Professional and ethical role
Professional and ethical role
This domain tests the standards expected of a registered practitioner: consent, capacity, confidentiality, boundaries, conflicts of interest, and the duty to report. Questions usually hinge on which obligation is paramount.
Core rules
- Four principles: beneficence, non-maleficence, autonomy, justice. Autonomy generally dominates when the patient has capacity.
- Valid consent: capacity, voluntariness, and adequate information - including material risks a reasonable person would want to know, and alternatives including doing nothing.
- Capacity requires the ability to understand, retain, weigh and communicate a decision; it is decision-specific, not global.
- Confidentiality exceptions: patient consent, serious threat to life or health, legal compulsion (court order, notifiable disease), and mandatory reporting of children at risk.
- Mandatory notification to AHPRA is required for a reasonable belief that a registered practitioner practices while intoxicated, breaches boundaries, or places the public at risk.
- Boundaries and conflicts: declare gifts, avoid treating close contacts where possible, and never enter financial relationships that could distort care.
Worked example
A colleague repeatedly smells of alcohol after lunch and jokes about “a big night”. He saw a complex patient that afternoon.
Reasoning: this meets the threshold for a mandatory notification - a reasonable belief that a registered practitioner is practising while impaired and placing patients at risk. The correct action is to notify AHPRA, and separately to encourage the colleague to seek help through the practitioners' health program. Simply “keeping an eye on it”, or raising it only with the practice principal, does not discharge the statutory duty.
Traps that cost marks
- Believing a family member can consent for a capable adult.
- Treating a refusal of treatment by a capable patient as a capacity problem.
- Choosing “discuss with the family” over notifying the regulator where statute applies.
- Overlooking the need to document the consent conversation.