Ethics provides a set of standards for behavior that helps us decide how we ought to act in a range of situations. Ethics is sometimes conflated or confused with other ways of making choices, including religion, law or mortality. Ethical dilemma that I have seen couple times during clinical practice is when family advocates for their elders who don’t speak English. Mrs. M.G. is an 83-year-old Hispanic female who is diabetic, CHF patient s/p CABG done 5 years ago. Currently taking 2 oral pills for diabetes and long acting insulin but the way she cooks food her blood sugar tends to be high. The family wants to add another Insulin to control sugar whereas a patient herself doesn’t want to add more medicines. Clinically provider has to manage the prescribed meds to control high sugar whereas patient is alert/ oriented and refused to add another treatment which puts the provider in dilemma. Mrs. M.G. has a right to make her own decisions. Patients the right of self-determination, independence and the ability to be active participants in their care but when they don’t want to make correct decisions it is a hard situation for providers to deal with. in this case provider will refer this patient to the endocrinologist to manage her diabetes.