You are seeing patients in clinic when two men in dark suits and dark glasses come in and show you badges marking them as members of a federal law enforcement agency. The identification is legitimate. These 'men in black' inform you that they are making a 'minor investigation' of one of your patients. They ask to look at the patient's chart for a few minutes, saying, 'You wouldn't want to interfere with a federal investigation, would you?' What should you do?

You are seeing patients in clinic when two men in dark suits and dark glasses come in and show you badges marking them as members of a federal law enforcement agency. The identification is legitimate. These 'men in black' inform you that they are making a 'minor investigation' of one of your patients. They ask to look at the patient's chart for a few minutes, saying, 'You wouldn't want to interfere with a federal investigation, would you?' What should you do?

A 67-year-old woman is diagnosed with breast cancer. She is fully alert and very specifically both verbally and in writing tells you that she does not want to have surgery on her breast to remove the tumor. She fully understands her condition and treatment options. This is a decision her husband and son both disagree with. Over the next several weeks the patient becomes confused and loses the capacity to understand the details of her medical care. The husband and son now approach you to perform the surgery. Which of the following is most appropriate?

Mr. Dorone is a 22-year-old man who sustained a subdural hematoma and a brain contusion in a motor vehicle accident. He needs blood in order to have the necessary lifesaving surgery done. His parents refuse to allow the transfusion based on their religious beliefs. What should be done?

A 79-year-old man comes to see you for assistance in ending his life. The patient is fully competent and has been suffering from progressively worsening amyotrophic lateral sclerosis for several years. He is not immediately preterminal. Despite this, he finds his quality of life to be unacceptable. More important, he correctly predicts that his level of function will deteriorate over the next several months and that he may become ventilator dependent. He is requesting that you administer a lethal injection in his home. He is not depressed. His family is aware of his desire and they are willing to honor the patient's wishes. You have discussed appropriate palliative care issues. What should you tell him?

A 4-year-old with an obviously broken forearm is brought to the emergency department by her baby-sitter. Both the baby-sitter and emergency room staff have attempted to reach her parents without success. Can you treat this child without parental permission?