Professionalism, Ethics, and Patient Safety
Core concepts
Understand informed consent, capacity, confidentiality, and surrogate decision-making. Know the principles of beneficence, nonmaleficence, autonomy, and justice. Master error disclosure, root cause analysis, and patient safety systems. Understand the surgical safety checklist, time-outs, and prevention of wrong-site surgery and retained foreign bodies. Know the approach to impaired colleagues, conflicts of interest, and research ethics. Understand advance directives and goals-of-care communication.
Traps in questions
Questions often test whether a patient has capacity versus whether a decision is wise. Distinguish confidentiality exceptions from routine disclosure. Another trap is assuming a family member can consent for an adult with capacity. Watch for questions about disclosing errors; disclosure is expected and does not necessarily increase liability.
Worked rule of thumb
For an ethical dilemma, identify the decision-maker, assess capacity, clarify goals, and choose the least restrictive option. When a patient lacks capacity and no surrogate exists, follow jurisdiction-specific processes and act in the patient's best interest.
Exam strategy
Apply the four principles explicitly. Autonomy usually governs when the patient has capacity; beneficence and nonmaleficence guide when they do not.