DEAR MISS MANNERS: Some feel that if a doctor calls the patient by his first name, it is appropriate to call the doctor by his first name; others have said that if you address the doctor using his title, the doctor should reciprocate; and still others believe that a doctor should always be addressed by his title, regardless of how he addresses you. What is the proper etiquette in this situation?

GENTLE READER: Doctors who address their patients by their first names will tell you that they do so because it is "friendly" and makes the patient relax. Miss Manners considers it a professional relationship requiring formality on both sides. Personally, she does not allow her friends to require her to take off her clothes so they can get a good look at her.

Some doctors, chiefly young ones, do not object being addressed similarly in return. Others do but should not be indulged in the rude wish of demanding a dignity from those to whom they deny it.

DEAR MISS MANNERS: What is the proper etiquette on baby showers for single moms and couples who are not married?

I received an invitation to a baby shower for a young lady I had never met, my cousin's son's girlfriend who is expecting. The couple, who are in their mid-20s, are not married, they do not live together, and from what I have learned from relatives, they have no intention of getting married or setting up house together anytime in the near future. (The young man lives with his parents and the young lady lives with her parents.)

Over the past few years, I have received several baby shower invitations and/or invitations to baptisms for babies of young men and women who are not married, not living together and in some instances no longer dating.

It used to be the wedding shower came first, then the wedding, then the baby shower, then the baptism, so you got a chance to meet and get to know the young couple a little bit.

Nowadays it seems as if people want the perks (gifts?) that come with celebrating events that were traditionally associated with young married couples, without being married.

I declined the shower invitation and I did not send a gift. My friend thinks that I am being snooty and old-fashioned. I think these people are being greedy, begging gifts from strangers. It is not about the lady being a single mom. I have no problem supporting a single mom I know and have a relationship with, but I believe that I have no obligation to purchase a gift and give up a Sunday afternoon for a woman I have never met.

GENTLE READER-- Right -- If you know and like the guest of honor, go, and if you don't, don't.

So if you would happily honor a single mother you knew, why did you throw in all that bit about modern mating customs? You only sidetracked Miss Manners and prickled your friend, although Miss Manners does not consider being called old-fashioned an insult.

But there is nothing snooty about declining the invitations of strangers, and one does not owe a present for a shower one did not attend.

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DEAR MISS MANNERS: We gave a graduation gift in the amount of $100 to a friend of our son who has done quite a bit for him over the years. A couple of weeks passed, and my son got a check for the same amount as a graduation gift from his parents.

We really didn't want them to feel obliged to do this. Should we have included a note in our card that reciprocity was not expected or warranted?

GENTLE READER: Your discomfort, with which Miss Manners sympathizes, arises from the substitution of money for objects in social giving. While undoubtedly practical, as its adherents argue, it strips the custom of any pretence to thoughtfulness (thinking that others could use more money doesn't count) and charm.

In effect, you paid your son's friend for graduating; as your son is also graduating, they reciprocated. To fail to reciprocate would have declared an imbalance in the relationship, suggesting that their son was either more in want or more deserving than his friend.

You cannot quarrel with their using money as a present, because that was what you deemed appropriate to give. And if they gave $75, for example, they would look less generous than you, while if they gave $125, it would look as if they were purposely showing you up.

Now suppose that you had sent, instead, a particular piece of sports equipment that your son knew his friend wanted, and that the friend, knowing that your son was spending the summer traveling, had had his parents send a travel bag that was more suitable than the family luggage he might otherwise have taken.

Perhaps these presents might not have cost the same, but it wouldn't matter. The reciprocity would consist of each having made an effort to please the other.

Now you have no choice but to allow your son to accept the check with gracious thanks. But in the future, you might consider going back to the traditional practice of selecting presents rather than simply writing checks.

DEAR MISS MANNERS: How does one address a person one does not know, or even has any vague connection with, on a sympathy card?

I am often asked and expected to put a word of encouragement to a friend or acquaintance's friend's cousin whose daughter is going through surgery. I am at a loss for anything meaningful to write, and I feel like I am intruding on them. I usually either sign my name or say something such as "Thinking of you."

Is this acceptable? Is there something more appropriate to write? Alternatively, is there a polite way to decline offering my sympathy to a complete stranger while making it clear I bear them no ill will?

GENTLE READER: Let us go with the alternative. Sympathy is of comfort to the bereaved when it comes from those who care about them or cared about the deceased.

To have a stranger's generalized lamentation about death would, in Miss Manners' view, only confuse and therefore distress someone who is already emotionally overburdened. The well-meaning instigator needs to be told that, very, very gently.

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DEAR MISS MANNERS: Our 26-year-old son lives out of state in San Francisco where unfortunately (from our point of view as traditional parents) he has partially gone native by having what we hope will be his first and last live-in girlfriend / concubine / mistress / future-spouse / POSSLQ.

How can we continue to show him a proper mix of parental affection and disapproval?

We are planning to visit his part of the country soon. He proposes bringing his live-in along to overnight stays in a resort, while I'm not inclined to socialize with her until she's an honest woman, or our son is on his deathbed.

However, I don't particularly want to push them into each other's arms, because I don't think our son is yet mature enough to marry, nor do I think they are all that suited to each other. I think both are losing out by not continuing to court rather than to make a decision that forecloses this possibility. Their affairs are beginning to entangle, e.g., a car they own together.

GENTLE READER: Would you mind sorting out your emotions a bit so that Miss Manners can figure out what it is that you do want?

You say you want to show affection for your son, but you are able to picture him on his deathbed.

You say you want to snub the, ah, co-owner of his car, but would accept her as a daughter-in-law (presumably what you mean by "an honest woman"), without considering whether, after such treatment, she would be willing to accept you.

Miss Manners cannot reconcile all that with a line of behavior. But if it would be of help, she can advise you about how to keep from alienating this couple -- yes, both of them -- while not conferring your blessing on their living arrangements.

Invite them to join you at the resort, ordering two rooms for them, preferably at some distance from your own. Treat your son's guest with gallant courtesy, as if this were the traditional type of courtship of which you approve. At any hint of its being otherwise, you should exhibit a bit of embarrassed confusion and change the subject.

Thus it will seem cruel and crude if they flaunt the situation, rather than respecting, if not acceding to, your standards. At the small price of seeming quaint, you will have registered your point without insulting someone to whom you may find yourself related.

DEAR MISS MANNERS: We were meeting a new couple that we had corresponded with over the Internet at a nice restaurant. Early in the dinner (after appetizers but before entrees), the woman slipped on the way to the bathroom and severely sprained her knee.

An ambulance was called and the boyfriend drove their car to the hospital with her. Once they had left, we somewhat awkwardly had our entrees and dessert, paid the bill and left. Should we have abandoned the dinner after the accident? If these were close friends, we absolutely would've gone to the hospital with them, but we had just met these people for the first time.

GENTLE READER: And did you really finish your meals in comfort with all those people looking at you?

Not that Miss Manners thinks that your behavior should be regulated by the glances of bystanders. But she would be looking askance at you herself -- and asking if the strangers needed help.

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