FANZCA Professional Standards and Ethics 2 — Questions and Answers
Question 1: A consultant anaesthetist discovers a colleague is performing procedures while impaired by alcohol. What is the FIRST appropriate action?
- Report directly to the hospital CEO
- Confront the colleague privately and document the incident
- Contact the Medical Board of Australia immediately
- Notify the department head or clinical lead as per hospital policy (Correct answer)
Correct answer: Notify the department head or clinical lead as per hospital policy
The first step is to follow institutional reporting pathways by notifying the department head, while ensuring patient safety is maintained.
Question 2: Under the ANZCA Code of Professional Conduct, what principle governs the duty to disclose a near-miss event to a patient?
- Beneficence — acting in the patient's best interest
- Open disclosure — honesty and transparency with patients (Correct answer)
- Non-maleficence — avoiding further harm through disclosure
- Justice — equitable treatment of all patients
Correct answer: Open disclosure — honesty and transparency with patients
Open disclosure is the specific ANZCA and Australian Commission on Safety and Quality in Health Care framework requiring honest communication of adverse events with patients.
Question 3: A patient who lacks decision-making capacity requires emergency surgery. No next of kin is reachable. The anaesthetist should:
- Refuse to proceed until a guardian is identified
- Obtain consent from the most senior nurse on shift
- Proceed on the basis of necessity and best interests, documenting reasoning (Correct answer)
- Apply to a court for emergency guardianship before proceeding
Correct answer: Proceed on the basis of necessity and best interests, documenting reasoning
In a genuine emergency where delay would cause serious harm, clinicians may act on the principle of necessity in the patient's best interests without formal consent.
Question 4: Which of the following best describes the concept of 'therapeutic privilege' in the context of informed consent?
- The right of a physician to withhold information if disclosure would harm the patient (Correct answer)
- A patient's right to waive detailed information about their procedure
- The anaesthetist's discretion to choose which technique to use
- Permission to administer sedation without consent during emergencies
Correct answer: The right of a physician to withhold information if disclosure would harm the patient
Therapeutic privilege is the controversial doctrine that allows withholding information if disclosure itself would cause significant psychological harm, though it is rarely accepted in modern Australian law.
Question 5: A trainee anaesthetist is asked by a supervisor to falsify a logbook entry. The trainee should:
- Comply to avoid conflict with the supervisor
- Refuse and report the request to the training committee or ANZCA (Correct answer)
- Discuss it with colleagues before deciding
- Complete the entry as requested but note the discrepancy privately
Correct answer: Refuse and report the request to the training committee or ANZCA
Falsifying training records is a serious breach of professional integrity; the trainee must refuse and escalate through appropriate channels such as the college or training committee.
Question 6: Regarding social media use, ANZCA's professional standards require Fellows to:
- Avoid all social media platforms to prevent ethical conflicts
- Ensure patient privacy is maintained and professional conduct upheld in all online activity (Correct answer)
- Obtain written consent before posting any clinical opinion online
- Use only ANZCA-approved platforms for professional communication
Correct answer: Ensure patient privacy is maintained and professional conduct upheld in all online activity
ANZCA guidance states that professionals must maintain patient confidentiality and uphold the profession's reputation in all online and social media activity.
Question 7: A patient revokes consent for a regional block after induction of general anaesthesia. The most appropriate response is:
- Proceed with the block as it is in the patient's best interests
- Defer the block and reassess consent when the patient regains capacity
- Document the refusal and omit the block from the anaesthetic plan (Correct answer)
- Seek consent from the patient's next of kin to proceed
Correct answer: Document the refusal and omit the block from the anaesthetic plan
A competent patient's earlier refusal of a specific component must be respected; the block should not be performed without valid consent, and the clinical plan adjusted accordingly.
FANZCA Professional Standards and Ethics 2
A consultant anaesthetist discovers a colleague is performing procedures while impaired by alcohol.
What is the FIRST appropriate action?