Medical Ethics and Deontology
Core concepts
Ethics questions test the four principles - autonomy, beneficence, non-maleficence, and justice - and their application to consent, confidentiality, end-of-life care, and resource allocation. Know the elements of valid informed consent (capacity, disclosure, understanding, voluntariness), the exceptions to confidentiality (mandatory reporting, serious harm to others, legal order), and the approach to refusing treatment by a capable patient. Understand the difference between withholding and withdrawing treatment, advance directives, and the role of surrogate decision-makers. Deontology emphasizes professional duties, honesty, and respect for the patient's dignity.
Common traps
A capable adult may refuse life-saving treatment - autonomy generally prevails, and questions often bait with "the doctor should persuade/override." Confidentiality may be breached only under specific legal or safety exceptions. Distinguish euthanasia (illegal in most jurisdictions including Albania) from withholding futile treatment and from adequate palliative sedation. In research ethics, know the role of the ethics committee and informed consent requirements. Watch for questions on conflicts of interest and dual obligations.
Worked example
A competent patient with a treatable condition refuses surgery. Rule of thumb: confirm capacity, ensure the patient understands the consequences, document the discussion, and respect the refusal - treating against a capable patient's will is battery.
Rule of thumb
When principles conflict, ask which one is most directly at stake and whether the patient has capacity; capacity is the gateway to autonomy.