This scenario is professionally challenging because it involves a patient with a potentially life-altering diagnosis who is experiencing significant emotional distress, impacting their capacity to process complex medical information. The doctor must balance the urgency of informing the patient with the ethical imperative to ensure understanding and autonomy, all within the framework of GMC guidance on consent and communication. The best approach involves a phased discussion, prioritising the patient’s immediate emotional needs while establishing a foundation for informed consent. This means acknowledging the patient’s distress, offering immediate support, and then breaking down the information into manageable parts, checking for understanding at each stage. This aligns with GMC guidance which stresses that consent is a process, not a single event, and requires effective communication tailored to the individual patient’s needs and capacity. It upholds the patient’s right to autonomy by ensuring they can make a decision based on adequate information, even if that information is delivered over time. An approach that immediately presents all treatment options and their risks without first addressing the patient’s emotional state and ensuring a basic level of comprehension fails to recognise the impact of distress on decision-making capacity. This could lead to a situation where the patient appears to consent but does not truly understand the implications, violating the principles of informed consent and potentially leading to regret or a feeling of being overwhelmed. Another unacceptable approach would be to delay informing the patient about the diagnosis and treatment options due to their distress. While empathy is crucial, withholding necessary information indefinitely can be paternalistic and deprives the patient of their right to be involved in decisions about their own care, potentially leading to missed opportunities for timely intervention. Finally, proceeding with treatment based on a perceived, but not confirmed, understanding of the patient’s wishes, without explicit consent, is a serious breach of ethical and legal requirements. It undermines patient autonomy and can lead to significant legal and professional repercussions. Professionals should employ a decision-making framework that prioritises patient-centred communication. This involves: assessing the patient’s current emotional state and capacity to understand; tailoring information delivery to their needs, breaking down complex information; actively checking for understanding throughout the conversation; offering support and time for reflection; and ensuring that consent is a dynamic, ongoing process.

This scenario presents a professional challenge due to the potential for delayed diagnosis and treatment of a serious inflammatory condition, impacting patient safety and outcomes. The physician must balance the need for thorough investigation with the urgency of addressing symptoms that could indicate significant pathology. Careful judgment is required to avoid both over-investigation and under-investigation. The best professional approach involves a systematic and evidence-based investigation of the patient’s symptoms, guided by clinical suspicion and differential diagnoses. This includes taking a detailed history, performing a thorough physical examination, and ordering appropriate investigations such as blood tests (e.g., inflammatory markers like CRP and ESR, full blood count), imaging (e.g., ultrasound, CT scan), and potentially specialist referral if indicated. This approach aligns with the General Medical Council’s (GMC) guidance on good medical practice, which emphasizes the doctor’s responsibility to provide good quality care, including making sure patients receive treatment that is appropriate to their needs. It also reflects the principles of clinical governance, which require doctors to maintain and improve their professional standards. An incorrect approach would be to dismiss the patient’s symptoms as minor without adequate investigation, potentially leading to a delayed diagnosis of a serious inflammatory condition. This fails to meet the GMC’s standards for patient care and could result in harm to the patient. Another incorrect approach would be to immediately escalate to highly invasive or expensive investigations without a clear clinical rationale or prior less invasive steps. While thoroughness is important, this can lead to unnecessary patient anxiety, potential risks associated with procedures, and inefficient use of healthcare resources, which is not in line with responsible medical practice. A further incorrect approach would be to rely solely on the patient’s self-reported improvement without objective clinical assessment. While patient feedback is valuable, it should not replace a physician’s clinical judgment and the need for objective diagnostic processes, especially when symptoms suggest an underlying inflammatory process. The professional reasoning framework for such situations involves: 1. Recognising and assessing the patient’s symptoms and signs. 2. Formulating a differential diagnosis, considering common and serious causes of inflammation. 3. Developing an investigation plan that is proportionate to the clinical suspicion, starting with less invasive and more readily available tests. 4. Continuously reassessing the patient’s condition based on investigation results and clinical progress. 5. Communicating effectively with the patient about the diagnostic process and findings. 6. Seeking specialist advice when necessary.

Scenario Analysis: This scenario is professionally challenging because it involves balancing the immediate need to protect public health from a potentially infectious disease with the individual patient’s right to confidentiality and autonomy. The doctor must act decisively to prevent transmission while respecting the patient’s wishes and understanding their reasons for reluctance. Failure to act appropriately could lead to a public health crisis, while overstepping boundaries could damage the doctor-patient relationship and violate ethical principles. Correct Approach Analysis: The best professional practice involves a multi-faceted approach that prioritises public health while maintaining ethical standards. This includes clearly explaining the public health risks to the patient, the legal and ethical obligations to report, and the potential consequences of non-compliance. It also involves exploring the patient’s concerns and offering support, such as addressing fears about stigma or treatment. If the patient remains unwilling to consent to notification, the doctor must then proceed with reporting to the relevant public health authorities, as mandated by law and professional guidance, while still attempting to minimise any potential harm to the patient’s reputation or well-being. This approach aligns with the General Medical Council’s (GMC) guidance on confidentiality and public health, which states that doctors have a duty to protect patients and the public, and that this duty can override confidentiality in specific circumstances, such as when there is a serious risk of harm to others. Incorrect Approaches Analysis: One incorrect approach involves immediately reporting the diagnosis to public health authorities without attempting to discuss the situation with the patient or understand their concerns. This fails to uphold the principle of patient autonomy and can erode trust in the doctor-patient relationship. While public health is paramount, a collaborative approach is generally preferred when possible. Another incorrect approach is to respect the patient’s wishes for absolute confidentiality and refrain from reporting the diagnosis, even when there is a clear risk of transmission to others. This directly contravenes the doctor’s legal and ethical duty to protect the public from infectious diseases, as outlined in public health legislation and GMC guidance. A further incorrect approach is to coerce or unduly pressure the patient into consenting to notification, using threats or ultimatums. This is ethically unacceptable as it undermines informed consent and can lead to significant distress for the patient. While persuasion and clear explanation are appropriate, coercion is not. Professional Reasoning: Professionals should employ a decision-making framework that begins with a thorough assessment of the public health risk. This should be followed by open and honest communication with the patient, explaining the diagnosis, the risks to others, and the legal/ethical obligations. The doctor should actively listen to the patient’s concerns and explore ways to address them, such as providing information or support. If the patient’s consent cannot be obtained, the doctor must then consider their overriding duty to protect public health and report the case to the appropriate authorities, ensuring this is done in a manner that respects the patient’s dignity as much as possible. This process prioritises patient safety and public well-being while adhering to ethical and legal requirements.

This scenario is professionally challenging because it involves a potential conflict between a doctor’s duty to their patient and the need to maintain the integrity of medical records and diagnostic processes. The doctor must act with honesty and diligence, ensuring that patient care is not compromised by any misinterpretation or omission of critical information. Careful judgment is required to balance these competing demands while adhering to professional standards. The best professional approach involves immediately informing the senior pathologist about the discrepancy and the potential for misinterpretation of the biopsy findings. This is correct because it upholds the principles of honesty, transparency, and professional accountability. By promptly disclosing the issue, the doctor ensures that the senior pathologist can review the case with full awareness of the potential error, allowing for accurate diagnosis and appropriate patient management. This aligns with the General Medical Council’s (GMC) guidance on good medical practice, which emphasizes the importance of open and honest communication, particularly when patient safety or diagnostic accuracy may be at risk. It also reflects the duty to ensure that patient records are accurate and that any potential errors are addressed promptly to prevent harm. An incorrect approach would be to proceed with the report without mentioning the discrepancy, hoping it might not be significant. This is professionally unacceptable as it constitutes a failure to be open and honest with colleagues and potentially with the patient. It risks perpetuating an inaccurate diagnosis, which could lead to inappropriate treatment or a delay in necessary interventions, thereby compromising patient safety. This breaches the GMC’s standards regarding honesty and integrity. Another incorrect approach would be to attempt to correct the slide or re-process it without informing the senior pathologist. This is a serious ethical and professional failing. It involves falsifying or manipulating evidence, which undermines the scientific integrity of the diagnostic process and constitutes a breach of trust. Such actions could have severe consequences for the patient and for the doctor’s professional standing, violating fundamental principles of medical ethics and GMC guidance on professional conduct. A further incorrect approach would be to discuss the discrepancy with junior colleagues before informing the senior pathologist. While collegial discussion can be valuable, in this instance, the primary responsibility is to inform the supervising pathologist who has the ultimate responsibility for the report. Delaying this communication or discussing it with less experienced colleagues first could be seen as an attempt to circumvent proper reporting channels or to seek validation for a potentially incorrect course of action, rather than directly addressing the issue with the appropriate authority. This fails to demonstrate professional accountability and timely escalation. The professional reasoning framework to use in such situations involves a clear, step-by-step process: 1. Identify the potential issue or discrepancy. 2. Assess the potential impact on patient care and diagnostic accuracy. 3. Consult relevant professional guidelines and ethical principles. 4. Communicate the issue promptly and transparently to the appropriate senior colleague or supervisor. 5. Document all communications and actions taken. 6. Follow established protocols for error reporting and resolution.

Scenario Analysis: This scenario presents a professional challenge due to the inherent uncertainty in diagnosing and managing autoimmune disorders, particularly when a patient’s presentation is complex or atypical. The doctor must balance the need for timely and accurate diagnosis with the potential risks of invasive investigations and the psychological impact of a potential misdiagnosis or delayed diagnosis on the patient. Ethical considerations include patient autonomy, beneficence, non-maleficence, and the duty to provide competent care within the scope of practice, all guided by the General Medical Council (GMC) principles. Correct Approach Analysis: The best professional practice involves a systematic and evidence-based approach. This includes a thorough history and physical examination, followed by the judicious selection of investigations tailored to the patient’s specific symptoms and signs. The doctor should consider a broad differential diagnosis, including autoimmune conditions, but also other potential causes. Collaboration with relevant specialists, such as rheumatologists or immunologists, is crucial when the diagnosis is uncertain or complex. This approach ensures that investigations are not only appropriate but also minimised to avoid unnecessary patient burden and cost, while maximising the likelihood of an accurate diagnosis and effective management plan. This aligns with GMC guidance on good medical practice, particularly regarding the need for doctors to maintain their knowledge and skills, and to work collaboratively. Incorrect Approaches Analysis: One incorrect approach would be to immediately initiate extensive and potentially unnecessary investigations without a clear diagnostic hypothesis. This could lead to patient distress, financial burden, and the risk of incidental findings that may not be clinically relevant. It fails to demonstrate a structured diagnostic process and may not be the most efficient or effective use of healthcare resources, contravening the GMC’s emphasis on responsible resource management. Another incorrect approach would be to dismiss the possibility of an autoimmune disorder solely based on the absence of classic symptoms, especially if the patient’s presentation suggests a systemic inflammatory process. Autoimmune diseases can manifest in diverse ways, and a premature closure of the diagnostic mind-set could lead to a delayed diagnosis and potentially irreversible damage. This would be a failure to uphold the principle of beneficence and could breach the duty of care. A further incorrect approach would be to rely solely on the patient’s self-diagnosis or information obtained from non-medical sources without critical appraisal. While patient engagement is important, medical decisions must be based on professional judgment and evidence. Uncritically accepting patient-led diagnostic conclusions without independent medical assessment would be a failure to exercise professional responsibility and could lead to inappropriate management. Professional Reasoning: Professionals should employ a structured diagnostic framework. This begins with a comprehensive assessment of the patient’s presenting complaint, including a detailed history and physical examination. A broad differential diagnosis should be generated, considering common and serious conditions. Investigations should then be selected based on their ability to confirm or refute specific diagnoses within the differential, prioritising those that are most informative and least invasive. The process should be iterative, with findings from investigations informing the next steps. Collaboration with colleagues and specialists is essential when faced with diagnostic uncertainty. Throughout this process, clear communication with the patient about the diagnostic process, potential diagnoses, and the rationale for investigations is paramount.

Scenario Analysis: This scenario is professionally challenging because it involves a patient presenting with symptoms that could indicate a serious underlying pathology, but the patient is also expressing significant anxiety and a desire for immediate reassurance. The challenge lies in balancing the need for thorough diagnostic investigation with the patient’s emotional state and their perception of urgency. A rushed or dismissive approach could lead to missed diagnoses or patient distress, while an overly cautious approach without addressing the patient’s immediate concerns could also be detrimental. Careful judgment is required to integrate clinical findings with patient-centred care. Correct Approach Analysis: The best professional practice involves a systematic approach that prioritises patient safety and well-being while adhering to good medical practice. This approach begins with a comprehensive history and examination to gather all relevant clinical information. It then involves considering the differential diagnoses based on the findings, and formulating an appropriate investigation plan. Crucially, it also includes open communication with the patient, explaining the diagnostic process, potential causes, and the rationale behind the chosen investigations, while also acknowledging and addressing their anxieties. This aligns with the GMC’s guidance on good medical practice, which emphasises the importance of effective communication, shared decision-making, and ensuring patients receive appropriate care and treatment. Incorrect Approaches Analysis: One incorrect approach would be to immediately dismiss the patient’s concerns and reassure them without a thorough assessment, based solely on their anxiety. This fails to acknowledge the potential for serious pathology and could lead to a missed diagnosis, violating the duty of care and potentially causing harm. It disregards the need for evidence-based decision-making. Another incorrect approach would be to proceed with extensive, potentially unnecessary, and invasive investigations without a clear diagnostic rationale or adequate explanation to the patient. This could cause undue distress, financial burden, and potential iatrogenic harm, and does not represent a proportionate or patient-centred approach to care. It also fails to involve the patient in shared decision-making. A further incorrect approach would be to focus solely on the physical examination findings and disregard the patient’s expressed anxiety and desire for reassurance. While clinical assessment is vital, failing to address the psychological component of the patient’s presentation can lead to a breakdown in the therapeutic relationship and patient dissatisfaction, even if a physical diagnosis is eventually reached. Professional Reasoning: Professionals should utilise a decision-making framework that integrates clinical assessment with patient-centred communication. This involves: 1. Active listening and empathetic engagement to understand the patient’s concerns and anxieties. 2. A thorough clinical assessment, including history and physical examination, to gather objective data. 3. Developing a differential diagnosis based on the gathered information. 4. Formulating an investigation plan that is proportionate, evidence-based, and tailored to the suspected diagnoses. 5. Communicating the findings, potential diagnoses, and investigation plan clearly and compassionately to the patient, involving them in shared decision-making. 6. Addressing the patient’s anxieties throughout the process.

This scenario is professionally challenging because it requires a doctor to balance the immediate needs of a patient with the ethical and regulatory obligations concerning the appropriate use of medicines and the potential for off-label prescribing. The doctor must consider the evidence base, patient safety, and the GMC’s guidance on good medical practice. The best professional approach involves a thorough assessment of the patient’s condition, a comprehensive review of the available evidence for the proposed off-label use of the enzyme, and a detailed discussion with the patient about the risks, benefits, and uncertainties. This includes confirming that no licensed alternative is suitable and that there is a strong clinical rationale for the off-label use, supported by robust evidence or expert consensus. The doctor must then document this decision-making process meticulously. This aligns with the GMC’s core principles of good medical practice, particularly regarding patient safety, informed consent, and professional judgment. The GMC expects doctors to prescribe medicines responsibly, which includes understanding the evidence base for any treatment, whether licensed or off-label. An incorrect approach would be to prescribe the enzyme solely based on anecdotal evidence or a personal belief without seeking further information or discussing the uncertainties with the patient. This fails to uphold the principle of evidence-based practice and could compromise patient safety by exposing them to unproven risks. It also falls short of the GMC’s requirements for informed consent, as the patient would not be fully aware of the lack of established evidence. Another incorrect approach would be to delay treatment indefinitely due to a lack of a licensed indication, even if there is a strong clinical need and emerging evidence suggesting potential benefit. While caution is necessary, a complete refusal to consider a potentially beneficial treatment without exploring all avenues, including seeking expert advice or considering compassionate use protocols where applicable, could be seen as failing to act in the patient’s best interest. A further incorrect approach would be to administer the enzyme without obtaining explicit informed consent, particularly regarding the off-label nature of its use and the associated uncertainties. This directly violates the GMC’s guidance on consent and undermines the patient’s autonomy. The professional reasoning framework for such situations should involve a systematic approach: 1. Patient Assessment: Thoroughly understand the patient’s condition and the unmet clinical need. 2. Evidence Review: Critically appraise the available literature and expert opinion regarding the off-label use of the enzyme. 3. Risk-Benefit Analysis: Weigh the potential benefits against the known and unknown risks. 4. Consider Alternatives: Ensure no licensed treatment is appropriate or effective. 5. Informed Consent: Engage in a comprehensive discussion with the patient, explaining the rationale, evidence, risks, benefits, uncertainties, and alternatives. 6. Documentation: Meticulously record the entire decision-making process, including the patient’s consent. 7. Consultation: Seek advice from colleagues, specialists, or relevant professional bodies if uncertainty remains.

Scenario Analysis: This scenario is professionally challenging because it involves a patient with a complex metabolic disorder presenting with new, potentially serious symptoms. The physician must balance the need for prompt diagnosis and treatment with the ethical and professional obligation to ensure the patient’s understanding and consent, especially when considering invasive investigations. The patient’s anxiety and potential for misinterpreting information add further complexity, requiring clear, empathetic communication. Correct Approach Analysis: The best professional approach involves a thorough clinical assessment to understand the current symptoms in the context of the patient’s known metabolic pathway disorder. This includes taking a detailed history, performing a physical examination, and reviewing relevant investigations. Following this, the physician should clearly explain the potential causes of the new symptoms, the diagnostic options available, and the rationale for each investigation, including the risks and benefits. Crucially, the physician must ensure the patient understands this information and provides informed consent before proceeding with any invasive tests. This aligns with the General Medical Council’s (GMC) guidance on good medical practice, particularly concerning communication, consent, and patient safety. The GMC emphasizes the importance of shared decision-making, ensuring patients are involved in decisions about their care and are given the information they need to make informed choices. Incorrect Approaches Analysis: Proceeding directly to invasive investigations without a thorough clinical assessment and clear explanation risks misdiagnosis, unnecessary patient distress, and potential harm. This approach fails to uphold the principle of acting in the patient’s best interest by not first establishing a clear diagnostic pathway based on current symptoms. It also breaches the GMC’s guidance on consent, as the patient would not have been adequately informed about the necessity or implications of the tests. Suggesting a broad range of investigations without a clear diagnostic rationale, based solely on the patient’s underlying condition, is inefficient and potentially exposes the patient to unnecessary risks and costs. This approach lacks the focused, evidence-based reasoning required for good medical practice and does not demonstrate a commitment to personalized patient care. Focusing solely on the patient’s known metabolic disorder and assuming the new symptoms are a direct exacerbation without considering other potential causes is a form of diagnostic bias. While the underlying condition is important, it should not preclude consideration of differential diagnoses, especially when new symptoms arise. This can lead to delayed diagnosis of other serious conditions. Professional Reasoning: Professionals should employ a structured decision-making framework when faced with new symptoms in a patient with a chronic condition. This framework typically involves: 1. Information Gathering: Obtain a comprehensive history of the new symptoms, including onset, duration, severity, and any associated factors. Perform a thorough physical examination. Review the patient’s medical history, current medications, and previous investigations. 2. Differential Diagnosis: Based on the gathered information, formulate a list of potential diagnoses, considering both exacerbations of the known condition and new, unrelated conditions. 3. Investigation Planning: Prioritize investigations based on their diagnostic yield, invasiveness, risks, and benefits, aiming for the most efficient and least burdensome pathway to diagnosis. 4. Communication and Consent: Clearly explain the suspected diagnoses, the rationale for proposed investigations, and the associated risks and benefits to the patient. Ensure the patient understands and provides informed consent. 5. Treatment and Review: Initiate appropriate treatment based on the diagnosis and arrange for follow-up to monitor the patient’s progress.

Scenario Analysis: This scenario is professionally challenging because it involves a patient with a potentially life-limiting condition, requiring a delicate balance between providing accurate information, respecting patient autonomy, and managing potential distress. The physician must navigate the complexities of discussing a neoplasm’s prognosis and treatment options while ensuring the patient’s understanding and capacity to make informed decisions. The GMC’s Good Medical Practice guidelines are paramount here, emphasizing the need for clear communication, respect for patients, and acting in their best interests. Correct Approach Analysis: The best approach involves a structured, empathetic, and patient-centred discussion. This includes clearly explaining the diagnosis of neoplasia, its implications, and the available treatment options, including their potential benefits and risks. Crucially, it requires assessing the patient’s understanding and capacity to make decisions, offering support, and involving them in shared decision-making. This aligns directly with GMC guidance on communication, consent, and patient partnership, ensuring the patient is fully informed and empowered to participate in their care plan. Incorrect Approaches Analysis: One incorrect approach would be to withhold significant details about the neoplasm’s prognosis due to concerns about upsetting the patient. This fails to uphold the GMC’s principle of honesty and transparency, denying the patient the right to know their condition and make informed choices about their treatment and future. It can also undermine trust and lead to resentment if the patient later discovers information was withheld. Another incorrect approach would be to present all information in a highly technical, jargon-filled manner without checking for understanding. This demonstrates a failure in effective communication, a core tenet of GMC guidance. Patients have a right to understand their medical situation in plain language, and a failure to ensure comprehension prevents true informed consent and shared decision-making. A third incorrect approach would be to make unilateral decisions about treatment without adequately involving the patient in the discussion. This disregards the patient’s autonomy and right to self-determination, which are fundamental ethical principles reinforced by the GMC. While the physician’s expertise is vital, treatment decisions should be a collaborative process. Professional Reasoning: Professionals should employ a decision-making framework that prioritises clear, honest, and empathetic communication. This involves: 1. Establishing rapport and a safe environment for discussion. 2. Explaining the diagnosis and its implications in understandable terms. 3. Assessing the patient’s understanding and capacity. 4. Discussing all reasonable treatment options, including risks, benefits, and alternatives. 5. Actively involving the patient in shared decision-making, respecting their values and preferences. 6. Offering ongoing support and opportunities for further questions.

Scenario Analysis: This scenario presents a professional challenge due to the sensitive nature of genetic information and the potential for significant emotional distress and societal implications for both the patient and their family. The clinician must navigate the ethical imperative of providing accurate information while respecting patient autonomy, confidentiality, and the potential for misinterpretation or undue anxiety. The complexity arises from the uncertainty inherent in genetic prognostication and the need to balance immediate disclosure with the patient’s capacity to process such information. Careful judgment is required to ensure that the communication is delivered in a manner that is both informative and supportive, adhering to professional standards of care and ethical guidelines. Correct Approach Analysis: The best professional practice involves a phased approach to disclosure. This begins with assessing the patient’s readiness and understanding of their condition and the implications of genetic testing. It then proceeds to a carefully planned discussion, ideally with appropriate support systems in place, where the genetic findings are explained in clear, understandable language, focusing on the most relevant and actionable information. This approach prioritises patient well-being, allowing them to absorb complex information at their own pace and to ask questions. It aligns with the General Medical Council’s (GMC) guidance on good medical practice, which emphasises clear communication, respect for patient autonomy, and the provision of information in a way that the patient can understand. The GMC stresses the importance of shared decision-making and ensuring patients are fully informed about their diagnosis, prognosis, and treatment options, including the implications of genetic information. Incorrect Approaches Analysis: Immediately disclosing all complex genetic findings without assessing the patient’s readiness or providing adequate context or support is professionally unacceptable. This approach fails to respect patient autonomy and can lead to overwhelming anxiety, misinterpretation, and a breakdown in the doctor-patient relationship. It contravenes GMC guidance on clear and sensitive communication. Providing only a summary of the genetic report without explaining its implications or offering further discussion is also professionally inadequate. This approach neglects the clinician’s duty to ensure the patient understands their health status and the potential consequences of genetic predispositions. It falls short of the GMC’s expectation that doctors provide information in a way that is comprehensible and facilitates informed decision-making. Delaying the disclosure of significant genetic findings indefinitely, or until the patient specifically asks, without a clear rationale based on their immediate well-being or capacity, is ethically problematic. While sensitivity is crucial, a complete lack of proactive communication about potentially impactful genetic information can be seen as a failure to uphold the duty of care and inform the patient about factors relevant to their health. This can hinder appropriate management and preventative strategies. Professional Reasoning: Professionals should employ a decision-making framework that prioritises patient-centred care. This involves: 1. Information Gathering: Understanding the patient’s current knowledge, concerns, and emotional state. 2. Risk/Benefit Assessment: Evaluating the potential impact of disclosing the genetic information versus withholding it, considering both medical and psychological factors. 3. Communication Planning: Strategising how, when, and with whom the information will be shared, ensuring clarity and support. 4. Shared Decision-Making: Engaging the patient in understanding the implications and making informed choices about next steps. 5. Ongoing Support: Providing continued access to information, counselling, and follow-up care. This framework ensures that decisions are made ethically, legally, and with the patient’s best interests at the forefront, in line with GMC principles.