Professional Conduct, Ethics and Scope of Practice
Foundations
Professional practice rests on acting within scope, in the patient's interests, with consent, confidentiality and accountability. Know the difference between scope of practice (what your level authorises) and competence (what you can actually do safely); both must be satisfied. Understand the duty to recognise limits, escalate, and hand over accurately.
Concepts to master
- Consent: valid consent requires capacity, information and voluntariness; know how to proceed when capacity is impaired or refusal occurs.
- Capacity and refusal: a capable adult may refuse; document the decision and the assessment of capacity.
- Confidentiality: share information only as necessary for care, with appropriate safeguards.
- Accountability and documentation: records must be accurate, contemporaneous and complete.
- Scope and delegation: what may be delegated, and what may not.
- Professional boundaries and conflicts of interest: recognise and manage them.
- Raising concerns: the duty to report unsafe practice through appropriate channels.
Traps
Questions often test whether you respect a capable refusal even when you disagree, whether you recognise that a guideline does not authorise an out-of-scope act, and whether you document a decision you made against advice. Another trap is sharing patient information casually, or assuming that a colleague's request extends your scope.
Rule of thumb
Patient's interests, within your scope, with consent, on the record. If an act is outside scope or competence, the correct response is to escalate or hand over - not to proceed because the situation is urgent.
Worked example
A patient with capacity declines transport after assessment. The correct approach is to confirm capacity, explain risks, respect the refusal, ensure safety and document the discussion and decision - not to override the refusal or omit the record because the outcome was against your advice.