The interview question bank

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

• EthicsAdvanced·MMI 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

  1. 1Clarify the facts: who ordered the test, for what clinical question, and whose information this is.
  2. 2Answer 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.
  3. 3Don'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.
  4. 4Speak with the wife privately: understand her fears, check her safety, encourage her to consider disclosure, offer counseling.
  5. 5Involve 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.

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

  During rotations, you see one of your closest friends cover up a medical error they made with a patient. What do you do?

  Integrity · Patient safety · Professionalism

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  Sample answer outline

  1. 1First check on the patient: are they at risk right now? If so, alert the team immediately.
  2. 2Speak to your friend promptly and privately. Encourage them to disclose and offer to go with them.
  3. 3If they won't, take it to your supervisor yourself. Patient safety outranks loyalty.
  4. 4Acknowledge the pull of friendship and their fear, and point out that errors are reported to fix systems, not only to punish people.

  What makes it work

  • It gives your friend the chance to do the right thing first.
  • Clear priorities: patient, honesty, then the friendship.

  Avoid

  • Staying quiet to protect the friendship.

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• EthicsIntermediate·MMI station · Dental, MD, DO, PA

  A patient asks you not to document their smoking habit because they don't want their insurance company to know. What do you do?

  Integrity · Confidentiality

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  How to approach ethical dilemma questions

  1. 1Clarify the facts and what you would want to know before acting.
  2. 2Name who is affected and the principles in tension: autonomy, doing good, avoiding harm, fairness, confidentiality.
  3. 3Walk through realistic options, starting with the least drastic.
  4. 4Choose a course of action, explain why, and say who you would involve.

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