Ethics, Professional Conduct, and Medico-Legal Issues
This domain tests whether you can act lawfully and ethically under pressure - consent, confidentiality, negligence, and the statutes that bind a health worker at the Health and Wellness Centre.
Core principles and consent
- Autonomy, beneficence, non-maleficence and justice.
- Valid informed consent needs capacity, adequate information (including risks and alternatives) and voluntariness. The legal age is 18; for a minor, the guardian consents. Emergency treatment to save life proceeds without consent.
- Confidentiality yields only for notifiable diseases, court orders, and statutory reporting such as POCSO.
Statutes to remember
- PCPNDT Act: no prenatal sex determination; only registered ultrasound facilities; Form F must be maintained.
- MTP Act 2021: termination up to 24 weeks for special categories, at an approved facility, with documented consent.
- POCSO: any sexual act with a person under 18 must be reported to police or Childline 1098.
- HIV and AIDS (Prevention and Control) Act 2017 protects confidentiality and prohibits discrimination.
- Negligence needs four elements: duty, dereliction of that duty, direct causation, and damage.
Worked example
A 15-year-old attends asking for contraception and refuses to involve her parents. You provide confidential clinical care and counselling, but because she is a minor who may be sexually active, POCSO mandates a report to the police or Childline 1098, and child-protection procedures must be explained to her honestly. Confidentiality is limited, and she should be told this at the start.
Traps
- Disclosing HIV status to relatives without consent.
- Performing an ultrasound for sex determination on family insistence.
- Treating a minor's request as ordinary adult consent.