Communication and Professional Ethics: Therapeutic Talk and Consent
What this domain tests
Therapeutic communication, confidentiality, consent, professional boundaries, and team communication.
Core rules and concepts
- Therapeutic communication is patient-centred: open questions, active listening, reflection, clarification, silence.
- Avoid false reassurance ("everything will be fine"), giving advice, and changing the subject.
- Confidentiality: share information only for care, on a need-to-know basis.
- Informed consent: voluntary, informed, and given by a competent adult. For minors, a guardian consents; emergency treatment may proceed without consent to save life.
- SBAR: Situation, Background, Assessment, Recommendation-use it for handover.
Worked example
A patient asks, "Do I have cancer?" The report is with the doctor, and the family has asked staff not to tell the patient. Reasoning: the nurse should not lie or disclose without authorization. Respond empathetically, explore what the patient knows, and tell the patient the doctor will discuss the results. In India, the patient's right to information is important; follow the institution's policy and the doctor's plan.
Traps that cost marks
- Promising confidentiality absolutely when disclosure is legally required.
- Discussing a patient in a lift or corridor.
- Obtaining consent from a relative when the patient is competent.
- Using jargon to impress rather than to inform.