Um Abdallah, a 56-year-old woman with a learning disability, is admitted to the hospital with an ovarian cyst blocking her ureter, which could lead to renal failure if left untreated. She requires surgery to remove the cyst but is afraid of needles and does not want the anesthesia. The clinician is concerned about renal failure without treatment, while the anesthetist worries about needing to physically restrain her. Her sons want her to receive treatment.