John, a 32-year-old lawyer, had been concerned for years about developing Huntington’s chorea, a neurological disorder that manifests in the 30s or 40s and causes uncontrollable twitching and contractions as well as progressive, irreversible dementia. It usually results in death after about ten years. This disease killed John’s mother. Huntington’s disease is autosomal dominant, which means that children of an affected person have a 50% chance of inheriting the condition. Many people had told John that he would rather die than live with the illness’s progression. He was anxious, drank heavily, and suffered from intermittent depression, for which he sought treatment from a psychiatrist. Nonetheless, he was a successful lawyer. John first noticed facial twitching three months ago, and two neurologists independently confirmed a Huntington’s diagnosis. He explained his situation to his psychiatrist and asked for assistance in committing suicide. When the psychiatrist refused, John assured him that he had no intention of committing suicide anytime soon. However, when he returned home, he ingested all of his antidepressant medication after pinning a note to his shirt explaining his actions and refusing any medical assistance that was offered. His wife, who had not yet learned of his diagnosis, discovered him unconscious and rushed him to the hospital without removing the note. How important should John’s preferences (particularly his attempt to end his life) be in managing his emergency and subsequent clinical care?