ABPS Professionalism & Ethical Medical Practice 5 — Questions and Answers
Question 1: A competent terminally ill patient requests physician-assisted death in a state where it is legal. The physician's ethical obligations include:
- Refusing because it conflicts with the duty to do no harm
- Complying automatically with all patient requests
- Discussing all options including palliative care, and deciding based on personal ethics and law (Correct answer)
- Reporting the patient to the ethics committee
Correct answer: Discussing all options including palliative care, and deciding based on personal ethics and law
In jurisdictions where legal, physicians must explore all options with the patient but may decline participation based on personal ethics, as long as referral is provided.
Question 2: Which of the following behaviors violates professional boundaries in the physician-patient relationship?
- Discussing a patient's fears about surgery
- Accepting a small token of thanks from a grateful patient
- Beginning a romantic relationship with a current patient (Correct answer)
- Providing home phone number in a rural area for after-hours calls
Correct answer: Beginning a romantic relationship with a current patient
Romantic or sexual relationships with current patients are unequivocally prohibited due to the inherent power imbalance in the physician-patient relationship.
Question 3: Which approach to allocating scarce medical resources (e.g., ventilators during a pandemic) is most ethically defensible?
- First-come, first-served basis
- Prioritizing patients most likely to benefit based on transparent criteria (Correct answer)
- Giving priority to healthcare workers over other patients
- Allocating resources based on social worth
Correct answer: Prioritizing patients most likely to benefit based on transparent criteria
Evidence-based triage protocols using transparent, clinically relevant criteria maximize benefit and are the most defensible ethical framework for resource allocation.
Question 4: A physician notices a pattern of unnecessary procedures being performed by a colleague for financial gain. The appropriate action is:
- Ignore the pattern unless a specific patient complains
- Document observations and report to the appropriate oversight body (Correct answer)
- Confront the colleague publicly at a department meeting
- Alert the patients being treated by that colleague directly
Correct answer: Document observations and report to the appropriate oversight body
Physicians have a duty to report colleagues who engage in fraud or unnecessary procedures through proper institutional or regulatory channels.
Question 5: The ethical concept of 'futility' in medicine refers to:
- Treatment that is too expensive to be cost-effective
- Interventions that are unlikely to achieve the patient's goals or provide meaningful benefit (Correct answer)
- Treatments not covered by insurance
- Procedures outside a physician's scope of practice
Correct answer: Interventions that are unlikely to achieve the patient's goals or provide meaningful benefit
Medical futility refers to interventions that cannot achieve the patient's goals or provide clinically meaningful benefit, not merely financial considerations.
Question 6: A physician working in a correctional facility is asked by authorities to evaluate whether an inmate is fit to be executed. The most appropriate ethical response is:
- Complete the evaluation as part of their employment duties
- Refuse, as participation violates core medical ethics prohibiting physician involvement in executions (Correct answer)
- Perform the evaluation but advocate against the execution
- Delegate the evaluation to a non-physician staff member
Correct answer: Refuse, as participation violates core medical ethics prohibiting physician involvement in executions
Medical organizations including the AMA prohibit physician participation in executions, as it fundamentally conflicts with the duty to heal and do no harm.
Question 7: When obtaining informed consent from a patient with limited English proficiency, the physician should:
- Use a family member to translate if a professional interpreter is unavailable
- Proceed with consent if the patient nods affirmatively
- Use a qualified medical interpreter and avoid using family members (Correct answer)
- Document that consent could not be obtained
Correct answer: Use a qualified medical interpreter and avoid using family members
Qualified medical interpreters should be used to ensure accurate communication; family members may introduce bias, errors, or confidentiality breaches.
ABPS Professionalism & Ethical Medical Practice 5
A competent terminally ill patient requests physician-assisted death in a state where it is legal.
The physician's ethical obligations include: