MRCPsych Professional Ethics and Standards 2

Question 1

A psychiatrist discovers that a colleague is regularly seeing patients while impaired by alcohol. What is the FIRST appropriate action?

Accepted Answer

Inform the clinical director or responsible officer

Answer

Report immediately to the General Medical Council

Answer

Discuss concerns directly with the colleague first

Answer

Document concerns and monitor the situation

Question 2

Under the Mental Capacity Act 2005, when assessing decision-making capacity, which principle is paramount?

Accepted Answer

Capacity is presumed present unless evidence indicates otherwise

Answer

Capacity is presumed absent until proven otherwise

Answer

A consultant psychiatrist must always assess capacity

Answer

Past decisions indicate future capacity

Question 3

A patient with schizophrenia discloses that they have been driving regularly despite being told not to by their GP. What is the psychiatrist's ethical obligation?

Accepted Answer

Advise the patient to inform the DVLA and breach confidentiality if they refuse

Answer

Maintain strict confidentiality as the GP has already addressed this

Answer

Immediately report to police without informing the patient

Answer

Document the disclosure but take no further action

Question 4

Which ethical framework best describes the approach of treating patients according to their own values and goals rather than imposing the clinician's values?

Accepted Answer

Autonomy

Answer

Beneficence

Answer

Justice

Answer

Non-maleficence

Question 5

A patient detained under Section 3 of the Mental Health Act refuses electroconvulsive therapy (ECT). Under what circumstance can ECT be given without consent?

Accepted Answer

If the patient lacks capacity and it is immediately necessary to save life or prevent serious deterioration

Answer

If two responsible clinicians agree it is necessary

Answer

Never — ECT requires explicit consent even in detained patients

Answer

If the patient's family consents on their behalf

Question 6

In Tarasoff-style duty-to-warn scenarios in the UK context, what does GMC guidance advise when a patient threatens serious harm to an identifiable person?

Accepted Answer

Disclosure to protect a third party may be justified if the risk is serious and credible

Answer

Confidentiality is absolute and no disclosure is permitted

Answer

The psychiatrist must always report to police regardless of risk assessment

Answer

Only the patient's family should be informed

Question 7

A trainee psychiatrist is asked by a senior colleague to falsify a patient's clinical record to avoid a complaint. The trainee should:

Accepted Answer

Refuse and escalate the request to a clinical supervisor or governance lead

Answer

Comply as the senior colleague takes responsibility

Answer

Seek advice from a medical defence organisation before deciding

Answer

Comply only if the falsification seems minor