FFICM Professional Ethics and Standards 3

Question 1

A Lasting Power of Attorney (LPA) for health and welfare has been registered for an incapacitated ICU patient. What authority does the attorney hold?

Accepted Answer

The attorney can make decisions about life-sustaining treatment only if the LPA explicitly grants this power

Answer

An LPA for health and welfare only extends to life-sustaining treatment decisions if the document explicitly includes this authority.

Question 2

In research involving incapacitated ICU patients, what mechanism most commonly authorises participation when the patient cannot consent?

Accepted Answer

Consultee agreement from a personal or nominated consultee

Answer

Under the Mental Capacity Act 2005, a personal or nominated consultee must be identified to advise on the incapacitated patient's likely wishes regarding research participation.

Question 3

Which of the following best describes 'therapeutic privilege' in the ICU context?

Accepted Answer

Withholding information from a patient when disclosure would cause serious harm to them

Answer

Therapeutic privilege refers to withholding information when the clinician believes disclosure would cause serious psychological harm, though it is controversial and rarely justified.

Question 4

A family requests that a dying patient not be told their prognosis. What is the ethical framework for responding to this request?

Accepted Answer

Assess whether the patient has expressed a wish to know, and generally respect the patient's own preferences

Answer

The patient's own wishes about receiving information take priority; family preferences are considered but cannot override a competent patient's right to know.

Question 5

What is the ethical status of 'double effect' as applied to opioid analgesia in dying ICU patients?

Accepted Answer

It justifies titrating analgesia to relieve symptoms even if there is a foreseeable risk of hastening death, provided intent is symptom relief

Answer

The doctrine of double effect permits actions with two effects — intended good (symptom relief) and foreseen but unintended harm (possible earlier death) — provided the intent is the good effect.

(FFICM) Final Faculty of Intensive Care Medicine Practice Test

(FFICM) Final Faculty of Intensive Care Medicine Practice Test

FFICM Professional Ethics and Standards 3