Professionalism, Ethics, Patient Safety and Research Methodology
Core rules
- Valid consent requires capacity, adequate information, understanding and voluntariness; document discussion of risks, benefits and alternatives.
- Disclose harmful errors openly and promptly, apologize, explain what happened and describe prevention; do not alter records.
- The WHO surgical safety checklist reduces wrong-site surgery and communication failures.
- Research follows PICO: population, intervention, comparator and outcome. Sensitivity detects disease among diseased patients; specificity detects non-disease among non-diseased patients.
- Bias, confounding and level of evidence affect interpretation; randomization reduces selection bias, while blinding reduces observer bias.
Worked example
A resident is asked to enroll a trauma patient in a trial during acute pain. Reasoning: assess capacity, ensure voluntary consent, avoid coercion, and use a legally approved surrogate or deferred consent pathway if the patient lacks capacity.
Traps
Do not accept consent obtained under pressure. Do not present association as causation. Do not hide a complication to protect a colleague.
Key points are listed separately.