My recommendation for the doctor is that he fully explain the danger of the medicine and liver toxicity but to ultimately prescribe the cholesterol medication. The HMO's needs, cost reduction, don't really merit concern in my opinion, as the HMO is only there to ensure that Jake can get the necessary treatments. The doctor should impress on Jake the seriousness of liver toxicity and the benefits of diet and exercise. However, the doctor could not force Jake to diet and exercise. Jake, having been reasonably educated by the doctor, should be able to make a reasoned decision. Jake clearly considers the toll of diet and exercising to be too much and is willing to risk the liver toxicity. This means that even if the diet and exercise is a better course of action, it will be unsuccessful because Jake will not do it. So the doctor's only course of action is to prescribe Jake the medicine. While it would be preferable for Jake to try dieting and exercising, the duty of the doctor is to preserve the health of the patient while operating within the confines of what the patient is willing to do. While Michael's opinion coincided with my own, Katie contended that the doctor should take a more proactive role in the patient's health. Katie believes that the doctor should not initially prescribe the medication and should first only recommend diet and exercise and, only if his cholesterol is higher, suggest the medication upon his next visit. Katie reached this conclusion when picking over the finer points of the situation, noting that Jake chose a parking spot that was further away because it was cheaper. Katie's reasoning is that Jake will chose the medication because he is lazy but that, with a little prodding, he will make the correct choice and diet and exercise. She further suggests that the doctor have Jake meet with a nutritionist to further his chances of successfully