Managing complex otolaryngology patients can be demanding; even more so when social determinants of health exist. This panel is designed to shed light on common issues that arise while caring for patients in these challenging situations. Resource depletion represents one of the most significant issues for our patients, manifesting in a variety of ways. In this panel, we will focus on issues related to Geographic, Emotional, Financial, and Caregiver resource depletion. These limitations play a major role in clinical care and ethical decision making which will be highlighted in our panel discussions. Specific ethical issues to be discussed include patient autonomy vs paternalism, surgical vs non-surgical therapy, the decision to modify standards of care, and managing support networks that may or may not be present. We hope that this panel will provide insight as to how to provide optimal care when faced with these ethical quandaries.