Behavioural Science, Ethics and Professionalism
What you must know
Ethics questions test the regulator's standards and the legal framework behind them: putting patients first, obtaining valid consent, maintaining confidentiality, raising concerns, and keeping complete records. Understand the four-principles approach (autonomy, beneficence, non-maleficence, justice) and how it maps onto real decisions. Know the two-stage capacity test under the Mental Capacity Act: can the patient understand, retain, weigh and communicate the decision? Capacity is decision-specific and time-specific, and adults are presumed to have it. Know Gillick competence for under-16s, safeguarding duties, the duty of candour after harm, and complaint handling. Behavioural content covers motivational interviewing, the transtheoretical (stages of change) model, the health belief model, and communication strategies for anxious or phobic patients.
Traps
The classic trap is citing the Bolam test for consent: for disclosure of risk the correct standard is Montgomery, which asks whether a reasonable person in that patient's position would attach significance to the risk. Another trap conflates “best interests” decision-making for adults lacking capacity with parental consent for children. Questions also blur confidentiality: disclosure without consent is lawful only where justified by law, public interest or safeguarding.
Worked example
A patient is not told that a planned lower third molar removal carries a roughly 1 in 100–1 in 200 risk of permanent lingual or inferior alveolar nerve injury. Afterwards she says she would have declined. Under Montgomery, the test is not what a responsible body of clinicians would disclose but whether this risk was material to a reasonable patient in her position - it plainly is, so consent was invalid. Rule of thumb: discuss any risk a reasonable patient would want to know, and record the discussion.