Ethics, Professional Standards, and Legal Issues
Core concepts
Master informed consent (capacity, voluntariness, disclosure, comprehension), confidentiality and its limits (danger to self/others, abuse reporting, court orders), and HIPAA basics including minimum necessary and permitted disclosures. Understand competence boundaries and scope of practice, multiple relationships, and the ethics of assessment (using valid instruments, avoiding misuse). Know decision-making capacity versus legal competence, surrogate decision-making, advance directives, and end-of-life issues. Grasp record-keeping standards, duty-to-protect statutes (Tarasoff lineage), and the distinction between ethical aspirational standards and enforceable legal requirements.
Traps
Stems exploit the gap between what is legal and what is ethical-both can matter, and the correct answer often satisfies both. Watch for confusing confidentiality with privilege (legal evidentiary protection) and for assuming a subpoena equals an order to disclose everything. Another trap: equating a patient's disagreement with treatment with incapacity. Also beware breaching confidentiality too readily (danger must be serious and imminent, per jurisdiction) or too rigidly (ignoring mandatory reporting).
Worked example
A patient with capacity refuses a recommended intervention. Best response: respect autonomy after ensuring informed refusal; do not override based on disagreement. Rule of thumb: capacity is decision-specific and functional-can the patient understand, appreciate, reason, and express a choice?
Study tip
Identify the specific ethical principle (autonomy, beneficence, nonmaleficence, justice, fidelity) at stake before choosing.