The primary therapeutic relationship is between the doctor and the patient. Unless the patient is not competent, e.g., the patient has severe dementia, it should not be assumed that decisions regarding the patient’s care will be made by, or shared with, the family. The family is not entitled to information about the patient without the patient’s knowledge and explicit consent. It is always important to ascertain from the patient what role he or she wishes family members to play in his or her care. It is of equal importance to respect and abide by that decision.