Professional, Ethical, and Legal Foundations
This domain tests informed consent, confidentiality, documentation, scope of practice, and ethical decision-making. Questions often hinge on the next best professional action.
Core rules
- Informed consent requires capacity, disclosure of risks and alternatives, understanding, and voluntariness. A signature alone is not consent.
- Confidentiality is protected by law and ethics, with exceptions such as reportable communicable diseases, suspected abuse, imminent harm, and court orders.
- Documentation should be contemporaneous, accurate, and complete; include history, findings, diagnosis, plan, and informed refusal.
- Scope of practice is defined by law and licensure; when a condition exceeds it, refer rather than abandon the patient.
- Malpractice requires duty, breach of standard of care, causation, and damages. Ethical principles include beneficence, nonmaleficence, autonomy, and justice.
Worked example
An adult patient with newly diagnosed angle-closure glaucoma refuses urgent referral. Reasoning: assess capacity and understanding, explain risks including permanent vision loss, offer a second opinion, document the informed refusal, and continue appropriate interim care. The clinician cannot coerce the patient, but must not abandon care or falsify records.
Traps that cost marks
- Disclosing protected health information to a family member without authorization.
- Treating a minor without considering parental consent rules and emergency exceptions.
- Altering a record after an adverse event instead of adding a dated addendum.