One Dozen Things

Discussion Questions

1. What are the likely motivations for the daughter’s request that the doctor deal with her, and only with her, with respect to her mother’s care?

2. Are there any circumstances in which the daughter’s request should be honored? If so, what are they?

3. Should the doctor verify the patient’s preferences directly with the patient? If so, how should that be done?

4. If the patient expresses the preference to have her daughter act as her intermediary with respect to information and decision making, how should this be documented?

5. If the patient expresses a desire to continue to receive information and participate in decision making herself, how should the physician proceed with respect to the family?

6. If the patient chooses to assume primary responsibility for her own health care, how much information should the physician provide to her family?

7. Assuming the patient concurs with her daughter’s request, how should the doctor proceed if the patient’s son becomes involved and disagrees with his sister’s decisions?

8. To what degree are these considerations affected by the patient’s age?

9. Under what circumstances would it be inappropriate to continue to allow the patient to take primary responsibility for decisions regarding her own care?

10. If the patient is found to be mentally incompetent to make decisions regarding her own care, how should the physician proceed?

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