Professional Communication, Medical Ethics and Deontology
This section tests how you behave when the clinical answer is already known: obtaining consent, breaking bad news, maintaining confidentiality, handling error and working in a team. In Kazakhstan these expectations sit within the Code on Public Health and the Healthcare System and the ethical code of the medical worker, and rest on autonomy, beneficence, non-maleficence and justice.
Core rules
- Informed consent requires capacity, adequate information about benefits, risks and alternatives, freedom from coercion, and documentation. Use teach-back to confirm understanding.
- Breaking bad news follows a structured sequence: setting, perception, invitation, knowledge, empathy, strategy and summary. Give information at the patient's pace and check what they have understood.
- Confidentiality covers diagnosis, images and any identifiable data, including on social media. Disclosure requires patient consent, a court order or a defined duty to prevent serious harm.
- Medical error is disclosed honestly, documented factually and reported through the organisation's internal review; hiding it breaches both ethics and law.
- Team communication uses structured tools such as SBAR and checklists; assertiveness in the face of a perceived error is a professional obligation.
- Vulnerable patients - children, older people, prisoners, patients with mental illness - require additional safeguards and a legal representative where the law requires it.
Worked example
An adult daughter asks you not to tell her mother about a cancer diagnosis. Reasoning: the patient's own right to information takes priority. You first ask the patient how much she wishes to know and to whom information may be given; if she wants full information, you tell her, and you may then agree with her what the family will be told.
Traps
- Informing relatives before the patient and leaving the patient uninformed.
- Using jargon and assuming comprehension.
- Promising a guaranteed outcome.
- Discussing a case with identifiable details in a public or online setting.