Professional and Ethical Practice - exam-focused guide
Professional and Ethical Practice tests consent, capacity, confidentiality, brain death, end-of-life decisions, error disclosure and resource use. The exam expects defensible reasoning, not memorized slogans.
Core rules
- Valid consent requires capacity, adequate information and voluntariness. Discuss diagnosis, proposed treatment, alternatives, material risks and consequences of refusal. Document the discussion.
- Adults are presumed to have capacity unless evidence suggests otherwise. Assess understanding, retention, reasoning and communication. If capacity is lost, use advance directives or the best-interests standard.
- In an emergency with immediate threat to life and no surrogate, treat under the best-interests principle and document why consent was not obtained.
- Minors generally require parental consent; mature-minor and emancipated-minor rules vary by jurisdiction. Assent is sought from the child.
- Confidentiality may be breached when required by law or to protect others, but disclose the minimum necessary.
- Brain death is a clinical diagnosis under a protocol; organ donation discussions should be separate from resuscitation decisions. Disclose harmful errors honestly.
Worked example: An unconscious patient with an acute extradural hematoma arrives without family. The surgeon explains to the team that delay would risk death, proceeds under the emergency exception, and documents the indication, urgency and attempts to contact next of kin. Consent is not fabricated after the fact.
Traps: obtaining consent from an incapacitated patient; letting a relative consent for a competent adult; disclosing information to employers without consent; conflating brain death with coma; hiding a surgical complication.