When a patient requests a treatment not clinically indicated, which principle should guide your response?

• A. Respect for patient autonomy with informed consent and professional judgment; provide education and alternatives, and document the discussion.
• B. Always refuse any non-indicated treatment to avoid liability.
• C. Tell the patient that you will do what you want regardless of consent.
• D. Delegate the decision entirely to billing staff.

Answer: (B)

When a patient asks for a treatment that isn’t clinically indicated, the guiding idea is to combine respect for the patient’s preferences with your professional judgment. The best approach is to have an open, informative conversation: explain why the proposed treatment isn’t supported by evidence, outline potential risks and lack of proven benefit, and discuss safer or more appropriate alternatives. Make shared decisions by exploring the patient’s goals and values, obtain informed consent for the path you agree on, and document that discussion and the rationale. This respects autonomy while ensuring patient safety and professional responsibility. blanket refusals to avoid liability, coercing the patient, or passing the decision to billing are not appropriate practices.