The interview question bank

Competing duties with no perfect answer: consent, confidentiality, fairness.

• EthicsAdvanced·MMI 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

  1. 1Start from a presumption of capacity: Down syndrome alone does not mean she can't make this decision.
  2. 2Assess capacity for this specific choice, with supports: plain language, time, visual aids, a trusted advocate.
  3. 3Meet with her alone to hear her wishes free of pressure, and screen for coercion.
  4. 4Acknowledge the family's worries and bring them into planning support for her, not into overriding her.
  5. 5If 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".

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• EthicsIntermediate·MMI station · MD, DO, PA, Nursing, Residency

  A convicted child molester comes to your ER needing emergency surgery. Do you treat him the same as everyone else?

  Professionalism · Equity and access

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  Sample answer outline

  1. 1Answer clearly: yes. Care is based on medical need, not moral worth. Justice and the duty to treat apply to everyone.
  2. 2Acknowledge that discomfort is human; professionalism means not letting it change the care.
  3. 3Handle the practical side: security and staff safety, and letting a colleague step in if someone truly can't give good care, as long as treatment isn't delayed.
  4. 4Note that punishment belongs to the justice system, not the hospital.

  What makes it work

  • A clear position up front, then nuance.
  • Honesty about feelings makes the commitment believable.

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• EthicsAdvanced·MMI station · MD, DO

  One liver, two patients: a 60-year-old surgeon who drinks, and a 25-year-old who overdosed. Who gets it?

  Equity and access · Critical thinking · Health systems

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  Sample answer outline

  1. 1Say who really decides: transplant teams follow set criteria, not one doctor's judgment of who deserves it.
  2. 2Name those criteria: medical urgency, likelihood of benefit, compatibility, time on the list, and the ability to follow through after transplant.
  3. 3Reject social worth: being a surgeon doesn't earn a liver. Be careful about blaming either patient for their illness.
  4. 4Note that an overdose, such as acetaminophen, can cause acute liver failure with top urgency, while alcohol use may raise questions about relapse.
  5. 5Conclude that you'd follow the criteria and support both patients.

  What makes it work

  • It moves the question from "who deserves it" to "how fair systems decide".

  Avoid

  • Choosing by age or profession alone.

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