MCCQE Ethics and Legal Duties 2

Question 1

A capable adult patient refuses a blood transfusion on religious grounds despite life-threatening hemorrhage. What is the physician's ethical obligation?

Accepted Answer

Respect the refusal and provide alternative management

Answer

Override the refusal to save the patient's life

Answer

Seek emergency court authorization

Answer

Transfer care to another physician immediately

Question 2

Under Canadian law, who is the most appropriate substitute decision-maker for an incapable adult patient with no advance directive?

Accepted Answer

The patient's spouse or partner

Answer

The attending physician

Answer

The provincial public guardian

Answer

The hospital ethics committee

Question 3

A patient discloses that they are HIV-positive and refuses to inform their regular sexual partner. The physician determines the partner is at serious risk. What is the most appropriate next step?

Accepted Answer

Continue counselling the patient and consider public health notification

Answer

Immediately notify the partner without further discussion

Answer

Document and take no action to protect patient confidentiality

Answer

Discharge the patient from care for non-compliance

Question 4

Which doctrine requires physicians to disclose information that a reasonable patient in the same circumstances would want to know before consenting to treatment?

Accepted Answer

Modified objective standard

Answer

Therapeutic privilege

Answer

Professional practice standard

Answer

Subjective patient standard

Question 5

A 15-year-old presents alone requesting contraception and demonstrates clear understanding of the treatment. Under the mature minor doctrine, what should the physician do?

Accepted Answer

Provide treatment after assessing capacity

Answer

Refuse treatment without parental consent

Answer

Notify parents before any treatment

Answer

Refer to a specialist only

Question 6

A surgeon discovers an unexpected finding during an operation that was not discussed preoperatively. The finding poses no immediate threat. What is the correct action?

Accepted Answer

Complete the consented procedure and discuss the finding postoperatively

Answer

Treat the finding immediately while the patient is already under anaesthesia

Answer

Wake the patient to obtain consent

Answer

Contact the next-of-kin for consent

Question 7

A physician learns that a colleague is practicing while impaired by alcohol. What is the primary professional obligation?

Accepted Answer

Report to the regulatory college or appropriate authority

Answer

Confront the colleague privately and take no further action if they deny it

Answer

Inform the hospital administrator only

Answer

Document observations and wait for a formal complaint