ABCS Professional Standards & Ethics 3 — Questions and Answers
Question 1: A patient with body dysmorphic disorder (BDD) requests rhinoplasty. What is the most appropriate ethical and clinical response?
- Perform the surgery since the patient signed consent
- Defer surgery and refer for psychiatric evaluation and treatment (Correct answer)
- Offer a less invasive procedure as a compromise
- Perform surgery only if a second surgeon also agrees
Correct answer: Defer surgery and refer for psychiatric evaluation and treatment
BDD is a contraindication for cosmetic surgery; performing procedures on patients with active BDD typically worsens outcomes and violates the standard of beneficence.
Question 2: Under ABCS standards, what is the minimum requirement for a valid informed consent process?
- Patient signature on a standard hospital consent form
- Verbal discussion only, with a witness present
- Written documentation that includes risks, benefits, alternatives, and patient understanding (Correct answer)
- A video recording of the surgeon explaining the procedure
Correct answer: Written documentation that includes risks, benefits, alternatives, and patient understanding
Valid informed consent requires documentation of a thorough discussion including risks, benefits, realistic outcomes, and alternatives that demonstrates patient comprehension.
Question 3: Which scenario best represents an appropriate boundary in the patient-physician relationship within cosmetic surgery?
- Accepting small gifts from grateful patients per office policy (Correct answer)
- Entering a romantic relationship with a former patient one week after care ends
- Providing personal cell phone number to all patients for after-hours contact
- Performing additional procedures on a patient in exchange for favorable online reviews
Correct answer: Accepting small gifts from grateful patients per office policy
Many professional codes permit accepting small, infrequent gifts that do not create undue obligation, while romantic involvement and review-for-treatment arrangements are clear violations.
Question 4: A surgeon witnesses a colleague performing cosmetic procedures while visibly impaired. What is the ethical obligation?
- Address the colleague privately and take no further action
- Ignore it unless a patient is harmed
- Report the impairment through appropriate hospital or board channels to protect patient safety (Correct answer)
- Cover for the colleague until the end of the shift
Correct answer: Report the impairment through appropriate hospital or board channels to protect patient safety
Physicians have an ethical and in many states legal duty to report impaired colleagues to protect patient safety, even if it is professionally uncomfortable.
Question 5: What does the principle of 'justice' require specifically in a cosmetic surgery practice?
- Ensuring only the most qualified patients receive care
- Distributing the benefits and burdens of care fairly and without discrimination (Correct answer)
- Charging all patients the same fee regardless of procedure complexity
- Giving priority scheduling to patients who pay cash
Correct answer: Distributing the benefits and burdens of care fairly and without discrimination
Justice in medical ethics requires fair, equitable treatment of all patients without discrimination based on race, gender, socioeconomic status, or other protected characteristics.
Question 6: A cosmetic surgeon in the US wants to advertise guaranteed results. Under ABCS and FTC guidelines, this is considered:
- Acceptable if statistical outcomes support the claim
- A violation of truth-in-advertising and professional ethics standards (Correct answer)
- Permissible with a disclaimer
- Required for transparency in direct-to-consumer marketing
Correct answer: A violation of truth-in-advertising and professional ethics standards
Guaranteeing surgical outcomes is both ethically prohibited and violates FTC advertising regulations because individual results are inherently variable.
Question 7: Which ethical principle is most directly invoked when a surgeon tailors the extent of a consultation to a patient's language and health literacy level?
- Non-maleficence
- Fidelity
- Informed consent and respect for autonomy (Correct answer)
- Beneficence through paternalistic decision-making
Correct answer: Informed consent and respect for autonomy
Ensuring patients understand information in accessible language is fundamental to meaningful informed consent and respecting patient autonomy.
ABCS Professional Standards & Ethics 3
A patient with body dysmorphic disorder (BDD) requests rhinoplasty.
What is the most appropriate ethical and clinical response?