Ethics and Practice Management
What the exam tests
Ethics and Practice Management tests consent, capacity, confidentiality, professionalism, record keeping, and safe practice systems. The exam expects you to apply principles to realistic dilemmas, not recite slogans.
Core rules
- The four principles are autonomy, beneficence, non-maleficence, and justice. Autonomy usually dominates when a competent adult makes an informed choice.
- Valid consent requires capacity, sufficient information, and voluntariness. A signature alone is not consent. Document the discussion, alternatives, and material risks.
- Assess capacity functionally: understand, retain, weigh, and communicate a decision. If capacity is absent, act in the patient's best interests, involve relatives where appropriate, and follow local law.
- Confidentiality is not absolute; disclose only with consent or a legal basis, and share the minimum necessary. Apply data protection rules to records, images, and social media.
- Keep contemporaneous records: history, examination, diagnosis, options, consent, treatment, and advice.
- Work within your competence and refer when needed. Manage complaints openly and learn from them.
Worked example
A competent adult with acute pain refuses a radiograph. You explain why imaging is needed for diagnosis and the risks of proceeding without it. He still refuses. You respect autonomy, document the informed refusal, offer analgesia and an alternative pathway, and avoid irreversible treatment without diagnosis. If the situation becomes an emergency, you provide urgent care within your competence and refer. The reasoning is that consent can be refused, but the clinician must not abandon the patient or treat blindly.
Traps
- Treating a signature as proof of consent.
- Breaching confidentiality in a public setting.
- Assuming a patient lacks capacity because of age or diagnosis.
- Failing to document advice and refusal.