GAMSAT Professional Ethics and Standards 2 — Questions and Answers
Question 1: A patient with terminal cancer asks their physician not to disclose the diagnosis to family members. The physician believes the family needs to know to arrange end-of-life care. What is the ethically correct approach?
- Disclose to family immediately for their benefit
- Honor the patient's request and maintain confidentiality (Correct answer)
- Consult the ethics committee and override the patient's wishes
- Inform only the next of kin as a compromise
Correct answer: Honor the patient's request and maintain confidentiality
Patient autonomy and confidentiality require the physician to respect the patient's explicit directive not to disclose, unless disclosure is legally mandated.
Question 2: In research ethics, what is the primary purpose of a Data Safety Monitoring Board (DSMB)?
- To manage the financial budget of a clinical trial
- To independently review accumulating trial data and recommend stopping if harm or clear benefit emerges (Correct answer)
- To recruit participants and obtain informed consent
- To publish interim results for public transparency
Correct answer: To independently review accumulating trial data and recommend stopping if harm or clear benefit emerges
A DSMB monitors ongoing trial data to protect participant safety and trial integrity by recommending early termination if warranted.
Question 3: A medical student witnesses a resident falsifying a patient's medication records to cover an error. The student's primary ethical obligation is to:
- Confront the resident privately to avoid escalating the issue
- Report the falsification through appropriate institutional channels (Correct answer)
- Document the incident privately and wait for future evidence
- Ignore it as hierarchy dictates deference to senior clinicians
Correct answer: Report the falsification through appropriate institutional channels
Patient safety and professional integrity require reporting falsified records through formal channels regardless of hierarchy.
Question 4: The principle of 'double effect' in medical ethics justifies which of the following?
- Administering a drug that relieves pain but may hasten death, when palliation is the intent (Correct answer)
- Withdrawing life support to accelerate death for organ donation
- Prescribing experimental drugs without informed consent in emergencies
- Disclosing confidential information to prevent minor social harm
Correct answer: Administering a drug that relieves pain but may hasten death, when palliation is the intent
Double effect permits an action with a foreseeable harmful side effect when the primary intent is beneficial and the harm is not the means to the good.
Question 5: A pharmaceutical company funds a researcher's study and offers authorship on the resulting paper. The researcher had minimal involvement. Publishing under these conditions constitutes:
- Collaborative authorship, which is ethically permissible
- Ghost authorship, a form of research misconduct (Correct answer)
- Gift authorship only if disclosed in the conflict of interest statement
- Honorary authorship, acceptable when properly acknowledged
Correct answer: Ghost authorship, a form of research misconduct
Ghost authorship involves a contributor being unlisted or a non-contributor being listed, both of which misrepresent accountability and constitute research misconduct.
Question 6: When a physician has a personal moral objection to performing a legally available procedure, the minimum ethical obligation is to:
- Refuse the procedure without any further responsibility
- Inform the patient and provide timely referral to a willing provider (Correct answer)
- Perform the procedure despite moral objection to avoid abandonment
- Seek a court order before refusing to perform the procedure
Correct answer: Inform the patient and provide timely referral to a willing provider
Conscientious objection is ethically permissible provided the physician discloses the objection and facilitates access to care through referral.
Question 7: The Tuskegee Syphilis Study is historically significant to research ethics primarily because it demonstrated the consequences of:
- Inadequate sample sizes in longitudinal studies
- Deliberate withholding of treatment and deception of vulnerable research subjects (Correct answer)
- Lack of funding transparency in government-sponsored research
- Insufficient peer review before study commencement
Correct answer: Deliberate withholding of treatment and deception of vulnerable research subjects
The Tuskegee study withheld penicillin from Black men with syphilis without their knowledge, leading to the Belmont Report and foundational research ethics protections.
GAMSAT Professional Ethics and Standards 2
A patient with terminal cancer asks their physician not to disclose the diagnosis to family members.
The physician believes the family needs to know to arrange end-of-life care.
What is the ethically correct approach?