The patient or family may still request therapies of marginal effectiveness that are outside the bounds of what the clinician considers appropriate. According to Quill et al (2009) the clinician should then:

  • review their understanding of the patient’s condition, values, and philosophy to ensure common understanding
  • reiterate his or her assessment of the patient’s condition and prognosis with or without treatment
  • Look for common ground and try to invent new solutions that accommodate all perspectives