Ethics and Professionalism
Core concepts
Understand informed consent elements, capacity assessment, confidentiality, conflicts of interest, and appropriate boundaries. Know how to handle medical errors and disclosure, and the principles of beneficence, nonmaleficence, autonomy, and justice.
Traps in questions
- Confusing capacity with competence; capacity is a clinical determination.
- Assuming a surrogate can override a capacitated patient's refusal.
- Missing the duty to disclose errors and adverse events.
- Overlooking conflicts of interest in industry relationships.
Rule of thumb
A patient with capacity may refuse any treatment, even if the team disagrees; document the discussion and honor autonomy.
Worked example
A capacitated patient refuses a recommended reconstructive procedure. The question asks what to do. The rule: respect autonomy, ensure the patient understands consequences, offer alternatives, and document. Proceeding over refusal is the wrong answer.