ABFM Professional Standards and Ethics 2 — Questions and Answers
Question 1: A patient with terminal cancer asks their family physician not to disclose the diagnosis to family members. The physician should:
- Inform the family anyway to ensure proper care planning
- Respect the patient's wishes and maintain confidentiality (Correct answer)
- Refer the patient to a specialist to avoid the ethical conflict
- Document the request but share the diagnosis with immediate family
Correct answer: Respect the patient's wishes and maintain confidentiality
Competent adult patients have the right to control their medical information, including deciding who receives their diagnosis.
Question 2: Which of the following best describes the ethical principle of 'justice' in medical practice?
- Providing the highest quality care to every patient regardless of cost
- Ensuring fair distribution of healthcare resources and equal treatment (Correct answer)
- Always acting in the patient's best interest above all other considerations
- Telling patients the truth about their diagnosis and prognosis
Correct answer: Ensuring fair distribution of healthcare resources and equal treatment
Justice in medicine refers to fair and equitable distribution of benefits, risks, and healthcare resources across patient populations.
Question 3: A physician discovers that a colleague is impaired by alcohol during call coverage. The most appropriate first step is to:
- Ignore the situation to avoid damaging a colleague's career
- Confront the colleague privately and document the incident
- Immediately remove the colleague from patient care and report to administration (Correct answer)
- Notify patients who were treated by the impaired physician
Correct answer: Immediately remove the colleague from patient care and report to administration
Patient safety takes priority; the impaired physician must be removed from care immediately and reported through appropriate channels.
Question 4: When obtaining informed consent, which element is most critical to document?
- The patient's signature on a standard consent form
- That the patient was offered the option to ask questions
- The patient's demonstrated understanding of risks, benefits, and alternatives (Correct answer)
- The date and time consent was obtained
Correct answer: The patient's demonstrated understanding of risks, benefits, and alternatives
True informed consent requires documentation that the patient understood the material information, not merely that they signed a form.
Question 5: A 16-year-old presents requesting contraception without parental knowledge. Under most US state laws, the physician should:
- Refuse to prescribe without parental consent
- Notify parents as required by HIPAA
- Provide contraception as minors typically have the right to confidential reproductive care (Correct answer)
- Require the patient to obtain a court order for confidential treatment
Correct answer: Provide contraception as minors typically have the right to confidential reproductive care
Most states grant minors the right to confidential reproductive health services, including contraception, without parental consent.
Question 6: A pharmaceutical company offers a physician a paid speaking engagement worth $5,000 to promote their new medication. The most ethical response is to:
- Accept as long as the information presented is accurate
- Decline if the payment exceeds a $100 threshold
- Carefully evaluate whether the arrangement could influence prescribing and disclose it to patients (Correct answer)
- Accept only if the medication is already on the formulary
Correct answer: Carefully evaluate whether the arrangement could influence prescribing and disclose it to patients
Physicians must evaluate conflicts of interest critically and disclose financial relationships that could influence clinical judgment.
Question 7: Which statement best reflects the concept of 'therapeutic privilege' in medical ethics?
- A physician's right to refuse treatment they find morally objectionable
- Withholding information from a patient if disclosure would cause serious psychological harm (Correct answer)
- The privilege to prescribe controlled substances without DEA oversight in emergencies
- A physician's authority to override a patient's refusal of life-saving treatment
Correct answer: Withholding information from a patient if disclosure would cause serious psychological harm
Therapeutic privilege is the controversial concept of withholding information when the physician believes disclosure would harm the patient, though it is now largely rejected.
ABFM Professional Standards and Ethics 2
A patient with terminal cancer asks their family physician not to disclose the diagnosis to family members.
The physician should: