PLAB 2 Ethics and Consent 2

Question 1

A junior doctor makes a prescribing error that causes harm to a patient. According to GMC Duty of Candour, what must happen?

Accepted Answer

The patient must be told honestly about the error, given an apology, and offered a remedy. The incident must be reported through the organisation's incident reporting system

Answer

The error should be hidden to avoid litigation

Answer

The error should only be disclosed if the patient specifically asks

Answer

The junior doctor should handle it alone without informing seniors

Question 2

A patient in A&E is unconscious after a road traffic collision and requires emergency surgery. There is no time to obtain consent and no family is contactable. What is the legal basis for proceeding with treatment?

Accepted Answer

Treatment can proceed under the doctrine of necessity and the Mental Capacity Act 2005 Section 5 — emergency treatment in the patient's best interests when they lack capacity and there is no time to consult

Answer

Treatment cannot proceed without consent under any circumstances

Answer

A court order must be obtained first

Answer

Two doctors must agree before treatment can proceed

Question 3

A competent adult patient with terminal cancer has decided to stop all active treatment. They understand the consequences. Their family disagrees and asks you to continue treatment. What should you do?

Accepted Answer

Respect the patient's autonomous decision — a competent adult has the right to refuse treatment even if it leads to death. Support the family with information and emotional care, but do not override the patient's wishes

Answer

Follow the family's wishes as they know the patient best

Answer

Seek a court order to continue treatment

Answer

Secretly continue treatment without the patient's knowledge

Question 4

You are a foundation year doctor and witness a senior colleague performing a procedure without proper consent. According to GMC guidance, what should you do?

Accepted Answer

Raise the concern — GMC guidance states that all doctors have a duty to raise concerns about patient safety regardless of the seniority of the person involved, through appropriate channels

Answer

Do nothing as they are more senior than you

Answer

Discuss it only with your peers

Answer

Wait to see if it happens again before acting

Question 5

A Lasting Power of Attorney (LPA) for Health and Welfare is activated. When does this LPA take effect?

Accepted Answer

Only when the person (donor) loses capacity to make the specific decision in question

Answer

Immediately upon registration, even if the person has capacity

Answer

When the attorney decides it should take effect

Answer

When the person is admitted to hospital

Question 6

A researcher approaches you about recruiting your patients for a clinical trial. What ethical principles must be followed according to the Declaration of Helsinki and UK research governance?

Accepted Answer

Voluntary informed consent is essential, participants must understand the risks and benefits, they can withdraw at any time, the research must have ethical approval (REC), and patient welfare must always take precedence over the interests of science

Answer

Patients can be enrolled without their knowledge for the greater good

Answer

Only written consent from the hospital is needed, not from patients

Answer

Research ethics approval is optional for observational studies