ABPS Professionalism & Ethical Medical Practice 3 — Questions and Answers
Question 1: A physician is approached by media regarding a celebrity patient's condition. The appropriate response is to:
- Provide general information without identifying the patient
- Decline to comment and refer media to the hospital's public relations office (Correct answer)
- Confirm the patient is under care but provide no details
- Discuss the case only if the celebrity is a public figure
Correct answer: Decline to comment and refer media to the hospital's public relations office
Physician confidentiality extends to all patients regardless of celebrity status; all media inquiries should be redirected to authorized hospital representatives.
Question 2: The principle of 'double effect' in medical ethics most commonly applies to:
- Using treatments that cure disease but cause side effects
- Administering pain medication that may hasten death as a foreseen but unintended consequence (Correct answer)
- Dual diagnosis treatment protocols
- Prescribing two medications for the same condition
Correct answer: Administering pain medication that may hasten death as a foreseen but unintended consequence
The doctrine of double effect permits actions with both good and bad effects when the harmful effect is unintended and the benefit outweighs the harm.
Question 3: A physician realizes they made a medical error that caused patient harm. Ethically, the physician must:
- Document the error in the chart without discussing it with the patient
- Disclose the error honestly to the patient and apologize (Correct answer)
- Consult legal counsel before speaking to the patient
- Correct the error and move forward without disclosure if the patient is stable
Correct answer: Disclose the error honestly to the patient and apologize
Ethical and professional standards require physicians to disclose errors to patients, including an honest explanation and apology.
Question 4: Which statement best defines informed refusal?
- A patient's right to refuse treatment after being fully informed of risks and alternatives (Correct answer)
- A physician's right to refuse treating non-compliant patients
- Refusing treatment due to financial constraints
- Declining to treat patients outside one's specialty
Correct answer: A patient's right to refuse treatment after being fully informed of risks and alternatives
Informed refusal is the corollary to informed consent, where a competent patient declines treatment after being fully informed of the consequences.
Question 5: A surrogate decision-maker disagrees with the medical team about withdrawing life support. The most appropriate next step is:
- Override the surrogate's decision based on medical judgment
- Involve an ethics committee to mediate the conflict (Correct answer)
- Immediately comply with the surrogate's wishes
- Transfer care to another physician
Correct answer: Involve an ethics committee to mediate the conflict
Ethics committee consultation is the appropriate mechanism for resolving conflicts between surrogates and medical teams regarding end-of-life decisions.
Question 6: Professional boundaries in the physician-patient relationship prohibit:
- Treating immediate family members in non-emergencies (Correct answer)
- Discussing a patient's social history
- Providing emotional support to grieving patients
- Referring patients to specialists
Correct answer: Treating immediate family members in non-emergencies
Treating close family members creates boundary issues and conflicts of interest; it is generally prohibited except in emergencies.
Question 7: Which of the following is an example of a physician violating the principle of veracity?
- Withholding a terminal diagnosis to prevent patient distress without consent (Correct answer)
- Providing probabilistic rather than certain prognoses
- Acknowledging uncertainty about a diagnosis
- Referring to a specialist when unsure
Correct answer: Withholding a terminal diagnosis to prevent patient distress without consent
Veracity requires truthfulness; withholding a terminal diagnosis without the patient's prior consent to limit information violates this principle.
ABPS Professionalism & Ethical Medical Practice 3
A physician is approached by media regarding a celebrity patient's condition.
The appropriate response is to: