There is a complication, however. Once patients have stated their goals, it is reasonable for the physician to suggest treatments consistent with those goals. Both patients and physicians may mistakenly believe that the physician is the expert on picking the treatment appropriate for achieving the patient’s goals. Typically, however, more than one treatment may, with varying degrees of probability, be expected to achieve various elements of the stated goal. The physician may have to negotiate with the patient to clarify and state the goal more precisely. The patient who says he or she wishes to live at all costs probably does not really mean that. The physician could consider various treatment options, including those, for example, that are extremely expensive, painful, inconvenient, and unaesthetic. In such a case, physicians need to ask patients to formulate their goals more precisely; this makes advising patients problematic.