EthicsIntermediateMMI station
Before a shift, you notice your senior resident smells of alcohol. What do you do?
Ethical dilemma: Competing duties with no perfect answer: consent, confidentiality, fairness.
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Sample answer outline
- State the priority: patient safety. If the resident may be impaired, they should not see patients until that is resolved.
- Don't assume. Speak to them privately and calmly, say what you noticed, and ask how they are.
- If the concern stands, tell the attending or supervisor before the shift starts. You don't need proof to raise a safety concern.
- Show care for the colleague: impairment can signal illness or crisis. Point to physician health and support programs.
- Acknowledge your position as a trainee and follow the hospital's reporting policy.
What makes it work
- It balances safety, fairness and compassion instead of picking one.
- Escalation is proportionate and quick, because patients are at stake.
Avoid
- Saying nothing because they are senior.
- Confronting them in front of the team.
How to approach ethical dilemma questions
- Clarify the facts and what you would want to know before acting.
- Name who is affected and the principles in tension: autonomy, doing good, avoiding harm, fairness, confidentiality.
- Walk through realistic options, starting with the least drastic.
- Choose a course of action, explain why, and say who you would involve.
What it tests
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