Medical Ethics, Law, and Professionalism
Ethics and law questions test whether you can reason to a defensible decision, not whether you can recite slogans.
Core rules
- Consent must be informed, voluntary, and given by a patient with capacity; it covers risks, benefits, alternatives, and the right to refuse.
- Capacity is decision-specific: assess understanding, retention, appreciation, and communication of a choice.
- Confidentiality may be breached only with consent, legal requirement, or overriding public interest - and then minimally.
- Minors: parental consent is generally required, with exceptions for emancipated minors and emergencies; competence is assessed individually where law allows.
- End of life: document advance wishes, withhold futile treatment, provide palliative care, and relieve pain even if it may shorten life (double effect).
- Professionalism: disclose errors honestly, maintain boundaries, and declare conflicts of interest. In Lebanon the Lebanese Order of Physicians regulates practice and professional discipline.
Worked example
A competent 70-year-old with a gangrenous leg refuses amputation. Confirm capacity, explore his reasons, treat pain, involve family and psychiatry, and document the discussion in detail. You may not operate; you must continue care and may not abandon him.
Traps
- Accepting a signature as consent without evidence of discussion.
- Assuming a psychiatric diagnosis removes capacity.
- Disclosing information to family without permission.
- Concealing a medication error to protect a colleague.