ABA Professional Ethics and Standards 2 — Questions and Answers
Question 1: An anesthesiologist discovers intraoperatively that a surgeon is performing a procedure outside the consented scope. What is the most appropriate ethical response?
- Continue anesthesia and document concerns afterward
- Immediately stop the procedure and wake the patient
- Inform the surgeon of the concern and advocate for the patient (Correct answer)
- Defer entirely to the surgeon's clinical judgment
Correct answer: Inform the surgeon of the concern and advocate for the patient
The anesthesiologist has an independent duty to advocate for the patient and must communicate concerns to the surgeon about scope of consent.
Question 2: Which principle underpins the ABA requirement that diplomates report impairment in a colleague?
- Beneficence toward the impaired physician
- Non-maleficence toward patients who may be harmed (Correct answer)
- Respect for the colleague's autonomy
- Justice in distributing clinical workload
Correct answer: Non-maleficence toward patients who may be harmed
Non-maleficence—preventing harm to patients—is the primary ethical basis for mandatory reporting of an impaired colleague.
Question 3: A patient refuses a blood transfusion on religious grounds despite a life-threatening hemorrhage. The anesthesiologist should:
- Administer blood because saving life overrides religious beliefs
- Honor the refusal if the patient is competent and properly informed (Correct answer)
- Seek an emergency court order to override the refusal
- Transfer care immediately without any further discussion
Correct answer: Honor the refusal if the patient is competent and properly informed
A competent adult's informed refusal of treatment must be respected regardless of the anesthesiologist's personal or religious views.
Question 4: Which action best demonstrates adherence to the ABA's commitment to professionalism regarding social media use?
- Posting de-identified but identifiable case photos in a closed physician group
- Sharing patient outcomes data publicly to promote research
- Avoiding any online commentary that could breach patient confidentiality (Correct answer)
- Using a pseudonym when discussing patient cases online
Correct answer: Avoiding any online commentary that could breach patient confidentiality
Avoiding disclosures that could breach confidentiality upholds professionalism and HIPAA compliance on all digital platforms.
Question 5: An anesthesiologist is asked to provide a medical opinion in a legal case involving a colleague's alleged malpractice. Ethical standards require that the expert:
- Advocate for the defendant colleague to protect the profession
- Provide an honest, objective opinion regardless of the outcome for the colleague (Correct answer)
- Decline to testify to avoid a conflict of interest
- Limit testimony to facts already in the medical record
Correct answer: Provide an honest, objective opinion regardless of the outcome for the colleague
Expert witnesses are ethically obligated to provide truthful, objective testimony and must not shade opinion to favor a colleague.
Question 6: When an anesthesiologist has a direct financial relationship with a device manufacturer whose product they recommend to patients, ABA ethics requires:
- Stopping all financial relationships with industry immediately
- Full disclosure of the relationship to patients and the institution (Correct answer)
- Limiting recommendations to verbal suggestions only
- Obtaining IRB approval before any device recommendation
Correct answer: Full disclosure of the relationship to patients and the institution
Full disclosure of financial conflicts of interest to patients and the institution is required to preserve trust and informed decision-making.
Question 7: A patient in the preoperative area becomes visibly distressed and withdraws consent minutes before induction. The correct action is:
- Proceed because the signed consent form is legally binding
- Administer anxiolytic medication and proceed once calm
- Halt the case and ensure the surgical team is notified of withdrawn consent (Correct answer)
- Ask the surgeon to persuade the patient to continue
Correct answer: Halt the case and ensure the surgical team is notified of withdrawn consent
Consent can be withdrawn at any time by a competent patient, and the entire team must be informed so the procedure is stopped.
ABA Professional Ethics and Standards 2
An anesthesiologist discovers intraoperatively that a surgeon is performing a procedure outside the consented scope.
What is the most appropriate ethical response?