Scenario Analysis: This scenario presents a significant ethical and legal challenge due to the inherent conflict between a patient’s autonomy and the clinician’s professional judgment regarding a potentially harmful but desired procedure. The patient, a minor, is seeking a procedure that carries substantial risks and may not be medically indicated for her age and developmental stage. The clinician must navigate the legal requirements for treating minors, the ethical principles of beneficence and non-maleficence, and the patient’s evolving capacity for decision-making. The core challenge lies in balancing the duty to protect the minor from harm with respecting her developing autonomy and her right to seek medical care, even if that care is controversial. Correct Approach Analysis: The best professional practice involves a comprehensive assessment of the minor’s capacity to understand the nature, risks, benefits, and alternatives of the proposed procedure. This assessment should be conducted with sensitivity and in an age-appropriate manner. If the minor demonstrates sufficient maturity and understanding (often referred to as “mature minor doctrine” in some jurisdictions, though specific legal frameworks vary), her assent should be sought and given significant weight. Simultaneously, the clinician must engage with the patient’s parents or legal guardians, explaining the situation, the assessment of the minor’s capacity, and the clinical recommendation. The goal is to reach a shared decision that prioritizes the minor’s well-being, respecting her developing autonomy while ensuring parental involvement and legal compliance. This approach aligns with the ethical principles of respecting autonomy (even in minors with developing capacity), beneficence (acting in the patient’s best interest), and non-maleficence (avoiding harm). Legally, it adheres to frameworks governing consent for minors, which often involve a tiered approach based on age, maturity, and the nature of the medical intervention. Incorrect Approaches Analysis: Proceeding with the procedure solely based on the minor’s request, without adequate parental consent or a thorough assessment of the minor’s capacity, would be a significant ethical and legal failure. This disregards the legal requirement for parental consent for minors in most jurisdictions and violates the principle of non-maleficence by potentially exposing the minor to harm without proper authorization or understanding. Refusing to discuss the procedure with the minor at all and solely deferring to parental wishes, even if the minor demonstrates significant maturity and understanding, would be ethically problematic. This fails to respect the minor’s developing autonomy and her right to be informed and involved in her own healthcare decisions, potentially eroding trust and leading to the patient seeking care elsewhere without proper oversight. Performing the procedure after obtaining parental consent but without a thorough assessment of the minor’s capacity to understand the implications would also be ethically and legally deficient. While parental consent is crucial, it does not absolve the clinician of the responsibility to ensure the patient herself comprehends the procedure, especially for interventions with significant risks or long-term consequences. This approach prioritizes legal compliance over ethical patient-centered care and the principle of informed consent for the individual receiving the treatment. Professional Reasoning: Professionals should employ a decision-making framework that begins with understanding the specific legal requirements for treating minors in their jurisdiction. This includes understanding the age of consent, requirements for parental consent, and any exceptions or nuances like the mature minor doctrine. Ethically, the framework should prioritize the patient’s best interests (beneficence and non-maleficence) while respecting their developing autonomy. A crucial step is assessing the minor’s capacity for decision-making, which involves evaluating their ability to understand information, appreciate the consequences of their choices, and communicate a choice. Open and honest communication with both the minor and their guardians is paramount, aiming for a collaborative approach that ensures informed consent and prioritizes the minor’s well-being.

Scenario Analysis: This scenario presents a significant ethical and professional challenge due to the sensitive nature of genetic information, the potential for profound personal and familial impact, and the clinician’s duty to balance patient autonomy with the responsibility to provide comprehensive and accurate information. The clinician must navigate the complexities of informed consent, potential psychological distress, and the implications for family members who may also be at risk. Correct Approach Analysis: The best professional approach involves a thorough, multi-stage process that prioritizes patient understanding and autonomy. This begins with a detailed discussion of the genetic test’s purpose, limitations, potential results (including implications for the patient and their family), and the availability of genetic counseling. It is crucial to ensure the patient comprehends this information before proceeding. Following the test, results should be communicated in a supportive environment, again with ample opportunity for questions and discussion. Crucially, the patient should be offered and strongly encouraged to engage with genetic counseling services to fully understand the implications of their results and to develop a personalized management plan. This approach respects patient autonomy by empowering them with knowledge and choice, while fulfilling the ethical obligation to provide appropriate support and resources. This aligns with professional guidelines emphasizing patient-centered care and the importance of genetic counseling in managing hereditary cancer risks. Incorrect Approaches Analysis: One incorrect approach involves proceeding with genetic testing without a thorough pre-test discussion about its implications, including the potential for familial risk and the availability of genetic counseling. This fails to meet the standard of informed consent, as the patient may not fully grasp what they are agreeing to or the potential consequences of the results. Ethically, this undermines patient autonomy and can lead to significant distress if unexpected or concerning results are revealed without adequate preparation or support. Another incorrect approach is to provide the genetic test results directly to the patient without first offering or strongly recommending genetic counseling. While the patient has a right to know their results, failing to facilitate access to specialized genetic counseling can leave them overwhelmed, misinformed, or unable to make informed decisions about their health and that of their family. This neglects the professional responsibility to ensure patients have the necessary resources to interpret and act upon complex genetic information. A third incorrect approach is to disclose the patient’s genetic predisposition to their family members without the patient’s explicit consent. This is a severe breach of patient confidentiality and privacy, violating fundamental ethical principles and potentially legal regulations regarding health information. While there may be a moral consideration for informing at-risk relatives, this must be done with the patient’s permission, often facilitated through the patient sharing information themselves or with the guidance of a genetic counselor. Professional Reasoning: Professionals facing such situations should adopt a structured decision-making process. This begins with a comprehensive assessment of the patient’s understanding and readiness for genetic testing. Prioritizing thorough informed consent, including detailed discussions about potential outcomes and the role of genetic counseling, is paramount. Following testing, results should be delivered with sensitivity and a clear pathway to further support, emphasizing the value of genetic counseling. Professionals must consistently uphold patient confidentiality and autonomy, ensuring that any communication with family members is patient-directed and consensual. This framework ensures that patient well-being, informed decision-making, and ethical conduct remain at the forefront of care.

The risk matrix shows a potential for significant patient distress and ethical compromise due to a misunderstanding of ovarian function in a sensitive gynecological context. This scenario is professionally challenging because it requires a healthcare provider to navigate a patient’s deeply personal health concerns while upholding professional standards of care and ethical communication. The provider must balance the patient’s immediate emotional needs with the imperative to provide accurate, evidence-based information about her reproductive health. The best professional approach involves a direct, empathetic, and factually accurate explanation of ovarian function, specifically addressing the patient’s misconception. This approach is correct because it prioritizes patient autonomy and informed consent by providing clear, understandable information. It aligns with ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm, including psychological distress caused by misinformation). Furthermore, it upholds the professional duty to educate patients about their bodies and health conditions, fostering trust and enabling better decision-making regarding their reproductive health. This method directly confronts the misinformation and replaces it with accurate knowledge, empowering the patient. An approach that dismisses the patient’s concerns as irrelevant or overly emotional is professionally unacceptable. This fails to acknowledge the patient’s lived experience and can lead to feelings of invalidation and distrust, potentially causing psychological harm. Ethically, it violates the principle of respect for persons and can impede the therapeutic relationship. Another unacceptable approach is to provide a vague or overly technical explanation that does not directly address the patient’s specific misunderstanding. While technically accurate, such an explanation would fail to achieve the goal of patient comprehension and could leave the patient feeling confused and still misinformed, thus not fulfilling the duty of care. Finally, an approach that involves sharing personal anecdotes or opinions about ovarian function, rather than evidence-based information, is also professionally inappropriate. This blurs the lines between professional advice and personal belief, potentially introducing bias and undermining the credibility of the healthcare provider. It deviates from the standard of care which mandates objective, evidence-based guidance. Professionals should employ a decision-making framework that begins with active listening to fully understand the patient’s concerns and misconceptions. This is followed by assessing the accuracy of the patient’s understanding and identifying the specific knowledge gap. The next step is to formulate a clear, concise, and empathetic explanation tailored to the patient’s level of understanding, directly addressing the misinformation. Finally, the provider should confirm the patient’s comprehension and offer further support or resources.

The risk matrix shows a potential for significant patient harm due to a misunderstanding of anatomical structures during a gynecological procedure. This scenario is professionally challenging because it requires the clinician to balance the immediate need for surgical intervention with the ethical obligation to obtain informed consent, which necessitates a clear and accurate explanation of the procedure and its risks. The complexity arises from the delicate nature of the fallopian tubes and their proximity to other vital pelvic organs, making any misidentification potentially catastrophic. Careful judgment is required to ensure the patient fully comprehends the implications of the surgery. The best professional approach involves a thorough and accurate explanation of the fallopian tube anatomy relevant to the planned procedure, including their function and potential risks associated with manipulation or intervention. This approach is correct because it directly addresses the core ethical principle of informed consent, ensuring the patient can make a voluntary and knowledgeable decision. Regulatory frameworks, such as those governing medical practice and patient rights, mandate that healthcare providers offer clear, understandable information about proposed treatments, including potential complications. Ethically, this respects patient autonomy and promotes trust in the doctor-patient relationship. An approach that involves a vague or overly technical description of the fallopian tubes fails ethically and regulatorily. This is because it does not provide the patient with sufficient information to understand the nature of the procedure, its potential benefits, and its risks, thereby undermining the validity of their consent. Such a failure violates the principle of patient autonomy and can lead to legal repercussions if the patient later claims they were not adequately informed. Another incorrect approach is to downplay the significance of the fallopian tubes or their potential involvement in the procedure. This is ethically problematic as it misrepresents the scope and potential impact of the intervention. Regulatorily, it can be seen as a breach of the duty of care to provide accurate information. Patients have a right to know the full extent of what is being proposed, even if the clinician believes certain aspects are less critical. Finally, an approach that avoids discussing the fallopian tubes altogether, perhaps due to the clinician’s own uncertainty or discomfort, is also professionally unacceptable. This constitutes a significant failure in communication and a dereliction of the duty to inform. It leaves the patient vulnerable to unexpected outcomes without having had the opportunity to consider them, violating both ethical and regulatory standards for informed consent. The professional reasoning process in such situations should involve a structured approach: first, accurately assess the patient’s understanding of their condition and the proposed treatment; second, clearly and concisely explain the relevant anatomy and physiology, tailoring the language to the patient’s comprehension level; third, detail the specific procedure, including any potential interventions involving the fallopian tubes; fourth, discuss the potential risks, benefits, and alternatives, ensuring the patient has ample opportunity to ask questions; and fifth, document the informed consent process thoroughly.

The evaluation methodology shows a common ethical dilemma encountered in clinical practice, particularly when managing chronic conditions like Polycystic Ovary Syndrome (PCOS). The challenge lies in balancing a patient’s immediate desires and perceived needs with the clinician’s professional responsibility to provide evidence-based, long-term, and holistic care. The patient’s insistence on a specific, potentially suboptimal, treatment pathway creates a conflict that requires careful navigation to uphold patient autonomy while ensuring patient safety and well-being. The best professional approach involves a thorough, patient-centered discussion that prioritizes education and shared decision-making. This approach begins with actively listening to the patient’s concerns and understanding the rationale behind her preference for a specific medication. It then involves clearly explaining the diagnostic criteria for PCOS, the evidence-based management options available, and the potential benefits and risks associated with each, including the specific medication she favors and alternative, potentially more appropriate, treatments. This allows for an informed discussion where the clinician can guide the patient towards a treatment plan that is both effective and aligned with her values, while also addressing any underlying misconceptions or anxieties. This aligns with ethical principles of beneficence (acting in the patient’s best interest) and autonomy (respecting the patient’s right to make decisions about her own care), as well as professional guidelines that emphasize clear communication and shared decision-making in chronic disease management. An approach that immediately concedes to the patient’s demand without a comprehensive discussion and explanation of alternatives fails to uphold the clinician’s duty of care. It risks prescribing a treatment that may not be the most effective, could have unnecessary side effects, or might not address the multifaceted nature of PCOS. This bypasses the opportunity to educate the patient and empower her to make truly informed choices, potentially leading to suboptimal outcomes and a breakdown in the therapeutic relationship. Another unacceptable approach is to dismiss the patient’s preference outright and rigidly impose a treatment plan. This disregards patient autonomy and can lead to feelings of disempowerment, distrust, and non-adherence to treatment. It fails to acknowledge the patient’s lived experience and her right to be involved in her healthcare decisions. Finally, an approach that focuses solely on the immediate symptom relief without considering the broader diagnostic and management implications of PCOS is also professionally inadequate. PCOS is a complex endocrine disorder with long-term health implications beyond immediate symptoms, and management should be comprehensive and proactive. Professionals should employ a decision-making process that begins with active listening and empathy, followed by a thorough assessment and clear, understandable explanation of diagnostic findings and treatment options. This should be a collaborative process, respecting patient values and preferences while ensuring that the recommended course of action is evidence-based and promotes the patient’s overall health and well-being.

Scenario Analysis: This scenario is professionally challenging because it requires a clinician to balance immediate patient care with the need for accurate diagnosis and appropriate management of a potentially serious condition. Misdiagnosis or delayed treatment of Pelvic Inflammatory Disease (PID) can lead to severe long-term complications, including infertility and chronic pelvic pain, necessitating careful clinical judgment and adherence to established diagnostic and treatment protocols. Correct Approach Analysis: The best professional practice involves a comprehensive approach that begins with a thorough patient history and physical examination, including a pelvic exam. This is followed by appropriate diagnostic investigations such as swabs for sexually transmitted infections (STIs) and potentially ultrasound or laparoscopy if the diagnosis is uncertain or severe. Based on these findings, empirical antibiotic treatment should be initiated promptly, covering the most common causative organisms, while awaiting definitive microbiological results. This approach aligns with clinical guidelines for PID management, which emphasize early diagnosis and treatment to prevent complications. The prompt initiation of treatment, even before definitive culture results, is crucial given the potential for rapid progression of the infection. Incorrect Approaches Analysis: Initiating treatment solely based on symptoms without any diagnostic investigations is professionally unacceptable. This approach risks misdiagnosis, leading to inappropriate treatment for other conditions and delaying effective management of PID. It also fails to identify the specific causative agents, hindering targeted therapy and potentially contributing to antibiotic resistance. Delaying treatment until all microbiological results are available, even if the clinical suspicion for PID is high, is also professionally unacceptable. This delay can allow the infection to ascend and cause irreversible damage to the reproductive organs, significantly increasing the risk of infertility and ectopic pregnancy. Clinical guidelines prioritize prompt empirical treatment in suspected cases of PID. Relying exclusively on imaging studies like ultrasound without considering clinical presentation and microbiological investigations is professionally inadequate. While imaging can be helpful in assessing complications or alternative diagnoses, it is not the primary diagnostic tool for PID and may not identify the causative pathogens. A holistic approach integrating clinical, microbiological, and, where necessary, imaging data is essential. Professional Reasoning: Professionals should employ a systematic decision-making framework when managing suspected PID. This involves: 1. Thoroughly gathering patient history, including sexual history and risk factors. 2. Conducting a comprehensive physical examination, including a pelvic exam. 3. Initiating appropriate diagnostic tests to identify causative agents and rule out other conditions. 4. Promptly initiating empirical antibiotic therapy based on clinical suspicion and local resistance patterns, while awaiting definitive results. 5. Re-evaluating the patient and adjusting treatment based on response and investigation outcomes. 6. Providing patient education on prevention and follow-up care.

Scenario Analysis: This scenario presents a professional challenge due to the need to accurately classify an ovarian cyst based on imaging findings and patient presentation, and then to determine the appropriate clinical management. Misclassification can lead to delayed diagnosis of malignancy, unnecessary interventions, or patient anxiety. The significance of ovarian cysts ranges from benign physiological findings to potentially life-threatening conditions, requiring a nuanced approach grounded in evidence-based practice and patient safety. Correct Approach Analysis: The best professional practice involves a systematic evaluation that integrates imaging characteristics with clinical context. This includes assessing the cyst’s size, morphology (simple vs. complex, presence of septations, solid components, papillary projections), and vascularity, alongside the patient’s age, menopausal status, symptoms (pain, pressure, menstrual irregularities), and relevant medical history. For a cyst described as simple, unilocular, and less than 5 cm in a premenopausal asymptomatic woman, the most appropriate approach is conservative management with follow-up imaging. This aligns with guidelines that recommend watchful waiting for uncomplicated, likely functional cysts in this demographic, as they often resolve spontaneously. This approach minimizes unnecessary interventions and associated risks while ensuring that significant pathology is not overlooked. Incorrect Approaches Analysis: Proceeding immediately to surgical intervention for a simple, asymptomatic cyst under 5 cm in a premenopausal woman is an over-treatment. While surgery is indicated for symptomatic cysts, complex cysts, or those with suspicious features, it carries risks of anesthesia, infection, bleeding, and potential impact on fertility. This approach fails to adhere to the principle of least harm and evidence-based management for likely benign conditions. Recommending immediate biopsy of a simple, asymptomatic cyst under 5 cm is also inappropriate. Biopsy of such cysts is technically challenging, may not yield accurate results due to the nature of cystic fluid, and carries risks of bleeding and infection without a clear diagnostic benefit when imaging characteristics are reassuring. This approach deviates from standard diagnostic pathways for ovarian cysts. Dismissing the cyst entirely without any follow-up imaging, even if it appears simple and the patient is asymptomatic, is a failure to adequately monitor for potential changes. While many simple cysts resolve, a small percentage may persist or evolve, necessitating a period of observation to ensure no underlying pathology is missed. This approach risks overlooking a developing malignancy or other significant condition. Professional Reasoning: Professionals should employ a decision-making framework that prioritizes accurate diagnosis and patient-centered care. This involves: 1. Comprehensive data gathering (imaging, clinical history, symptoms). 2. Applying established classification systems for ovarian cysts (e.g., simple vs. complex, benign vs. potentially malignant features). 3. Correlating findings with patient demographics and risk factors. 4. Consulting relevant clinical guidelines and evidence-based literature. 5. Developing a management plan that balances the need for timely intervention with the risks of over-treatment, including a clear plan for follow-up and escalation of care if indicated.

This scenario presents a professional challenge due to the subjective nature of vulvodynia and the potential for misdiagnosis or underestimation of lichen sclerosus, both of which can significantly impact a patient’s quality of life and reproductive health. The clinician must navigate patient-reported symptoms with objective findings, while also considering the long-term implications of treatment and the psychological distress associated with these conditions. Careful judgment is required to ensure accurate diagnosis, appropriate management, and compassionate care. The best professional approach involves a comprehensive diagnostic process that integrates detailed patient history, a thorough physical examination, and consideration of differential diagnoses. This includes actively listening to the patient’s subjective experience of pain and discomfort, which is central to diagnosing vulvodynia. For lichen sclerosus, it necessitates a meticulous visual inspection for characteristic signs such as hypopigmentation, epidermal thinning, and potential scarring. The clinician should also be prepared to consider a biopsy if the diagnosis of lichen sclerosus is uncertain or if there are concerns for premalignant changes. This multi-faceted approach ensures that both conditions are appropriately identified and managed, prioritizing the patient’s well-being and adherence to best practices in gynecologic care. An approach that solely relies on visual inspection without adequately exploring the patient’s reported pain and discomfort fails to address the core diagnostic criteria for vulvodynia. This oversight can lead to a misdiagnosis or delayed treatment, causing prolonged suffering for the patient. Similarly, dismissing the patient’s symptoms as psychosomatic without a thorough physical and diagnostic workup is ethically unsound and professionally negligent. It undermines the patient’s experience and can damage the therapeutic relationship. Focusing only on the most visually obvious signs of lichen sclerosus while neglecting the possibility of early or atypical presentations, or failing to consider the need for biopsy when indicated, can result in missed diagnoses or delayed intervention for a potentially progressive condition. Professionals should employ a systematic decision-making process that begins with active listening and empathetic engagement with the patient. This is followed by a systematic physical examination, considering a broad differential diagnosis. When faced with subjective symptoms and objective findings that may overlap or point to multiple conditions, the clinician must integrate all available information. This includes considering the need for further investigations, such as biopsies, and consulting with specialists if necessary. The ultimate goal is to arrive at the most accurate diagnosis and develop a personalized, evidence-based treatment plan that addresses the patient’s immediate concerns and long-term health.

This scenario presents a professional challenge due to the critical nature of accurate staging and grading for gynecologic cancers. Misinterpretation can lead to inappropriate treatment decisions, impacting patient prognosis and potentially violating ethical obligations to provide competent care. The need for precise application of established classification systems, such as the FIGO staging system for gynecologic cancers, is paramount. The correct approach involves a meticulous review of all available diagnostic information, including imaging, pathology reports, and surgical findings, to accurately assign the FIGO stage and the relevant grade based on established criteria. This ensures that treatment planning is evidence-based and aligned with international standards, promoting optimal patient outcomes and adhering to professional standards of care. This approach is correct because it prioritizes patient safety and evidence-based medicine, directly aligning with the ethical duty of beneficence and non-maleficence, and the professional responsibility to maintain competence in diagnostic interpretation. An incorrect approach would be to rely solely on initial imaging findings without integrating detailed histopathological data. This is professionally unacceptable because imaging alone can be insufficient for definitive staging, particularly for determining the extent of local invasion or lymph node involvement, which are crucial for accurate FIGO staging. This failure to incorporate all necessary diagnostic components can lead to under-staging or over-staging, resulting in suboptimal or potentially harmful treatment. Another incorrect approach would be to apply a grading system that is not universally recognized or is outdated for the specific gynecologic cancer type. This is professionally unacceptable as it deviates from established best practices and can lead to inconsistent and unreliable prognostic information. The use of non-standardized grading systems undermines the ability to compare patient outcomes, participate in clinical trials, and ensure that patients receive treatments tailored to their specific tumor biology as understood by current scientific consensus. A further incorrect approach would be to defer the final staging and grading decisions to a less experienced clinician without adequate oversight or consultation. This is professionally unacceptable as it can compromise the quality of care and potentially expose the patient to diagnostic errors. The responsibility for accurate staging and grading ultimately rests with the treating team, and delegation must be accompanied by appropriate supervision and validation to ensure accuracy and patient safety. Professionals should employ a systematic decision-making process that includes: 1) thorough review of all diagnostic modalities; 2) consultation with pathology and radiology experts when necessary; 3) adherence to the most current and recognized staging and grading systems (e.g., FIGO for staging, WHO for grading); and 4) clear documentation of the rationale for the assigned stage and grade.

Scenario Analysis: This scenario is professionally challenging because it requires the clinician to balance patient autonomy, adherence to established screening guidelines, and the potential for over-screening or under-screening, all within the framework of evidence-based practice and regulatory expectations. The clinician must navigate a patient’s personal history and preferences against population-level recommendations, ensuring informed consent and appropriate care pathways. Correct Approach Analysis: The best professional practice involves a thorough discussion with the patient about her personal and family history of gynecologic cancers, including any symptoms she may be experiencing. This discussion should then inform a shared decision-making process regarding cervical cancer screening, aligning with current guidelines from reputable bodies such as the US Preventive Services Task Force (USPSTF) or the American College of Obstetricians and Gynecologists (ACOG). For ovarian cancer, given the lack of effective screening methods for the general population, the focus should be on risk assessment and counseling, particularly for individuals with a strong family history or known genetic predispositions. Uterine cancer screening is generally not recommended for asymptomatic women without specific risk factors. This approach is correct because it prioritizes individualized patient care, respects autonomy through shared decision-making, and adheres to evidence-based guidelines that aim to maximize benefits while minimizing harms associated with screening. It ensures that screening is offered when indicated and that patients understand the rationale and limitations of each screening modality. Incorrect Approaches Analysis: One incorrect approach would be to proceed with a Pap smear and HPV testing solely based on the patient’s age and a general desire for “checking everything,” without a detailed discussion of her specific risk factors or symptoms, and without considering the current guidelines for cervical cancer screening frequency and modality. This fails to engage in shared decision-making and may lead to unnecessary testing or anxiety. Another incorrect approach would be to recommend transvaginal ultrasound for ovarian cancer screening for this patient without any specific indication of increased risk (e.g., strong family history, known BRCA mutation). Current evidence does not support routine ovarian cancer screening in asymptomatic women of average risk due to low efficacy and potential for false positives leading to invasive procedures. A third incorrect approach would be to dismiss the patient’s concerns about ovarian cancer entirely and refuse any discussion about screening, even if she expresses significant anxiety or a perceived family history. While routine screening may not be indicated, a compassionate and informative discussion about risk assessment and symptom recognition is ethically imperative. Professional Reasoning: Professionals should employ a systematic approach that begins with a comprehensive patient assessment, including a detailed history and physical examination. This should be followed by an informed discussion of relevant screening guidelines, tailored to the individual patient’s risk profile. Shared decision-making is paramount, ensuring the patient understands the benefits, risks, and limitations of any proposed screening tests. Professionals must remain current with evidence-based guidelines and be able to articulate the rationale behind recommending or not recommending specific screening modalities. When uncertainty exists or a patient presents with complex factors, consultation with specialists or multidisciplinary teams should be considered.