MRCPsych Clinical Practice & Ethical Standards 2

Question 1

A psychiatrist is treating a patient with schizophrenia who refuses depot antipsychotic medication. The patient has capacity. What is the most appropriate action?

Accepted Answer

Respect the refusal and explore reasons, offering alternative formulations

Answer

A capacitous patient has the right to refuse treatment; the clinician should explore barriers and offer alternatives rather than overriding consent.

Question 2

During a ward round, a trainee psychiatrist notices their consultant is consistently documenting assessments without examining patients. What should the trainee do first?

Accepted Answer

Raise concerns with the consultant directly or through local clinical governance channels

Answer

The GMC's Good Medical Practice requires raising concerns through local processes first before escalating to regulatory bodies.

Question 3

A patient on a Section 3 of the Mental Health Act 1983 requests access to their medical records. What applies?

Accepted Answer

They retain rights under the Data Protection Act 2018 subject to limited exemptions

Answer

Detention under the MHA does not remove a patient's data rights; records can be withheld only where disclosure would cause serious harm.

Question 4

A forensic psychiatrist is asked by a solicitor for a report on a defendant's fitness to plead. Which legal test applies in England and Wales?

Accepted Answer

The Pritchard criteria

Answer

The Pritchard criteria (1836) assess whether a defendant can understand the charge, distinguish a plea, follow court proceedings, instruct counsel, and challenge jurors.

Question 5

A 16-year-old presents requesting contraception and discloses she is in a relationship with a 25-year-old. She has capacity and asks for confidentiality. What must the clinician prioritise?

Accepted Answer

Assess safeguarding risk given the significant age gap and potential grooming

Answer

A significant age gap raises safeguarding concerns that override standard confidentiality; a structured risk assessment and referral to safeguarding should occur.

(MRCPsych) Member of the Royal College of Psychiatrists Practice Test

(MRCPsych) Member of the Royal College of Psychiatrists Practice Test

MRCPsych Clinical Practice & Ethical Standards 2