A recent example of an ethical issue in my workplace, which resulted in conflicts between hospital or facility etiquette and hospital or facility policy, and superiors, is now presented. A client well known to our service was admitted to our facility, floridly psychotic, with difficulty in swallowing. A consulting psychiatric who deemed the client to be manifesting the swallowing difficulties as an attention seeking behaviour saw the client. Over a three-day period, the client lost seven pounds. This was reported to the consulting psychiatrist who recommended that the client be sent to the emergency room of the Royal Columbian Hospital. The hospital administered three litres of electrolyte fluid and returned the client to our facility. The client continued to have difficulty swallowing and over the next four days, the client lost fourteen pounds. It was noted that the client was making extraordinary efforts to take