ECFMG Professionalism & Ethics 4

Question 1

A physician caring for a VIP patient is pressured by hospital administrators to expedite discharge prematurely to free a suite. The physician's ethical obligation is to:

Accepted Answer

Discharge based on clinical readiness, not administrative or social pressure

Answer

Comply to maintain hospital relationships and patient satisfaction scores

Answer

Consult the ethics committee before making any discharge decision

Answer

Transfer the patient to another service to avoid the conflict

Question 2

A physician who personally opposes abortion on moral grounds is asked to provide pregnancy termination services. Which option best balances the physician's conscience with professional obligations?

Accepted Answer

Decline to perform the procedure but provide timely referral to a willing provider

Answer

Refuse without explanation and refer to a specialist

Answer

Perform the procedure despite personal objections to avoid abandonment

Answer

Ask the hospital ethics board to make the decision for the patient

Question 3

During a research study, an enrolled participant develops a serious adverse event possibly related to the intervention. The principal investigator must first:

Accepted Answer

Report the event to the IRB and sponsor according to protocol-defined timelines

Answer

Complete the study and then report the event in the final publication

Answer

Inform only the participant's family and continue the study

Answer

Withdraw the participant and destroy their data to protect confidentiality

Question 4

A physician is asked by a defense attorney to provide expert testimony exaggerating the plaintiff's injuries for compensation. Providing such testimony would violate:

Accepted Answer

Medical ethics and potentially constitute perjury

Answer

Procedural justice only, since expert opinions are protected speech

Answer

Hospital bylaws but not broader ethical codes

Answer

No rule as long as the physician is paid as a consultant

Question 5

An intern is unsure about a medication dose but is afraid to ask the attending at 3 AM. She administers what she believes is correct and a patient error occurs. This scenario best illustrates the risk of:

Accepted Answer

Hierarchy-induced communication failure

Answer

Scope of practice violation

Answer

Negligent credentialing by the hospital

Answer

Autonomous clinical decision-making

Question 6

A patient signs an advance directive designating a healthcare proxy but later develops capacity and verbally contradicts the directive. Which statement is correct?

Accepted Answer

The patient's current verbal wishes take precedence when they have decision-making capacity

Answer

The advance directive always takes legal precedence over verbal statements

Answer

The healthcare proxy's decisions take precedence since they were legally designated

Answer

The physician must defer to both and cannot proceed until they agree

Question 7

Which of the following is the best example of the ethical principle of justice in clinical practice?

Accepted Answer

Distributing scarce ventilators using objective, clinically-based triage criteria

Answer

Ordering every available diagnostic test for a patient who can pay out-of-pocket

Answer

Allocating scarce ICU beds based on ability to pay

Answer

Providing additional services to patients who are kind to the healthcare team