NZREX Professional Ethics

Question 1

Which of the four pillars of medical ethics refers to the obligation to act in the patient's best interest?

Accepted Answer

Beneficence

Answer

Beneficence refers to the duty to act in the patient's best interest and promote their wellbeing. Non-maleficence is 'do no harm', autonomy respects the patient's right to decide, and justice concerns fair distribution of resources.

Question 2

A junior doctor witnesses a colleague arriving to work smelling of alcohol. What is the most appropriate action?

Accepted Answer

Report the concern to a senior colleague or supervisor immediately to protect patient safety

Answer

Protecting patient safety takes precedence. This situation requires immediate escalation to a senior colleague or supervisor. NZ's Medical Council and MCNZ guidelines on professional obligations require doctors to act on concerns about impaired colleagues.

Question 3

Which of the following best describes 'double effect' in medical ethics?

Accepted Answer

An action intended for a good effect that has a foreseen but unintended harmful effect — morally permissible if the harm is proportionate

Answer

The principle of double effect holds that an action with both good and harmful effects (e.g., high-dose opioids for pain relief that may hasten death) is permissible if: the action is not intrinsically wrong, intent is the good effect, the harm is not the means to the good, and the benefit is proportionate to the harm.

Question 4

A patient discloses in confidence that they intend to seriously harm a specific person. What is the most appropriate action?

Accepted Answer

Warn the identifiable potential victim and notify police, overriding confidentiality due to serious risk of harm

Answer

The 'duty to protect' (Tarasoff principle) applies when there is a credible, serious, imminent threat to an identifiable third party. NZ law and ethics allow (and in some circumstances require) confidentiality to be breached to prevent serious harm.

Question 5

What does the term 'futility' mean in the context of end-of-life medical decision-making?

Accepted Answer

Treatment that provides no physiological benefit or cannot achieve the patient's goals of care

Answer

Medical futility refers to treatment that cannot achieve its intended physiological effect or cannot achieve the patient's goals. Futile treatment need not be offered; however, this decision should be made in consultation with the patient, family, and team.

NZREX Practice Test

NZREX Practice Test

NZREX Professional Ethics