Ethics

In medical school interviews, understanding and articulating key ethical principles is crucial as it reflects your ability to navigate the complex moral landscape of healthcare. Here are the primary ethical principles you should be familiar with, often summarised as the four pillars of medical ethics, along with how they might be applied or discussed in a medical school interview:

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Autonomy

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Definition: Autonomy refers to respecting the patient's right to make their own informed decisions about their healthcare. It involves honoring their values, beliefs, and choices even when they differ from those of the healthcare provider.

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Key Points for Interviews:

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• Informed Consent: Emphasize the importance of providing patients with all the necessary information to make informed decisions about their treatment.

• Respect for Patient Choices: Even if a patient’s decision differs from what the physician believes is best, respecting their autonomy is crucial.

• Patient Education: Ensuring that patients understand their condition and treatment options is a part of respecting their autonomy.

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Example 

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• Scenario: A patient refuses a life-saving blood transfusion due to religious beliefs

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• ​Response: "I would respect the patient's beliefs while ensuring they understand the potential consequences of refusing the transfusion. I would explore alternative treatments and discuss these options with the patient to align their care with their values as much as possible."

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Beneficence

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Definition: Beneficence involves acting in the best interest of the patient. It is about providing care that benefits the patient, promoting their well-being, and taking positive steps to prevent or remove harm.

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Key Points for Interviews:

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• Acting in the Patient’s Best Interest: Always aim to provide treatments and interventions that will benefit the patient.

• Balancing Benefits and Risks: Assess and weigh the potential benefits against the risks to ensure the chosen action maximizes patient welfare.

• Proactive Care: Includes preventing illness, alleviating suffering, and improving health outcomes.

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Example

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• Scenario: Deciding whether to recommend a risky surgery that could significantly improve a patient's quality of life.

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• Response: "I would thoroughly evaluate the potential benefits and risks of the surgery and discuss these with the patient. Ensuring the patient understands the possible outcomes and supporting them in making an informed decision aligns with the principle of beneficence."

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Non-Maleficence

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Definition: Non-maleficence means "do no harm." It involves avoiding actions that could cause unnecessary harm or suffering to the patient.

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Key Points for Interviews:

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• Avoiding Harm: Prioritize treatments and procedures that do not cause unnecessary harm.

• Risk Assessment: Carefully consider and minimize the risks associated with any medical intervention.

• Ethical Dilemmas: Sometimes treatments beneficial in the long term may cause short-term harm. Balancing these situations is critical.

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Example

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• Scenario: Considering whether to recommend aggressive chemotherapy with severe side effects for a terminal cancer patient.​

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• Response: "I would weigh the potential benefits of extending life against the significant risks and side effects of the chemotherapy. Engaging in a candid discussion with the patient about their goals and quality of life considerations is essential to uphold non-maleficence."

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Justice

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Definition: Justice in healthcare involves fairness and equality in the distribution of resources and treatment. It means providing care without discrimination and ensuring equitable access to healthcare services.

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Key Points for Interviews:

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• Fair Distribution of Resources: Addressing how to allocate limited resources (e.g., organ transplants, ICU beds) fairly.

• Non-Discrimination: Ensuring equal treatment and access to care for all patients, regardless of background, socio-economic status, or other factors.

• Addressing Inequities: Recognizing and actively working to reduce healthcare disparities and inequities.

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Example

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• Scenario: Deciding how to allocate a limited number of ventilators during a pandemic.

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• Response: "I would consider criteria that ensure the most fair and equitable distribution of ventilators, prioritizing patients based on clinical need and potential for recovery rather than on non-medical factors. Transparent communication and consistent application of guidelines are crucial to uphold justice."

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Additional Ethical Principles

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While the four pillars are foundational, understanding additional concepts can further demonstrate your ethical awareness.  

 

These can be built in to responses in general ethical questions and when understood with a few examples, can really bolster answers and make you stand out!

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We'll cover a lot of these separately however these are overviews of the basics.

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Confidentiality

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Definition: Confidentiality involves protecting patient information and ensuring that it is only shared with those directly involved in their care, unless consent is given or there is a significant risk to the patient or others.

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Key Points for Interviews:

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• Patient Trust: Confidentiality is crucial for maintaining trust between patients and healthcare providers.

• Legal and Ethical Obligations: Understand when it is appropriate to breach confidentiality, such as when there is a risk of harm to the patient or others.

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Example

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• Scenario: A teenager asks for information about their health to be kept private from their parents

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• Response: "I would respect the teenager's request for confidentiality, while also assessing their capacity to understand their medical condition and the implications of their choices. It's important to explain the limits of confidentiality, particularly if there are concerns about their safety."

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Veracity

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Definition: Veracity is the obligation to be truthful and transparent with patients. It involves providing accurate information and being honest about diagnoses, treatments, and prognoses.

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Key Points for Interviews:

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• Building Trust: Being honest with patients helps build and maintain trust.

• Informed Decision-Making: Patients need truthful information to make informed decisions about their care.

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Example 

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• Scenario: Explaining the side effects of a new medication to a patient.

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• Response: "I would provide a clear and honest explanation of the potential side effects, ensuring the patient understands both the benefits and risks associated with the medication. This transparency helps the patient make an informed decision about their treatment."

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Fidelity

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Definition: Fidelity involves being faithful to commitments and promises, providing consistent and reliable care, and upholding professional standards.

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Key Points for Interviews:

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• Professional Relationships: Maintaining trust and fulfilling promises to patients and colleagues.

• Consistency in Care: Providing reliable and continuous care, especially in long-term patient-provider relationships.

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Example 

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• Scenario: Managing patient expectations when delays in care occur.

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• Response: "I would communicate honestly with the patient about the reasons for any delays and provide them with updated information as soon as possible. Keeping the patient informed and ensuring that I follow through on any commitments made helps maintain their trust and confidence."

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Preparing for Ethical Questions in Interviews

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1. Understand Basic Principles: Be comfortable discussing autonomy, beneficence, non-maleficence, and justice.

2. Reflect on Personal Experiences: Think about how you’ve encountered or can relate to these principles in your own life.

3. Consider Current Issues: Stay informed about current ethical issues in healthcare, such as resource allocation during crises, patient privacy in the digital age, or access to care.

4. Practice Scenarios: Practice applying these principles to common ethical dilemmas you might face as a medical student or doctor.

5. Be Balanced and Thoughtful: Show that you can see different sides of an issue and are capable of making balanced, informed decisions.

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Being well-versed in these principles and demonstrating how they guide your thinking and actions will show interviewers that you are prepared for the ethical challenges of a medical career.