Professional Ethics and Communication: Consent, Confidentiality and Therapeutic Talk
What this domain tests
Professional Ethics and Communication tests ethical principles, informed consent, confidentiality, legal responsibilities, incident reporting and therapeutic communication. Scenario questions ask what the nurse should do first or say next.
Core rules
- Ethical principles: autonomy (respect the patient's choice), beneficence (do good), non-maleficence (avoid harm), justice (fair treatment), veracity (truthfulness) and confidentiality.
- Informed consent requires capacity, adequate information, understanding and voluntariness. The nurse witnesses consent; the doctor obtains it.
- Confidentiality is a duty but not absolute: disclose only as required by law, to the care team, or to prevent serious harm.
- Therapeutic communication: open questions, reflection, silence, seeking clarification, summarising. Avoid false reassurance, advice-giving, and why questions that sound accusatory.
- Record facts objectively and promptly. Never falsify, alter or destroy records. Report incidents, including near misses.
- Respect a competent patient's refusal after explaining risks; document it and inform the doctor.
Worked example
A patient refuses an insulin injection, saying he fears needles. Reasoning: respect autonomy first. Sit down, ask what worries him, clarify that the injection is prescribed and explain the consequence of missing it. Do not threaten or force. If he still refuses, document the refusal, inform the doctor, and continue monitoring. Force would be justified only under specific legal provisions for urgent, life-saving treatment, not routine care.
Traps
- Promising absolute secrecy; you cannot promise what the law may require you to disclose.
- Discussing a patient in a lift or corridor.
- Signing a consent form for a patient who does not understand it.
- Giving sympathy instead of empathy, or saying don't worry when the patient is afraid.