Ethics, Legal Issues and Professional Practice
This domain tests consent, capacity, confidentiality, involuntary care, documentation, boundaries, and professional duties. Questions often turn on the least restrictive lawful option and on documenting reasoning.
Core rules
- Valid consent requires capacity, adequate information, and voluntariness.
- Capacity is decision-specific: understand, retain, weigh, and communicate the decision. Disagreement is not incapacity.
- Confidentiality has limits: risk of serious harm, safeguarding, court orders, and necessary sharing with consent.
- Involuntary treatment must meet legal criteria, use the least restrictive setting, and be reviewed; clinical need alone is insufficient.
- Keep records factual, timely, and attributable; declare conflicts and maintain boundaries.
Worked example
A patient with a treatable infection refuses antibiotics but understands the consequences and can explain alternatives. Reasoning: assume capacity unless evidence shows otherwise. Respect the refusal, document the discussion, and treat the infection as clinically indicated only within the legal framework; do not equate refusal with incompetence.
Traps
Do not breach confidentiality broadly when a targeted disclosure would suffice. Do not use involuntary admission merely because treatment is advisable. Do not document conclusions without the facts and reasoning that support them.