Professionalism, Ethics, and Communication
Core concepts
Expect questions on consent, capacity, confidentiality, truth-telling, boundaries, and conflict of interest. Understand the four ethical principles (autonomy, beneficence, non-maleficence, justice) and how they interact. Know that capacity is decision-specific and assessed functionally (understand, retain, weigh, communicate), while competence is a legal status. Understand substitute decision-making hierarchies, advance directives, and best-interests standards. Communication concepts include breaking bad news, shared decision-making, health literacy, and interpreter use.
Traps
A common trap is assuming that refusing treatment equals lacking capacity. Another is disclosing information to family without the patient's consent, or breaching confidentiality without a recognized exception. Watch for options that impose the clinician's values or that treat "do everything" as the default ethical choice. Also beware conflating an ethical duty with a legal one.
Rule of thumb
Autonomy leads when the patient has capacity and is informed; safety-net only when capacity is genuinely absent or risk to others is imminent. When in doubt, ask the patient what matters to them before advising.
Worked example
A competent adult declines a recommended life-saving procedure after full explanation. The correct response is to document the informed refusal, explore concerns, offer alternatives, and continue care - not to override the decision or involve family against the patient's wishes.