In Mrs. Rivera's situation the fact that she can not understand some of the things that the doctor might be saying and that she has no clue about what will happen and what her choices are. This is where Marcos should have though about her past and how all this has happended and how much longer would she actually live once getting the transplant, she will still have diabetes which could cause death later on. I think Marco should have got a "hospice" and should have brought the family closer by speding more time with here as she went out.