PLAB Ethics & Communication — Questions and Answers
Question 1: What are the four pillars of medical ethics?
- Autonomy, beneficence, non-maleficence, and justice (Correct answer)
- Honesty, charity, loyalty, and efficiency
- Consent, confidentiality, competence, and care
- Privacy, dignity, safety, and transparency
Correct answer: Autonomy, beneficence, non-maleficence, and justice
The four pillars of medical ethics — autonomy (patient choice), beneficence (doing good), non-maleficence (do no harm), and justice (fairness) — guide all medical decision-making.
Question 2: When can patient confidentiality be legally breached in the United States?
- When required by law, such as reporting certain communicable diseases or suspected child abuse (Correct answer)
- Whenever a family member requests medical information
- When the physician feels the family should know
- Patient confidentiality can never be breached under any circumstance
Correct answer: When required by law, such as reporting certain communicable diseases or suspected child abuse
Patient confidentiality may be legally breached when required by law (mandatory disease reporting, suspected child/elder abuse), when there is a serious risk to others, or with valid court orders.
Question 3: What is informed consent?
- A process where patients receive adequate information to make voluntary decisions about their treatment (Correct answer)
- A signed form that protects the hospital from lawsuits
- A verbal agreement between the doctor and patient's family
- Automatic consent given when a patient enters a hospital
Correct answer: A process where patients receive adequate information to make voluntary decisions about their treatment
Informed consent is a process (not just a form) where patients receive information about diagnosis, treatment options, risks, benefits, and alternatives, enabling voluntary, informed decision-making.
Question 4: What is Gillick competence?
- A legal concept where a minor under 16 can consent to treatment if they demonstrate sufficient understanding (Correct answer)
- A test measuring a doctor's clinical competence
- A standardized exam for medical licensing
- A rating system for hospital quality
Correct answer: A legal concept where a minor under 16 can consent to treatment if they demonstrate sufficient understanding
Gillick competence (established in Gillick v West Norfolk, 1985) allows minors under 16 to consent to medical treatment if they demonstrate sufficient intelligence and understanding of the proposed treatment.
Question 5: How should a physician deliver bad news to a patient?
- Using a structured approach like SPIKES: Setting, Perception, Invitation, Knowledge, Emotions, Strategy (Correct answer)
- By having a nurse deliver the information instead
- As quickly as possible to minimize the patient's time in the office
- Only in writing to avoid emotional confrontation
Correct answer: Using a structured approach like SPIKES: Setting, Perception, Invitation, Knowledge, Emotions, Strategy
The SPIKES protocol provides a structured approach: prepare the Setting, assess patient's Perception, get an Invitation to share, give Knowledge/information, address Emotions, and discuss Strategy/next steps.
Question 6: What is a 'Do Not Resuscitate' (DNR) order?
- A medical order indicating that CPR should not be performed if the patient's heart stops (Correct answer)
- A hospital policy that limits visiting hours
- A request to not be given pain medication
- An instruction to discharge the patient immediately
Correct answer: A medical order indicating that CPR should not be performed if the patient's heart stops
A DNR order is a medical directive stating that cardiopulmonary resuscitation should not be attempted if the patient experiences cardiac or respiratory arrest, respecting the patient's wishes about end-of-life care.
PLAB Ethics & Communication
What are the four pillars of medical ethics?