This scenario presents a professional challenge due to the inherent tension between patient autonomy, the physician’s duty of care, and the responsible allocation of healthcare resources, particularly when advanced imaging modalities are involved. The physician must navigate the ethical imperative to provide the best possible care while also considering the potential for over-investigation and its associated risks and costs. Careful judgment is required to balance these competing interests. The best professional approach involves a systematic and evidence-based workflow that prioritizes diagnostic reasoning and judicious imaging selection. This begins with a thorough clinical assessment, including a detailed history and physical examination, to formulate a differential diagnosis. Based on this, the physician should then consider the most appropriate imaging modality that will yield the necessary diagnostic information with the lowest risk and cost. This often means starting with less invasive or less resource-intensive imaging before escalating to more advanced techniques, unless the clinical presentation strongly suggests the need for immediate advanced imaging. This approach aligns with principles of beneficence (acting in the patient’s best interest), non-maleficence (avoiding harm), and justice (fair allocation of resources). It also adheres to professional guidelines that emphasize evidence-based medicine and the avoidance of unnecessary diagnostic procedures. An approach that immediately opts for the most advanced imaging modality without a clear clinical indication is professionally unacceptable. This fails to uphold the principle of non-maleficence by exposing the patient to potential risks associated with advanced imaging (e.g., radiation exposure, contrast reactions, incidental findings) without a commensurate diagnostic benefit. It also disregards the principle of justice by potentially consuming valuable healthcare resources that could be better utilized for other patients or conditions. Furthermore, it deviates from evidence-based practice by bypassing a structured diagnostic reasoning process. Another professionally unacceptable approach is to rely solely on patient preference for a specific imaging modality, even if it is not clinically indicated or is the most advanced option available. While patient autonomy is crucial, it must be balanced with the physician’s professional responsibility to guide diagnostic pathways based on medical evidence and patient safety. Uncritically accepting a patient’s request for advanced imaging without a proper clinical rationale can lead to unnecessary investigations, increased costs, and potential harm, thereby violating the physician’s duty of care. Finally, an approach that delays necessary imaging due to concerns about cost or resource availability, without exploring all clinically appropriate diagnostic options, is also professionally problematic. While resource stewardship is important, patient well-being must remain paramount. If advanced imaging is genuinely indicated for a correct diagnosis and treatment, delaying it without a valid medical reason can lead to adverse patient outcomes and potentially increase overall healthcare costs in the long run due to complications from delayed diagnosis. Professionals should employ a decision-making framework that begins with a comprehensive clinical assessment, followed by the formulation of a differential diagnosis. This should then guide the selection of diagnostic tests, prioritizing those that are most likely to provide the necessary information with the least risk and cost. This process should be iterative, with the interpretation of initial findings informing the need for further investigations. Open communication with the patient about the rationale for diagnostic choices, potential risks, and benefits is also essential.

Scenario Analysis: This scenario is professionally challenging because it pits the desire for professional advancement and recognition against the fundamental ethical obligation to maintain the integrity of proficiency verification processes. Misrepresenting data or eligibility for the Integrated Global Cardio-Renal Medicine Proficiency Verification can have serious consequences, including undermining public trust in medical professionals and potentially leading to suboptimal patient care if individuals are deemed proficient without adequate evidence. Careful judgment is required to navigate the pressure to appear successful while upholding ethical standards. Correct Approach Analysis: The correct approach involves diligently and accurately documenting all relevant experience and qualifications, and only submitting an application for the Integrated Global Cardio-Renal Medicine Proficiency Verification when all eligibility criteria are demonstrably met. This aligns with the core principles of honesty, integrity, and accountability in professional practice. The purpose of the verification is to ensure a baseline level of competence and knowledge in a specialized field, and eligibility requirements are designed to safeguard this standard. Adhering strictly to these requirements upholds the credibility of the verification process and protects the public. Incorrect Approaches Analysis: Submitting an application with a slightly inflated number of supervised procedures, even if the intention is to “round up” to meet the minimum, is ethically problematic. It constitutes a misrepresentation of factual data, violating principles of honesty and integrity. The eligibility criteria are precise for a reason; any deviation, however minor it may seem, undermines the validity of the verification process and the trust placed in certified professionals. Applying for the verification without meeting the minimum required years of post-certification experience, with the hope of completing the remaining time before the review, is also an ethical failure. This approach bypasses the established safeguards designed to ensure that candidates have a sufficient period of practical application and experience to be considered proficient. It prioritizes expediency over adherence to established standards, potentially leading to the certification of individuals who are not yet adequately prepared. Seeking a waiver for a significant portion of the required supervised procedures based on anecdotal evidence of competence, without formal documentation or a recognized pathway for such waivers, is another unacceptable approach. This circumvents the structured assessment process intended to objectively evaluate skills and knowledge. It relies on subjective claims rather than verifiable evidence, which is contrary to the principles of objective assessment and professional accountability. Professional Reasoning: Professionals facing such situations should always prioritize transparency and adherence to established guidelines. The decision-making process should involve a clear understanding of the purpose and eligibility criteria for the Integrated Global Cardio-Renal Medicine Proficiency Verification. When in doubt about eligibility, it is best practice to seek clarification from the certifying body rather than attempting to interpret or bend the rules. Maintaining a commitment to ethical conduct and accurate representation of one’s qualifications is paramount for long-term professional credibility and patient safety.

This scenario presents a professional challenge due to the inherent conflict between a patient’s expressed wishes and the clinician’s assessment of their best interests, particularly when those wishes might lead to suboptimal health outcomes. The need for evidence-based management in acute, chronic, and preventive care requires a delicate balance between patient autonomy and the clinician’s duty of care, guided by ethical principles and professional standards. The correct approach involves a thorough, empathetic, and collaborative discussion with the patient, aiming to understand the root of their reluctance and to educate them on the evidence supporting the recommended treatment plan. This approach prioritizes shared decision-making, respecting the patient’s right to self-determination while ensuring they are fully informed about the risks and benefits of all available options, including the consequences of non-adherence. This aligns with the ethical principle of beneficence (acting in the patient’s best interest) and respect for autonomy, as well as professional guidelines that emphasize patient-centered care and informed consent. It also implicitly acknowledges the importance of addressing psychosocial factors that may influence treatment adherence, which is crucial for effective chronic and preventive care. An incorrect approach would be to dismiss the patient’s concerns outright and proceed with a treatment plan they are unwilling to follow, without further exploration. This fails to uphold the principle of autonomy and can lead to poor adherence, rendering the evidence-based management ineffective and potentially causing harm. Another incorrect approach is to unilaterally alter the treatment plan based on the clinician’s assumptions about the patient’s capacity or motivation, without engaging in a dialogue. This undermines trust and violates the principles of informed consent and shared decision-making. Finally, pressuring the patient into accepting a treatment they are clearly resistant to, without addressing their underlying concerns, is ethically problematic and unlikely to result in sustainable adherence, negating the benefits of evidence-based preventive and chronic care strategies. Professionals should employ a decision-making framework that begins with active listening and empathetic inquiry to understand the patient’s perspective. This should be followed by clear, jargon-free communication of the evidence supporting recommended interventions, tailored to the patient’s level of understanding. The process should involve exploring all treatment options, including their risks, benefits, and alternatives, and collaboratively developing a plan that the patient can realistically adhere to, while continuously reassessing and adapting the plan as needed.

Scenario Analysis: This scenario presents a professional challenge due to the inherent tension between a candidate’s desire to achieve certification and the institution’s commitment to maintaining the integrity and validity of its assessment processes. The weighting and scoring of an examination, along with retake policies, are critical components of this integrity. A candidate’s attempt to circumvent established procedures, even with a perceived justification, raises ethical concerns regarding fairness to other candidates and the credibility of the certification itself. Careful judgment is required to uphold the established policies while addressing the candidate’s concerns appropriately. Correct Approach Analysis: The best professional practice involves a transparent and consistent application of the established blueprint weighting, scoring, and retake policies. This approach prioritizes fairness and the integrity of the examination process. When a candidate inquires about potential adjustments to scoring or retake eligibility based on perceived external factors, the appropriate response is to reiterate the existing, clearly communicated policies. This includes explaining the rationale behind the established weighting and scoring mechanisms, which are designed to assess a broad range of competencies, and clearly outlining the conditions under which retakes are permitted. This upholds the principle of equal treatment for all candidates and maintains the standardized nature of the assessment. Incorrect Approaches Analysis: One incorrect approach involves agreeing to a personalized review of the candidate’s performance that deviates from the standard scoring rubric or offers a modified retake pathway. This undermines the standardized nature of the examination and creates an unfair advantage for the candidate, violating the principle of equitable assessment. It also sets a dangerous precedent for future candidates. Another incorrect approach is to dismiss the candidate’s concerns outright without providing a clear explanation of the existing policies and their rationale. While maintaining policy is crucial, a complete lack of empathy or explanation can lead to perceived unfairness and damage the institution’s reputation. It fails to educate the candidate on the importance of the established procedures. A further incorrect approach is to suggest that the blueprint weighting or scoring might be subject to change or interpretation based on individual circumstances. This introduces ambiguity and erodes confidence in the established assessment framework. The blueprint and its associated policies are designed to be objective and consistently applied to ensure the validity of the certification. Professional Reasoning: Professionals faced with such inquiries should first ensure they have a thorough understanding of the institution’s examination blueprint, scoring methodology, and retake policies. They should then communicate these policies clearly and empathetically to the candidate, explaining the rationale behind them. If a candidate raises a concern that suggests a potential error in the examination administration or scoring, a process for formal review should be followed, adhering strictly to established protocols. The decision-making process should prioritize fairness, transparency, and the preservation of the assessment’s integrity, ensuring that all candidates are evaluated under the same objective standards.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the candidate’s desire for efficient preparation with the ethical and regulatory imperative to ensure genuine understanding and competence, not just superficial familiarity. The pressure to pass a rigorous proficiency verification exam, especially in a specialized field like Integrated Global Cardio-Renal Medicine, can lead candidates to seek shortcuts. Professionals must navigate this by recommending resources that promote deep learning and adherence to professional standards, rather than merely optimizing for speed. Careful judgment is required to distinguish between effective preparation strategies and those that might compromise the integrity of the verification process. Correct Approach Analysis: The best professional approach involves recommending a structured, multi-modal preparation strategy that integrates foundational knowledge review with practical application and continuous assessment. This includes utilizing official study guides, peer-reviewed literature relevant to current cardio-renal guidelines, case-based learning modules, and practice examinations that simulate the actual verification format. A realistic timeline should be established, allowing for iterative learning, reflection, and reinforcement of complex concepts. This approach is correct because it aligns with the ethical duty to ensure competence and patient safety, as mandated by professional bodies that oversee medical proficiency. It fosters a deep understanding of the subject matter, which is essential for effective clinical practice and is the underlying purpose of any proficiency verification. Regulatory frameworks implicitly support this by requiring demonstrable competence, which cannot be achieved through superficial or rushed preparation. Incorrect Approaches Analysis: Focusing solely on memorizing question banks without understanding the underlying principles is professionally unacceptable. This approach bypasses the development of critical thinking and diagnostic reasoning skills, which are paramount in medicine. It may lead to a candidate passing the exam through rote memorization but failing to apply knowledge effectively in real-world clinical scenarios, posing a risk to patient care and violating the ethical obligation to practice competently. Prioritizing only the most recent, high-yield topics while neglecting foundational or less frequently tested areas is also professionally unsound. While efficiency is desirable, a comprehensive understanding of cardio-renal medicine requires a grasp of both established principles and evolving advancements. Omitting core knowledge can lead to gaps in understanding that may be critical in complex patient presentations, contravening the professional responsibility to provide holistic and informed care. Relying exclusively on condensed review materials or summaries without engaging with primary sources or detailed explanations is another flawed strategy. These materials can be useful supplements but are rarely sufficient on their own to build the depth of knowledge required for a proficiency verification in a specialized medical field. This approach risks superficial learning and an inability to critically evaluate information or adapt to novel clinical situations, which is ethically problematic as it undermines the commitment to lifelong learning and evidence-based practice. Professional Reasoning: Professionals should adopt a decision-making framework that prioritizes the candidate’s long-term competence and patient safety over short-term exam success. This involves: 1. Understanding the purpose of the verification: It’s about ensuring safe and effective practice, not just passing a test. 2. Assessing the candidate’s current knowledge base and learning style: Tailoring recommendations to individual needs. 3. Recommending resources that promote deep understanding and critical thinking: Emphasizing primary literature, case studies, and official guidelines. 4. Advocating for a structured and realistic timeline: Allowing for thorough learning and retention. 5. Emphasizing continuous self-assessment and feedback: Encouraging practice exams and reflection on performance. 6. Upholding ethical obligations: Ensuring that recommendations support the development of a competent and responsible medical professional.

Scenario Analysis: This scenario presents a professional challenge due to the inherent tension between the need for efficient patient care and the imperative to maintain comprehensive, accurate, and secure patient records. The rapid pace of clinical practice, especially in specialized fields like cardio-renal medicine, can lead to information silos and potential data integrity issues if not managed proactively. Ensuring that all relevant clinical data is accessible and integrated across different care settings is crucial for patient safety and optimal treatment outcomes, while simultaneously adhering to strict data protection regulations. Correct Approach Analysis: The best approach involves establishing a standardized, secure, and interoperable electronic health record (EHR) system that facilitates real-time data sharing between primary care physicians, cardiologists, nephrologists, and other specialists. This system should incorporate robust data validation protocols and audit trails to ensure accuracy and accountability. Regulatory frameworks such as HIPAA (Health Insurance Portability and Accountability Act) in the US mandate the protection of Protected Health Information (PHI) and require covered entities to implement safeguards to prevent unauthorized access, use, or disclosure. An integrated EHR system, when properly implemented and secured, directly supports these requirements by centralizing information, enabling controlled access, and providing a clear audit history of data access and modifications. This approach optimizes the process by ensuring that all members of the cardio-renal care team have access to a complete and up-to-date patient profile, thereby reducing the risk of medical errors and improving diagnostic and treatment efficiency. Incorrect Approaches Analysis: One incorrect approach is relying solely on disparate, paper-based patient charts and manual communication between specialists. This method is highly susceptible to data loss, transcription errors, and delays in information transfer, increasing the risk of suboptimal care and potential breaches of patient confidentiality if records are not securely stored and transported. It fails to meet the spirit or letter of data protection regulations that emphasize secure and accessible record-keeping. Another incorrect approach is utilizing unsecured, cloud-based personal storage solutions for patient data, such as personal email accounts or unencrypted file-sharing services. This practice represents a severe violation of data privacy and security regulations, as it exposes sensitive patient information to unauthorized access and potential breaches. Such methods lack the necessary audit trails and access controls required by data protection laws. A third incorrect approach is to limit data sharing to only the most critical information, requiring manual requests for additional details from other specialists. While seemingly efficient in the short term, this can lead to incomplete patient histories, missed diagnostic clues, and delayed treatment decisions. It creates an inefficient process that compromises patient safety and does not align with the principles of coordinated care and comprehensive data management mandated by regulatory bodies. Professional Reasoning: Professionals should adopt a systematic process optimization framework that prioritizes patient safety, data integrity, and regulatory compliance. This involves: 1) Identifying current process bottlenecks and risks related to data management and interdisciplinary communication. 2) Researching and implementing technologically advanced, secure, and interoperable solutions that meet or exceed regulatory requirements for data protection and privacy. 3) Developing clear protocols for data entry, access, and sharing, including comprehensive training for all staff. 4) Regularly auditing the system and processes to ensure ongoing compliance and identify areas for further improvement. The decision-making process should always weigh the potential benefits of efficiency against the risks to patient privacy and safety, with regulatory compliance serving as a non-negotiable baseline.

This scenario is professionally challenging because it requires balancing the immediate need for diagnostic information with the ethical imperative of patient autonomy and informed consent, particularly when dealing with a vulnerable patient population. The integration of foundational biomedical sciences with clinical medicine necessitates a thorough understanding of the underlying pathophysiology of cardio-renal disease, but also the practical application of this knowledge within a patient-centered framework. Careful judgment is required to ensure that diagnostic procedures are not only scientifically sound but also ethically permissible and aligned with patient wishes and capacity. The best approach involves a comprehensive assessment of the patient’s capacity to understand their condition and the proposed diagnostic procedures. This includes clearly explaining the rationale for the cardiac catheterization, the potential benefits, risks, and alternatives in a manner that the patient can comprehend. If the patient demonstrates capacity, their informed consent must be obtained. If capacity is lacking, the process must involve consultation with the designated next of kin or legal guardian, ensuring that decisions are made in the patient’s best interests, adhering to established ethical guidelines for surrogate decision-making. This approach prioritizes patient rights and well-being while ensuring necessary medical interventions are pursued appropriately. An incorrect approach would be to proceed with the cardiac catheterization solely based on the clinical team’s assessment of medical necessity without a formal capacity assessment or attempting to obtain informed consent from the patient or their surrogate. This disregards the fundamental ethical principle of patient autonomy and can lead to a violation of patient rights, potentially resulting in legal repercussions and a breakdown of trust. Another incorrect approach would be to delay the procedure indefinitely due to the patient’s confusion, without actively seeking to clarify their understanding or involve appropriate support systems like family or a designated healthcare proxy. While caution is warranted, inaction in the face of a potentially life-threatening condition, without a structured plan to address the consent issue, is not professionally sound and could lead to adverse patient outcomes. A further incorrect approach would be to assume the patient’s family has the authority to consent without verifying their legal status as a designated next of kin or healthcare proxy, or without assessing the patient’s own capacity first. While family involvement is crucial when a patient lacks capacity, the legal and ethical framework dictates specific procedures for surrogate decision-making that must be followed. The professional decision-making process for similar situations should involve a systematic evaluation: first, assess the patient’s capacity to make healthcare decisions; second, if capacity is present, obtain informed consent; third, if capacity is lacking, identify and consult with the legally authorized surrogate decision-maker; fourth, ensure all decisions are made in the patient’s best interest, considering their known values and preferences; and fifth, document all assessments, discussions, and decisions thoroughly.

Scenario Analysis: This scenario presents a professional challenge rooted in the intersection of health systems science, ethics, and patient autonomy. The core conflict lies in balancing the perceived systemic benefit of a novel treatment protocol with the individual patient’s right to make informed decisions about their care, especially when that care involves significant risks and potential benefits that are not fully established. The physician’s role as a gatekeeper of information and a facilitator of informed consent is paramount, and any deviation can lead to ethical breaches and potential legal ramifications. The pressure to adopt new protocols, often driven by institutional goals or research objectives, can inadvertently overshadow the fundamental ethical obligation to the individual patient. Correct Approach Analysis: The best professional approach involves a thorough, transparent, and patient-centered discussion about the investigational nature of the treatment, its potential risks and benefits, and the availability of standard care options. This includes clearly explaining that participation is voluntary and that the patient can withdraw at any time without penalty. This approach aligns with the fundamental ethical principles of autonomy and beneficence, as well as regulatory requirements for informed consent, which mandate that patients receive sufficient information to make a voluntary and informed decision. Specifically, it upholds the patient’s right to self-determination and ensures that their decision is based on a comprehensive understanding of their situation, not on coercion or incomplete information. Incorrect Approaches Analysis: One incorrect approach involves presenting the investigational treatment as the only viable option for improved outcomes, thereby implicitly pressuring the patient into participation. This fails to uphold the principle of autonomy by withholding information about alternative standard treatments and misrepresents the experimental nature of the protocol, potentially leading to a non-informed consent. Another incorrect approach is to proceed with the investigational treatment without a detailed discussion of the risks, benefits, and alternatives, assuming the patient’s implicit trust or prior knowledge. This violates the core tenets of informed consent, which require explicit and comprehensive disclosure of all relevant information. It also neglects the ethical duty to ensure the patient understands the implications of their choices. A further incorrect approach involves downplaying the potential risks and uncertainties associated with the investigational treatment to encourage participation, perhaps due to institutional pressure or a strong belief in the protocol’s efficacy. This constitutes a breach of honesty and transparency, undermining the informed consent process and potentially exposing the patient to unforeseen harm without their full awareness. Professional Reasoning: Professionals should adopt a decision-making framework that prioritizes patient autonomy and informed consent above all else. This involves: 1) Identifying the ethical and regulatory obligations related to the specific situation (e.g., informed consent for investigational treatments). 2) Gathering all relevant information about the treatment, including its experimental status, known risks, potential benefits, and available alternatives. 3) Communicating this information clearly, comprehensively, and in a manner understandable to the patient, ensuring they have the opportunity to ask questions and express concerns. 4) Respecting the patient’s decision, even if it differs from the physician’s recommendation, and ensuring they understand their right to change their mind. This systematic approach ensures that patient welfare and ethical integrity are maintained.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the immediate needs of a specific patient population with broader public health goals and the ethical imperative of health equity. Clinicians and public health professionals must navigate resource allocation, potential biases in data collection and intervention design, and the systemic factors that contribute to health disparities within the cardio-renal domain. Careful judgment is required to ensure that interventions are not only clinically effective but also equitable and sustainable. Correct Approach Analysis: The best professional practice involves a comprehensive, multi-stakeholder approach that prioritizes understanding the specific epidemiological profile and health equity challenges of the target population. This includes actively engaging with community representatives, utilizing disaggregated data to identify disparities, and co-designing interventions that address social determinants of health. This approach is correct because it aligns with ethical principles of justice and beneficence, ensuring that interventions are tailored to the unique needs of vulnerable groups and do not inadvertently exacerbate existing inequities. It also reflects best practices in population health management, which emphasize community engagement and evidence-based strategies to reduce health disparities. Incorrect Approaches Analysis: An approach that focuses solely on the most prevalent cardio-renal conditions without considering underlying social determinants or demographic variations risks overlooking the specific needs of marginalized groups. This can lead to interventions that are less effective for those most affected by health inequities and may perpetuate disparities by not addressing root causes. An approach that relies on generalized national health statistics without disaggregating data by socioeconomic status, race, ethnicity, or geographic location fails to identify specific pockets of inequity. This can result in a one-size-fits-all strategy that is inappropriate or insufficient for certain subgroups, thereby failing to promote health equity. An approach that prioritizes interventions based on perceived patient compliance or willingness to adopt new technologies, without investigating the systemic barriers that might influence these factors (e.g., access to technology, health literacy, trust in the healthcare system), can lead to inequitable outcomes. This approach risks blaming individuals for systemic failures and further marginalizing those who face greater obstacles. Professional Reasoning: Professionals should adopt a framework that begins with a thorough epidemiological assessment of the population, paying close attention to disaggregated data to identify disparities. This should be followed by robust community engagement to understand lived experiences and co-design culturally appropriate and accessible interventions. Continuous monitoring and evaluation, with a focus on equity metrics, are crucial to ensure that interventions are achieving their intended impact across all segments of the population.

This scenario is professionally challenging because it requires balancing the immediate needs of a patient with complex, potentially life-limiting cardio-renal conditions against the ethical imperative of informed consent and the regulatory framework governing medical decision-making, particularly when a patient’s capacity is in question. Careful judgment is required to ensure the patient’s autonomy is respected while also acting in their best interests, adhering to established medical ethics and legal guidelines. The best professional approach involves a comprehensive assessment of the patient’s capacity to make decisions regarding their treatment. This includes understanding the nature of their illness, the proposed treatments, the potential benefits and risks, and the alternatives. If the patient is deemed to have capacity, their wishes should be respected, even if they differ from the medical team’s recommendations. If capacity is lacking, the medical team must act in the patient’s best interests, which may involve consulting with family or designated surrogates, and adhering to established protocols for substitute decision-making. This approach is correct because it upholds the fundamental ethical principles of autonomy and beneficence, and aligns with regulatory requirements that mandate respecting patient rights and ensuring appropriate decision-making processes are followed, especially in complex cases involving multiple organ systems. An incorrect approach would be to proceed with a significant treatment change without a formal capacity assessment, assuming the patient understands or accepting the family’s immediate insistence without due diligence. This fails to respect the patient’s right to self-determination and could lead to treatments that are not aligned with their values or best interests. Another incorrect approach would be to unilaterally make decisions based solely on the medical team’s assessment of what is “best” without engaging the patient or their designated surrogate in a meaningful discussion, thereby undermining the principle of shared decision-making and potentially violating the patient’s autonomy. Furthermore, ignoring the potential for reversible causes of impaired capacity, such as delirium or medication side effects, and immediately resorting to substitute decision-making without exploring these possibilities is also professionally unacceptable. Professionals should employ a structured decision-making process that begins with a thorough understanding of the patient’s clinical status and the proposed interventions. This should be followed by a systematic evaluation of the patient’s decision-making capacity, involving clear communication and assessment of their understanding. If capacity is present, shared decision-making should be prioritized. If capacity is absent, the process should involve identifying and consulting with appropriate surrogate decision-makers, ensuring all decisions are made in the patient’s best interests and in accordance with legal and ethical guidelines.