NZREX Professional Ethics 2 β Questions and Answers
Question 1: A doctor is asked by a pharmaceutical company to speak at a conference and will receive a payment. What is the most ethical approach?
- Disclose the conflict of interest to the audience and ensure the content is evidence-based and independent (Correct answer)
- Accept without disclosure as it is a common practice
- Decline all such invitations automatically
- Ask a junior colleague to present instead
Correct answer: Disclose the conflict of interest to the audience and ensure the content is evidence-based and independent
Conflicts of interest (COI) in medicine must be disclosed transparently. Receiving payment from industry creates a potential COI that can bias clinical recommendations. Disclosure does not eliminate bias but allows the audience to judge the information critically.
Question 2: Which of the following best describes the duty of candour for doctors in New Zealand?
- An obligation to be open and honest with patients when something goes wrong and they are harmed (Correct answer)
- Routinely disclosing all clinical decisions to patients' families
- Reporting all adverse events to the media
- Documenting all errors internally without patient notification
Correct answer: An obligation to be open and honest with patients when something goes wrong and they are harmed
The duty of candour requires healthcare providers to proactively tell patients when they have been harmed by their care, apologise, and explain what happened. In NZ, this is supported by the Health and Disability Commissioner Act and HDC Code.
Question 3: A medical student is asked by a consultant to perform an intimate examination on an anaesthetised patient purely for teaching purposes without the patient's prior consent. What should the student do?
- Decline and raise the concern with a senior or the medical school β this is unethical without consent (Correct answer)
- Perform the examination as the consultant has authority
- Perform the examination but document it did not occur
- Ask another student to perform it instead
Correct answer: Decline and raise the concern with a senior or the medical school β this is unethical without consent
Performing intimate examinations on anaesthetised patients without prior consent is unethical and potentially unlawful, regardless of seniority or teaching value. Students must feel empowered to decline and escalate such requests.
Question 4: What is the appropriate management when a competent patient refuses a recommended treatment?
- Document the discussion and refusal thoroughly, ensure the patient understands the consequences, and respect the decision (Correct answer)
- Override the refusal if you believe the treatment is in the patient's best interest
- Seek a guardianship order
- Discontinue care entirely
Correct answer: Document the discussion and refusal thoroughly, ensure the patient understands the consequences, and respect the decision
A competent patient's refusal of treatment is legally and ethically binding in NZ. The doctor's obligations are: ensure decision-making capacity, provide clear information about consequences, document thoroughly, and continue providing care within the patient's wishes.
Question 5: Under the NZ Crimes Act, which of the following could constitute criminal conduct by a doctor?
- Performing a procedure on a patient without consent (assault) or negligently causing serious harm (Correct answer)
- Reporting a mandatory notifiable disease without patient consent
- Sharing records within the treating team on a need-to-know basis
- Providing a second opinion at the patient's request
Correct answer: Performing a procedure on a patient without consent (assault) or negligently causing serious harm
Operating on a patient without valid consent may constitute assault under the Crimes Act 1961. Gross negligence causing death or serious harm may constitute a criminal offence. Professional and civil accountability also applies through the HDC and Medical Council.
Question 6: A patient presents with a gunshot wound. The patient asks you not to report it to police. What is the correct action in NZ?
- You are not legally required to report gunshot wounds to police in NZ β clinical care and patient confidentiality guide the approach, though police may be informed in public interest situations (Correct answer)
- Always report all gunshot wounds to police immediately by law
- Never share any information with police under any circumstances
- Report only if the patient consents
Correct answer: You are not legally required to report gunshot wounds to police in NZ β clinical care and patient confidentiality guide the approach, though police may be informed in public interest situations
Unlike some jurisdictions, NZ has no mandatory legal requirement to report gunshot wounds to police. Clinicians must balance confidentiality with public interest. If there is ongoing risk to the public, disclosure may be justified. Clinical care is the priority.
NZREX Professional Ethics 2
A doctor is asked by a pharmaceutical company to speak at a conference and will receive a payment.
What is the most ethical approach?