"The first thing I would do is assess the awareness of my patient. It may be that he or she approves of whatever financial scenarios are at work here. However, if I felt the patient were being misled or that there was confusion due to cognitive impairment from illness, I would contact the hospital's legal counsel to set into motion the appropriate protocols to address this, ethically, morally, and even legally."

One of the most common types of elder abuse is financial, but this just underscores how people who can take advantage of others usually pick the most vulnerable. Similarly, terminal disease will involve patients who are confused, fatalistic, or who feel helpless. If aware of what's going on, the last thing such a patient wants is confrontation with 'loved ones' to add unnecessary drama to his or her final days. Regardless of whether the patient cares or not, financial abuse of anyone is ethically wrong and illegal, and you have a responsibility to act on it like on any abuse.

"My duties are to my patient, even if I see things that are unethical or illegal outside of my specialty. As such, I have the obligation to take all of the appropriate steps to stop the abuse and to address those who are doing it."