FRACGP Professional Standards and Ethics 3 — Questions and Answers
Question 1: A GP treating an adult patient with severe depression learns that the patient has written a will excluding their family. The family requests this information. What should the GP do?
- Disclose to the family to protect their interests
- Maintain confidentiality; the patient's legal decisions are not a clinical disclosure matter (Correct answer)
- Notify the Public Guardian immediately
- Inform the family only if the patient has capacity concerns
Correct answer: Maintain confidentiality; the patient's legal decisions are not a clinical disclosure matter
A competent adult's legal decisions, including will-making, are confidential and not subject to third-party disclosure by the GP.
Question 2: Which principle underpins the concept of 'informed consent' as required by the RACGP?
- Beneficence only
- Respect for patient autonomy, including disclosure of material risks (Correct answer)
- Non-maleficence and justice equally weighted
- Paternalism tempered by clinical judgment
Correct answer: Respect for patient autonomy, including disclosure of material risks
Informed consent is grounded in respect for autonomy, requiring disclosure of risks that a reasonable patient would consider material to their decision.
Question 3: A GP is approached by a pharmaceutical company offering a fully-funded overseas conference trip in exchange for prescribing their product. The most appropriate response is to:
- Accept if the conference is genuinely educational
- Decline, as this represents an unacceptable conflict of interest (Correct answer)
- Accept and disclose to patients that you attended a sponsored event
- Seek Medical Board approval before accepting
Correct answer: Decline, as this represents an unacceptable conflict of interest
Accepting benefits contingent on prescribing behaviour constitutes an unacceptable conflict of interest under RACGP and Medicines Australia codes.
Question 4: When documenting a clinical encounter, a GP realises they made an error in a previous note. What is the correct approach?
- Delete the incorrect entry and retype it correctly
- Draw a single line through the error, add the correction with date and signature, leaving the original legible (Correct answer)
- White out the error and write the correct information
- Leave the error and add a separate file note
Correct answer: Draw a single line through the error, add the correction with date and signature, leaving the original legible
Correct medical record amendment requires the original entry to remain legible with a dated, signed correction added alongside.
Question 5: A 15-year-old presents alone requesting contraception. The GP assesses that the patient understands the implications. Under the Gillick competence framework, the GP should:
- Refuse to treat without parental consent
- Provide the service respecting the patient's confidentiality if competence is established (Correct answer)
- Notify parents as a mandatory legal requirement
- Refer to a specialist as GPs cannot treat minors independently
Correct answer: Provide the service respecting the patient's confidentiality if competence is established
A Gillick-competent minor can consent to and receive confidential medical treatment including contraception without parental involvement.
Question 6: A GP working in a rural area is the only provider for hundreds of kilometres. A patient requests termination of pregnancy services, which conflicts with the GP's beliefs. What is the best course of action?
- Refuse and advise the patient to travel
- Provide the service as an exception to conscientious objection given the access context
- Facilitate a telehealth referral and ensure the patient can access services remotely (Correct answer)
- Report the situation to AHPRA for guidance before acting
Correct answer: Facilitate a telehealth referral and ensure the patient can access services remotely
When geographic isolation limits access, the GP has an enhanced duty to actively facilitate access via referral or telehealth to avoid abandonment.
Question 7: A GP becomes aware that a colleague is practising while under the influence of alcohol during working hours. The most appropriate initial step is to:
- Report directly to AHPRA without speaking to the colleague
- Approach the colleague directly or through the practice principal, and encourage them to seek help (Correct answer)
- Ignore it unless a patient complaint is made
- Inform the next patient scheduled to see the colleague
Correct answer: Approach the colleague directly or through the practice principal, and encourage them to seek help
Initial peer intervention is appropriate; escalation to mandatory reporting follows if the practitioner does not modify their practice and risk to patients persists.
FRACGP Professional Standards and Ethics 3
A GP treating an adult patient with severe depression learns that the patient has written a will excluding their family.
The family requests this information.
What should the GP do?