Medical Ethics, Deontology, and Patient Rights
What candidates must know
This domain tests the four principles - autonomy, beneficence, non-maleficence, justice - and their application. Know the elements of valid informed consent (capacity, information, voluntariness, documentation), confidentiality and its limits, truth-telling, and end-of-life decisions. Deontology covers professional duties: respect for the patient, avoiding discrimination, maintaining boundaries, and the duty to treat in emergencies. Patient rights include access to care, information, privacy, second opinion, and complaint mechanisms. Understand ethical conduct in research, conflicts of interest, and the handling of medical errors and disclosure.
Traps in questions
A frequent trap is a conflict between autonomy and beneficence where the competent patient refuses beneficial treatment; the answer respects the refusal. Another is confusing confidentiality breach justified by law (notifiable disease, court order, risk to third parties) with unjustified disclosure to family without consent. Questions may test whether a physician may withdraw from care - generally only with proper transfer and no abandonment. Watch for scenarios involving minors and the role of parents versus the mature minor's assent.
Worked example: rule of thumb
A competent adult Jehovah's Witness refuses a blood transfusion: respect the refusal after full information and documentation, even if the physician disagrees. Rule of thumb: capacity plus information plus voluntariness equals valid consent - and valid refusal. When a patient lacks capacity and no surrogate exists, act in the patient's best interest and document the reasoning.