore, it involves seeking formal ethical review and approval from the relevant institutional review board or ethics committee, which is a standard regulatory requirement for the use of experimental therapies. This ensures that the decision is not solely at the physician’s discretion but is scrutinized by a multidisciplinary body, safeguarding both the patient and the institution. An incorrect approach would be to administer the experimental treatment based solely on the physician’s belief in its efficacy, without obtaining comprehensive informed consent from the patient and their guardian. This violates the principle of patient autonomy and potentially exposes the patient to undue risk without their full understanding. It also bypasses essential regulatory safeguards designed to protect patients participating in experimental protocols. Another incorrect approach would be to refuse to consider the experimental treatment altogether, citing only institutional policy without exploring potential exceptions or avenues for approval. While adherence to policy is important, a rigid refusal without considering the patient’s unique circumstances and the potential for life-saving intervention can be seen as a failure of the physician’s duty of beneficence, especially if established treatments have failed. This approach neglects the ethical imperative to explore all reasonable options for patient well-being. Finally, an incorrect approach would be to proceed with the treatment under the guise of an emergency without proper ethical or regulatory authorization. While emergencies necessitate swift action, the use of experimental therapies requires specific protocols and approvals, even in urgent situations, to ensure patient safety and maintain ethical standards. Misrepresenting the situation to bypass these procedures is a serious ethical and regulatory breach. Professionals should employ a decision-making framework that begins with a comprehensive assessment of the patient’s condition and available treatment options. This should be followed by open and honest communication with the patient and their family, ensuring they understand all aspects of their care. When considering novel or experimental treatments, the framework must include consultation with colleagues, seeking ethical review, and adhering to all applicable institutional and national regulations regarding patient consent and experimental therapies. The ultimate decision should be a collaborative one, grounded in ethical principles and regulatory compliance.

The control framework reveals a complex scenario involving a young adult with congenital heart disease (CHD) facing a significant life decision with potential long-term health implications. This situation is professionally challenging due to the inherent tension between patient autonomy, the clinician’s duty of care, and the complexities of managing a chronic, life-limiting condition within a European healthcare system. The patient, though an adult, may have varying levels of understanding and capacity to make fully informed decisions, especially concerning reproductive choices that carry known risks for individuals with CHD. Careful judgment is required to balance the patient’s right to self-determination with the ethical imperative to ensure they comprehend the risks and benefits, and that the decision is truly their own, free from undue influence. The correct approach involves a comprehensive, multi-disciplinary discussion that prioritizes the patient’s understanding and autonomy. This entails clearly explaining the specific cardiac risks associated with pregnancy for their particular condition, outlining available management strategies, and discussing alternative options for family planning. Crucially, this approach ensures that the patient is empowered to make an informed decision by providing all necessary information in an accessible manner, respecting their values and preferences, and involving them in shared decision-making. This aligns with fundamental ethical principles of autonomy and beneficence, and is supported by European guidelines on patient rights and informed consent, which emphasize the patient’s right to receive clear, understandable information about their condition and treatment options, and to make decisions about their own healthcare. An incorrect approach would be to present a single, predetermined recommendation without thoroughly exploring the patient’s understanding or alternatives. This fails to uphold the principle of autonomy, as it may unduly influence the patient’s decision or imply that their personal preferences are secondary to the medical recommendation. It also risks violating the spirit of informed consent by not ensuring the patient has a complete picture of all viable options and their associated risks and benefits. Another incorrect approach would be to defer the decision entirely to the patient’s parents or guardians, even though the patient is legally an adult. While parental involvement can be valuable, the ultimate decision-making authority rests with the competent adult patient. Failing to engage directly with the patient and respect their autonomy in this regard is a significant ethical and legal failing, potentially contravening European data protection and patient rights legislation that grants adults the right to control their own medical information and decisions. A further incorrect approach would be to provide only a brief overview of the risks without exploring the patient’s personal circumstances, values, or concerns. This superficial engagement with informed consent does not adequately equip the patient to make a decision that is truly aligned with their life goals and understanding. It neglects the crucial aspect of shared decision-making, where the clinician acts as a facilitator and educator, rather than simply a dispenser of medical facts. Professionals should employ a structured decision-making process that begins with assessing the patient’s capacity and understanding. This involves open-ended questioning, active listening, and using clear, jargon-free language. The clinician should then present all relevant information, including risks, benefits, and alternatives, tailored to the patient’s comprehension level. Encouraging questions and addressing concerns is paramount. Finally, the decision should be a collaborative one, respecting the patient’s ultimate choice while ensuring they are fully supported in their chosen path.

This scenario presents a professional challenge due to the inherent tension between resource allocation, the ethical imperative to address health inequities, and the need for evidence-based interventions in a pan-European context. Decision-making requires a nuanced understanding of population health data, epidemiological trends, and the specific socio-economic determinants of health affecting adult congenital heart disease (ACHD) patients across diverse European healthcare systems. Careful judgment is required to balance the immediate needs of high-prevalence areas with the long-term goal of equitable access to specialized care. The best approach involves a comprehensive, multi-stakeholder strategy that prioritizes targeted interventions based on robust epidemiological data and a clear commitment to health equity. This means actively engaging with patient advocacy groups, national health authorities, and research institutions across Europe to identify regions with the greatest burden of ACHD and the most significant disparities in access to care. The strategy should then focus on developing and implementing tailored programs that address the specific barriers faced by underserved populations, such as geographical access, financial constraints, and cultural factors. This aligns with the ethical principles of justice and beneficence, and is supported by the overarching goals of European public health initiatives that emphasize reducing health inequalities. An approach that solely focuses on the highest incidence rates without considering the underlying reasons for those rates or the accessibility of existing services would be professionally unacceptable. This fails to address the root causes of health disparities and may inadvertently exacerbate inequities by directing resources to areas that already have better access, even if their raw incidence is higher. Another professionally unacceptable approach would be to implement a one-size-fits-all intervention across all European countries. This ignores the significant diversity in healthcare infrastructure, cultural contexts, and socio-economic conditions that influence health outcomes for ACHD patients. Such an approach lacks the specificity needed to effectively address the unique challenges faced by different populations and is unlikely to achieve meaningful improvements in health equity. Furthermore, an approach that relies solely on the availability of existing infrastructure without assessing its adequacy or equitable distribution would be flawed. This overlooks the possibility that even where infrastructure exists, it may not be accessible or effective for all segments of the ACHD population, particularly those from marginalized communities. Professionals should employ a decision-making framework that begins with a thorough epidemiological assessment, followed by a socio-economic analysis of identified disparities. This should be coupled with extensive stakeholder consultation to understand local needs and barriers. Interventions should then be designed with a clear focus on equity, measurability, and adaptability, ensuring that progress is monitored and strategies are refined based on real-world outcomes and feedback from affected communities.

This scenario presents a professional challenge due to the inherent conflict between a clinician’s duty of care and the patient’s autonomy, particularly when dealing with a vulnerable adult with a complex congenital heart condition. The physician must navigate the patient’s expressed wishes against what they perceive as the patient’s best medical interest, requiring careful ethical deliberation and adherence to professional standards. The best approach involves a comprehensive, multi-faceted strategy that prioritizes open communication, shared decision-making, and robust support for the patient. This includes thoroughly explaining the risks and benefits of the proposed treatment, exploring the patient’s understanding and concerns, and involving the patient’s designated support network (if applicable and with consent). Crucially, it necessitates documenting all discussions and decisions meticulously. This aligns with the ethical principles of beneficence, non-maleficence, and respect for patient autonomy, as well as professional guidelines emphasizing patient-centered care and informed consent. An approach that unilaterally overrides the patient’s stated preference, even with good intentions, fails to respect their autonomy and can lead to a breakdown of trust. This contravenes ethical principles and professional standards that mandate shared decision-making. Another incorrect approach would be to disengage from the patient or dismiss their concerns as a result of their condition. This constitutes a failure in the duty of care and professional responsibility to engage with and support the patient, potentially leading to suboptimal outcomes and ethical breaches. Finally, an approach that solely relies on the opinion of other medical professionals without direct, empathetic engagement with the patient and their family (where appropriate) neglects the individual’s lived experience and personal values, which are integral to ethical medical practice. Professionals should employ a decision-making framework that begins with understanding the patient’s perspective and values. This involves active listening, clear communication of medical information in an understandable format, and exploring all available options. When there is a divergence between the clinician’s recommendation and the patient’s wishes, a structured ethical discussion, potentially involving an ethics committee or senior colleagues, should be considered, always keeping the patient’s well-being and autonomy at the forefront.