Governance, Ethics, and Professional Responsibility
Who decides, and on what basis
Governance questions test the board's role versus management's role. The governing body sets strategy, ensures financial viability, appoints and evaluates the CEO, and oversees quality and compliance through a duty of care and duty of loyalty. Management executes. A candidate must know the board's fiduciary duties - care, loyalty, obedience - and understand that the board retains ultimate accountability for quality oversight even when it delegates to committees.
Concepts to master
Know the elements of an effective board quality committee and the concept of the quality dashboard reported to the board. Understand conflict of interest policies, community benefit obligations for tax-exempt hospitals, and executive compensation review through independent comparability data. Understand the ethics frameworks relevant to resource allocation, informed consent, end-of-life care, and research. Know the professional responsibility concepts: informed consent elements, confidentiality, mandatory reporting, and impaired colleague obligations.
Traps
A frequent trap is assigning operational decisions to the board. Boards approve policy and oversee; they do not run daily operations. Another trap is treating a conflict-of-interest disclosure as sufficient - disclosure must be paired with recusal or management. Watch for questions that confuse ethics (what is right) with law (what is required); conduct can be lawful yet unethical.
Rule of thumb
For any governance question, ask: Is this a policy, oversight, or fiduciary decision (board) or an execution decision (management)? If the question mentions accountability for quality or compliance failures, the board owns it.