Professionalism & Ethics

Essential elements of valid informed consent include:

Best first step when a patient appears confused and you must obtain consent for surgery?

Adult patient with capacity refuses recommended life-saving operation. Appropriate response?

Emergency laparotomy is needed and no surrogate is available. Ethical action?

Who is an appropriate surrogate decision-maker when there is no advance directive (general hierarchy varies)?

A 16-year-old requests contraception counseling without parents. Ethical approach?

Patient’s adult daughter asks you not to tell her mother about a cancer diagnosis “to protect her.” Best response?

Acceptable confidentiality breach without patient permission?

Handling a medical error that caused harm (e.g., retained item): first steps?

Colleague appears intoxicated on call. Ethical duty?

Gift from a device company in exchange for using their product. Ethical stance?

A grateful patient offers expensive tickets. Best response?

Posting a de-identified operative photo on personal social media without consent:

Use of a professional medical interpreter vs family member?

Teaching hospital: involving trainees in the OR requires:

Concurrent (“overlapping”) operations—ethical requirement?

Perioperative DNR order—ethical handling?

Palliative sedation at end of life vs euthanasia:

Jehovah’s Witness adult with capacity refuses transfusion for major surgery. Plan?

Minor JW needs emergent transfusion to live; parents refuse. Ethical action?

Research involving human subjects requires:

Belmont principles are:

Authorship on a paper ethically requires (ICMJE-like):

Morbidity & Mortality (M&M) conference ethics:

Acceptable way to photograph a wound for teaching?

Patient asks you to alter the operative note to omit a complication. Response?

When an adolescent seeks confidential STI testing, you should:

Using a chaperone is recommended for:

A surgical device representative in the OR may:

Billing ethics: “upcoding” to increase reimbursement is:

Nurse reports a senior surgeon belittling staff publicly. Professional response?

Receiving samples or meals from industry should be:

Patient asks for a backdated sick note. Appropriate reply?

You discover a wrong-site mark before incision. Best action?

Patient requests prescription for a family member you have never examined. Ethical approach?

Telemedicine visit: ethical/ legal requirements include:

Managing disruptive patient behavior that threatens staff safety:

Allocation of scarce ICU beds should be based on:

During a pandemic, a surgeon’s duty includes:

Incidental genomic finding relevant to a patient’s health (actionable). Ethical step?

Cultural requests that conflict with standard care (e.g., same-gender clinician). Best approach?

A competent patient wants to leave AMA before post-op monitoring. Appropriate action?

When a patient lacks capacity and has no surrogate or directive, decisions should be:

A junior doctor suspects data fabrication in a quality project. First step?

Patient demands an unnecessary antibiotic after minor I&D. Best response?

Managing dual roles (e.g., treating a colleague from your department):

Patient requests access to their medical record. Ethically:

A resident forgot to obtain consent for a blood transfusion. Next best step?

Offering “cash-only, no receipt” discount for a procedure:

A patient brings sweets for the ward team during holidays. Appropriate handling?

Duty-hours policy conflict: attending pressures resident to stay post-call for elective case. Ethical response?

Recording devices in clinic (patient wants to record). Best response?

Compassionate use/expanded access to an investigational therapy requires:

Handling requests for gender-affirming name/pronouns in records:

A trainee posts a photo with a patient’s room number visible. Appropriate action?

Managing a complaint about perceived discrimination:

Patient with limited literacy signing a complex consent. Ethical best practice?

A dying patient asks, “Am I going to die soon?” Ethical response?

Fee-splitting/referral bonuses from imaging center:

When is it appropriate to terminate a clinician–patient relationship?