A 64-Year-Old Man Walks in for a Check-Up Six Months

A 64-year-old man walks in for a check-up six months after having a myocardial infarction. The patient's health has gradually improved, despite a pulmonary embolus and a urinary tract infection complicating his clinical path. During the session, the patient presents the doctor with handmade cookies and a thank-you note with four professional basketball game tickets. He claims, "I'd like to express my gratitude for everything you've done. Please accept these tickets and have a good game." He encourages the doctor not to worry about the cost, stating, "Every year, I get season tickets but haven't been able to attend any games due to illness. You have been a good doctor, and I wanted to thank you by giving you something." Which of the following statements is the most appropriate?

A) "Thank you, but I cannot accept any of these gifts from you; it's enough for me to see that you've been sticking with the treatment plan and getting better."
B) "Thank you for the card and cookies; unfortunately, the tickets are so valuable that my acceptance of them as your physician could affect our relationship."
C) "Thank you for the kind gesture, but I cannot accept any of these gifts; please know that it would be unethical for me to do so."
D) "Thank you for these gifts, but I can accept them only if you understand that this will not change our relationship or the care that I provide you."
E) "Thank you very much for the cookies and tickets; I will share these with my staff because they are part of your treatment team as well."