Professional Ethics, Law and Patient Safety
This domain tests professional conduct, consent, confidentiality, scope of practice and everyday safety behaviours. Questions tend to be scenario-based: what should the therapist do next, and what must be documented?
Ethical principles in practice
Autonomy (the patient decides), beneficence (act for the patient's good), non-maleficence (avoid harm), justice (fair access and fair use of resources), veracity (honesty) and fidelity (keeping commitments). When principles conflict, reason explicitly and record your reasoning.
Informed consent
Valid consent requires capacity, adequate information about benefits, risks and alternatives, and voluntariness. It is a process, not a signature, and it can be withdrawn at any time. Minors and adults lacking capacity require a guardian or legal representative; where possible, seek the patient's own assent. Document what was discussed, not only that a form was signed.
Confidentiality and its limits
Confidentiality may be overridden for legally mandated reporting, a court order, or a serious risk of harm to the patient or others. Disclose the minimum necessary information to the fewest people.
Scope of practice and referral
Practise only within your training and competence, refer when the presentation falls outside it, and collaborate with the referring physician where regulations require it. Performing a technique you have not been trained in is a disciplinary matter, not merely a clinical error.
Documentation and safety
Notes should be contemporaneous, factual, signed and dated, in a recognised format such as SOAP; corrections must be made transparently, never erased. Core safety behaviours are hand hygiene, standard precautions, falls-risk assessment, skin checks before and after modalities, safe moving and handling, and blameless incident reporting.
Worked example
A patient whose rehabilitation goals have been met asks for six more sessions 'just in case', and offers to pay for them. Reasoning: continuing treatment without a clinical indication conflicts with non-maleficence and with justice in the use of resources, and it fosters dependency. Explain the discharge plan, provide a written home programme with review criteria, offer an open appointment if symptoms recur, and document the discussion as a shared decision.
Traps that cost marks
- Treating a signed form as proof of informed consent.
- Breaching confidentiality casually in corridors or on messaging apps.
- Continuing treatment because the patient requests it, when goals are met.