Behavioural Sciences and Medical Ethics: capacity, consent and confidentiality
Scope
The paper tests human development and behaviour, learning and memory, personality, stress and coping, the doctor–patient relationship, and the ethical and legal framework of Nigerian practice.
Core rules
- Four principles: respect for autonomy, beneficence, non-maleficence and justice.
- Valid consent requires capacity, adequate information and voluntariness; documentation follows consent, it does not create it.
- Negligence needs four elements: a duty of care, breach of that duty, causation and damage.
- Confidentiality may be broken with consent, when required by statute (notifiable diseases), by court order, or in the public interest.
Worked example
A 14-year-old presents for contraceptive advice and asks that her parents not be told. Reasoning: under the Nigerian Child Rights Act, a minor's competence is assessed functionally - can she understand and weigh the information? If she has capacity, confidential advice can be given in her best interests while encouraging parental involvement. If she lacks capacity, or if there is evidence of abuse or risk of serious harm, confidentiality yields to protection and reporting.
Traps that cost marks
- Treating parental consent as always necessary, or always unnecessary.
- Listing the elements of negligence as three rather than four.
- Breaching confidentiality in a teaching session through identifiable details.
- Assuming a signed form proves valid consent when the patient was not informed.