HOW TO INSTILL HEALTHY HABITS?

Introduction and objectives: Family physicians are presented with several ethical issues. In the domain of doctor-patient relationship, negotiation of treatment strategies and discussion of patient's prognosis remains a difficult assignment. The principle of patient autonomy and right to self-determination are frequently seen as being in conflict with the principle of beneficence and nonmaleficence. Methods: We present a 51-years-old male, married, have two children, heavy smoking habits and diary ingestion of alcoholic beverages. Additionally, with history of dyslipidemia, overweight and panic-attacks. His father died at age 68 in consequence of a suicide attempt and his mother at age 67 with acute myocardial infarction. In 2013, he had acute myocardial infarction and underwent angioplasty. In 2014, he was submitted to a right colectomy with adjuvant chemotherapy for colon adenocarcinoma. Nevertheless, the patient keeps alcoholic and smoking habits and physical inactivity. Despite all these events, isn’t motivated to change harmful habits and refuses any support programs. Results and conclusion: Sometimes, isn’t easy provide help to our patients. Listening is key to determine your needs more pressing and to identify goals that matter to them and will lead to the most appropriate care. Currently, family medicine shouldn’t be paternalistic, nevertheless family doctors should try to find appropriate strategies to each patient that will lead to an improved health. Doctors must embrace clinical judgment based on their assessment of patient’s needs. This case aims to show the importance of medicine tailored to the patient and the importance of generalist skills.