Geriatric medicine can be described as a primary-care discipline whose spectrum includes prevention and wellness and acute, chronic, rehabilitive and long-term care for the elderly. The multifaceted, multidisciplinary nature of geriatrics poses numerous, complex challenges, resulting in “Clinical Decisions” which are highly individualized and, at times, unorthodox. Since the presentation of illness is often subtle in older persons, falling, incontinence, weight loss, or changes in cognition presage disease or overmedication and not solely aging. Once this understanding is ingrained and practiced, then “Clinical Decisions” can be made based on good judgment and confirmed by the appropriate standards of care. The Journal of the American Geriatrics Society has inaugurated a section entitled “Clinical Decisions.” This new category of primarily solicited articles discusses in appropriate depth various stages in the management of very complex clinical problems in older patients. The purpose of this section is to demonstrate the many difficult clinical, social, and ethical decisions that health-care professionals must make when caring for older patients with complex problems. The first paper in this series, by Williams and Lowenthal, examines the obstacles to rehabilitation of an older man with advanced peripheral arterial vascular disease, below-knee amputation, transient ischemic attack, overmedication, and angina pectoris caused by coronary artery disease. Careful management of the problems in this common yet complex scenario enabled a patient to make progress toward functional independence. The second paper, to be published early in 1995, concerns a medical-ethical dilemma involving an 85-year-old demented woman with a breast mass. This paper, by Robinson and Balducci, traverses the maze of ethics, biostatistics, clinical medicine, and social factors to clarify a wise “Clinical Decision.” It is anticipated that this section will prompt the readers to generate submissions that clearly demonstrate the complexities of caring for older persons. The format initially requires a partial case description, which may pose problems and/or questions. This should be followed by a discussion of the material presented, the problems dissected, and the questions answered. More of the case should then be revealed with further discussion of the new problems and choices or options for further care. Despite their complexity, many cases will demonstrate opportunities for problems to be rectified or reversed and a beneficial outcome to be expected. On the other hand, it would be naive to assume that all problems, when solved, result in a favorable outcome. Those situations whose outcome is undoubtedly gloomy, as in case number 2, can teach us how to deal with family, how to relate to probability, and how to think in terms of what would the patient want if only she could tell us. Therefore, the actual format is open but absolutely needs: (1) a clinical base from which (2) a multitude of complex problems arise, followed by (3) discussion of the case and problems and (4) how the team concept in geriatric medicine is useful in the patient's complicated management. This innovation of problem solving in geriatrics can be a learning experience for all health care providers. It is not solely for the academic readership. In fact, careful attention will be given to the many mundane problems of the elderly, without emphasizing strictly esoterica. Your suggestions for topics are encouraged and welcome. Your criticisms can only help to improve this important section on “Clinical Decisions.” Please send all papers to: