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Communication · Advanced5
Clear filters- Practice this question nowEthicsAdvancedMMI station MD, DO, PA
Genetic testing shows the husband isn't the father. The wife begs you not to tell him. Then he asks you if anything came back abnormal. What do you say?
Confidentiality · Integrity · Communication
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Sample answer outline
- Clarify the facts: who ordered the test, for what clinical question, and whose information this is.
- Answer his actual question truthfully: report the results relevant to the child's health. Non-paternity was an incidental finding, not what the test was for.
- Don't lie, and don't disclose what isn't yours to share. You can say you will go over the medical findings with both parents.
- Speak with the wife privately: understand her fears, check her safety, encourage her to consider disclosure, offer counseling.
- Involve genetics colleagues and ethics, and follow local law and policy, which vary.
What makes it work
- It separates honesty from full disclosure, which is the heart of the dilemma.
- It keeps the child's medical interests in view.
Avoid
- Telling the husband outright, or lying to him.
- Treating it as a simple yes or no.
- 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
A 12-year-old asks you for birth control and begs you not to tell her parents. What do you do?
Confidentiality · Patient safety · Communication
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Sample answer outline
- Notice the age. At 12, sexual activity is a safeguarding concern in most places, so the child's safety comes first.
- Before she shares more, explain honestly what you can keep private and what you can't.
- Talk gently and privately: who she is involved with, whether she feels safe, any signs of coercion or abuse.
- Follow mandatory reporting duties where they apply, with your supervisor and child protection services.
- Still meet her health needs: information, protection, and encouragement to involve a trusted adult.
What makes it work
- It recognizes the safeguarding issue many applicants miss.
- Being honest about the limits of confidentiality keeps her trust.
Avoid
- Promising total secrecy.
- Treating it like the same request from a 16-year-old.
- 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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