Ethics and Professionalism
Ethics and professionalism tests consent, capacity, confidentiality and resource stewardship in thoracic and cardiovascular practice. The exam expects defensible reasoning when values conflict.
Core rules
- Informed consent requires capacity, disclosure of material risks, benefits and alternatives, and freedom from coercion.
- Capacity is decision-specific; a patient may refuse surgery even when the team disagrees.
- Confidentiality can be breached only within legal and safety limits, and team communication should be need-to-know.
- Resource allocation and conflict-of-interest decisions must be transparent and patient-centered.
Worked example
A competent patient with critical limb ischemia refuses amputation after full explanation. The reasoning should confirm understanding, explore reasons and offer second opinions, but not override the refusal. Emergency treatment without consent is reserved for imminent harm and incapacity under local law.
Traps
Do not equate disagreement with incapacity; do not obtain consent from a relative when the patient has capacity; do not hide a complication; do not let resource pressure distort individualized clinical advice.