Medical Ethics and Professionalism: Principles in Practice
Ethics questions test principled reasoning in context. Know the four principles: autonomy, beneficence, non-maleficence, and justice. Informed consent requires capacity, adequate information, voluntariness, and the absence of coercion. Capacity is decision-specific and assessed clinically - the ability to understand, appreciate, reason, and communicate a choice. A patient with capacity may refuse treatment even if the refusal seems unwise.
Confidentiality and disclosure
Respect confidentiality, with limited exceptions such as mandatory reporting of certain communicable diseases or imminent risk of serious harm to others. In emergencies, treat first and obtain consent later when the patient lacks capacity and delay would cause harm.
Professionalism
Recognize conflicts of interest, boundary violations, and the duty to report impaired colleagues. Understand research ethics: institutional review, informed consent, and equipoise. Cultural and religious sensitivity matters, particularly around blood products and end-of-life care.
Traps
Examiners offer a "beneficent" option that overrides a competent patient's wishes - this is usually wrong. Another trap is breaching confidentiality without a recognized exception. Read whether the patient has capacity and whether an emergency exists.
Rule of thumb
Ask: does this patient have capacity, and is there an emergency? If capacity is present and no emergency exists, autonomy governs. If capacity is absent and harm is imminent, act in the patient's best interest.