NAC OSCE Medical Ethics & Professionalism 2

Question 1

A physician learns that a colleague is practising while impaired by alcohol. According to the CMA Code of Ethics and provincial college obligations, what is the MOST appropriate action?

Accepted Answer

Report concerns to the provincial regulatory college (e.g., CPSO) and offer support to the colleague through physician health programs

Answer

CMA ethics and provincial college regulations require physicians to report a colleague whose impairment poses a risk to patients; physician health programs provide confidential support, but patient safety must be prioritised.

Question 2

A patient lacks decision-making capacity and has no advance directive. Who is the appropriate substitute decision maker (SDM) under Ontario's Health Care Consent Act?

Accepted Answer

The highest-ranked capable person in the hierarchy: spouse/partner > adult child > parent > sibling > other relative > OPGT

Answer

Ontario's Health Care Consent Act specifies a legal hierarchy for SDMs; the spouse/partner ranks first, followed by adult children, parents, siblings, and then the Office of the Public Guardian and Trustee (OPGT).

Question 3

A physician provides care to a remote First Nations community in Northern Ontario. Which principle from the TRC Calls to Action should guide their practice?

Accepted Answer

Acknowledging and integrating culturally safe, trauma-informed care that recognises the impacts of residential schools and colonisation

Answer

The TRC Calls to Action (particularly #23-24) call on health professionals to integrate Indigenous health knowledge and provide culturally safe care that acknowledges the intergenerational trauma of residential schools.

Question 4

A pharmaceutical representative offers a physician tickets to a major sporting event. According to the CMA Code of Ethics and provincial college policies, what is the MOST appropriate response?

Accepted Answer

Decline the gift — gifts from industry that could influence prescribing decisions are prohibited

Answer

CMA Code of Ethics and CPSO policies prohibit physicians from accepting gifts from industry that could influence clinical decisions or create a perception of bias, regardless of monetary value.

Question 5

A patient with a serious psychiatric illness lacks capacity to consent to treatment. The patient previously expressed in a capable state that they would not want antipsychotic medications. What should guide the SDM's decision?

Accepted Answer

The patient's prior capable wishes (prior capable wish) take precedence over best interests

Answer

Ontario's Health Care Consent Act and Canadian ethics principles hold that prior capable wishes expressed by the patient when capable must be followed by the SDM, even if they conflict with current best interests.

NAC OSCE Practice Test

NAC OSCE Practice Test

NAC OSCE Medical Ethics & Professionalism 2