OSCE Professional Ethics and Standards 3 — Questions and Answers
Question 1: A patient discloses active suicidal ideation with a specific plan. Which ethical obligation overrides strict confidentiality in this scenario?
- Beneficence toward future patients
- Duty to warn and protect the patient from imminent harm (Correct answer)
- Respect for community autonomy
- Justice in resource allocation
Correct answer: Duty to warn and protect the patient from imminent harm
Imminent risk of self-harm creates a duty to protect that overrides the standard obligation of confidentiality.
Question 2: The principle of justice in healthcare ethics primarily concerns:
- Honesty between clinician and patient
- Fair distribution of healthcare resources and equal treatment (Correct answer)
- Preventing physical harm
- Respecting patient decisions
Correct answer: Fair distribution of healthcare resources and equal treatment
Justice requires equitable allocation of resources and non-discriminatory treatment of all patients.
Question 3: A patient asks for their medical record to be altered to remove a prior psychiatric diagnosis before applying for life insurance. The clinician should:
- Alter the record as a courtesy
- Explain that medical records cannot be falsified and offer to add a patient statement instead (Correct answer)
- Delete the record entirely
- Transfer care to avoid the situation
Correct answer: Explain that medical records cannot be falsified and offer to add a patient statement instead
Altering records to deceive third parties is fraud; clinicians can offer a formal patient statement addendum as a legal alternative.
Question 4: In an OSCE communication station, maintaining appropriate professional boundaries with a patient means:
- Sharing personal social media contacts to build rapport
- Keeping the relationship focused on the patient's clinical needs (Correct answer)
- Accepting gifts of significant monetary value
- Developing personal friendships outside the clinical setting
Correct answer: Keeping the relationship focused on the patient's clinical needs
Professional boundaries ensure the therapeutic relationship remains focused on the patient's wellbeing and avoid exploitation.
Question 5: Which of the following best describes a conflict of interest in clinical practice?
- A clinician disagreeing with a consultant's opinion
- A personal financial interest that could improperly influence clinical decision-making (Correct answer)
- Two physicians managing the same patient
- A patient refusing recommended treatment
Correct answer: A personal financial interest that could improperly influence clinical decision-making
A conflict of interest exists when a secondary interest—such as financial gain—could compromise a clinician's primary duty to the patient.
Question 6: A competent elderly patient with terminal cancer declines further chemotherapy. The clinical team should:
- Override the decision because the patient is elderly
- Respect the refusal, ensure the patient is fully informed, and transition to comfort-focused care (Correct answer)
- Seek a court order to compel treatment
- Convince the family to persuade the patient
Correct answer: Respect the refusal, ensure the patient is fully informed, and transition to comfort-focused care
A competent patient's informed refusal of treatment must be respected regardless of the clinician's personal views.
Question 7: The duty of non-maleficence requires a clinician to:
- Always pursue aggressive treatment
- Avoid actions that cause unnecessary harm to the patient (Correct answer)
- Disclose all potential treatments regardless of risk
- Prioritize institutional profits
Correct answer: Avoid actions that cause unnecessary harm to the patient
Non-maleficence is the obligation to refrain from actions that cause harm, including excessive or futile interventions.
OSCE Professional Ethics and Standards 3
A patient discloses active suicidal ideation with a specific plan.
Which ethical obligation overrides strict confidentiality in this scenario?