A 51-Year-Old Man Comes to the Office for a Follow-Up

question 12

Multiple Choice

A 51-year-old man comes to the office for a follow-up appointment.  The patient was recently diagnosed with amyotrophic lateral sclerosis (ALS) , and his condition has deteriorated rapidly.  Physical examination shows progressive muscle weakness and atrophy.  The patient says, "I need to know that, when things get really bad and I can't take care of myself, you will help me end my life.  I haven't discussed this with my wife yet, but I think she would agree that it would be better to end my suffering when the time comes."  The patient has no psychiatric history and is not currently suicidal.  Which of the following is the most appropriate response to the patient's request or concern?

• A)"I understand that this disease has affected all aspects of your life; let's focus on how we can optimize the remaining time you have with family."
• B)"I'm concerned your mood may be changing your outlook; would you consider speaking with a counselor before making this decision?"
• C)"Not having control of how your symptoms progress can be distressing; have you considered how ending your life would affect your family?"
• D)"This is not an uncommon request given the progressive nature of ALS; we can discuss your decision in detail when the time comes."
• E)"You've been thinking about the end of your life and what that might be like for you; let's talk more about how you came to this decision."

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Definitions:

Sole Practitioner

An individual who operates their professional practice independently, without partners or associates.

Multipurpose Building

A structure designed to be suitable for a variety of uses or functions.

Self-Checkins

A process allowing individuals to register or confirm their presence in a location or event autonomously, often through digital means.

Mental Health Monitoring

The ongoing observation and assessment of an individual's mental well-being.