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PA · Autonomy and consent · Advanced4
Clear filters- Practice this question nowEthicsAdvancedMMI station MD, DO, PA
A 9-year-old with measles begs you for the vaccine. The parents still refuse. Do you vaccinate?
Autonomy and consent · Communication
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Sample answer outline
- Spot the clinical detail: a child who already has measles won't be helped by the measles vaccine now. The priority is treating them, isolating them and protecting contacts.
- Explain the frame: a 9-year-old can't consent alone; parents decide unless their choice puts the child at serious risk.
- Explore the parents' reasons with respect and correct misinformation. The illness is a natural moment to revisit vaccines for the child's siblings and the child's other vaccines.
- Keep the child's voice in the room: acknowledge their fear and explain what will happen.
- Notify public health as required.
What makes it work
- Catching the clinical premise shows careful reading, which interviewers love.
- It respects parents while still protecting children and the public.
Avoid
- Vaccinating against the parents' wishes without legal grounds.
- Lecturing the parents.
- Practice this question nowEthicsAdvancedMMI station MD, DO, PA
A patient with Down syndrome is pregnant and wants to keep the baby. Her mother and husband want her to have an abortion. What do you do?
Autonomy and consent · Communication · Equity and access
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Sample answer outline
- Start from a presumption of capacity: Down syndrome alone does not mean she can't make this decision.
- Assess capacity for this specific choice, with supports: plain language, time, visual aids, a trusted advocate.
- Meet with her alone to hear her wishes free of pressure, and screen for coercion.
- Acknowledge the family's worries and bring them into planning support for her, not into overriding her.
- If capacity is truly lacking, follow legal surrogate processes and involve ethics, still centered on her values.
What makes it work
- It avoids the common trap of assuming disability means incapacity.
- It treats the family as partners without handing them the decision.
Avoid
- Siding with the family because they seem more "reasonable".
- Practice this question nowEthicsAdvancedMMI station MD, DO, PA, Nursing, Residency
A mother refuses a life-saving blood transfusion for her 4-year-old because of her religious beliefs. What do you do?
Autonomy and consent · Cultural humility · Patient safety
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Sample answer outline
- The child's best interests come first. Parents' right to refuse has limits when a child's life is at risk.
- Approach the mother with empathy, explore her beliefs and offer every acceptable alternative that is medically safe.
- Involve the senior physician, ethics and the hospital's legal team early. Courts can authorize treatment.
- In a true emergency, treat to save the child's life as the law allows.
- Protect the relationship: this family will still care for the child afterward.
What makes it work
- It shows exactly where autonomy ends: a parent deciding for a child.
- It handles the family with compassion, not force alone.
- Practice this question nowEthicsAdvancedMMI station MD, DO, PA
How would you explain informed consent to a minor who disagrees with their guardian?
Autonomy and consent · Communication
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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.
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