The interview question bank

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

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

  Before a shift, you notice your senior resident smells of alcohol. What do you do?

  Professionalism · Patient safety

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  1. 1State the priority: patient safety. If the resident may be impaired, they should not see patients until that is resolved.
  2. 2Don't assume. Speak to them privately and calmly, say what you noticed, and ask how they are.
  3. 3If the concern stands, tell the attending or supervisor before the shift starts. You don't need proof to raise a safety concern.
  4. 4Show care for the colleague: impairment can signal illness or crisis. Point to physician health and support programs.
  5. 5Acknowledge 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.

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• 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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  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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• EthicsAdvanced·MMI 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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  1. 1Spot 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.
  2. 2Explain the frame: a 9-year-old can't consent alone; parents decide unless their choice puts the child at serious risk.
  3. 3Explore 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.
  4. 4Keep the child's voice in the room: acknowledge their fear and explain what will happen.
  5. 5Notify 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.

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• 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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  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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• EthicsAdvanced·MMI station · MD, DO

  A deaf couple doing IVF asks you to help them pick an embryo that will also be deaf. What do you do?

  Autonomy and consent · Cultural humility · Critical thinking

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  1. 1Acknowledge both views: many Deaf people see deafness as a culture and identity, not a disability. Others see choosing it as limiting the child's options.
  2. 2Name the principles in tension: the parents' reproductive autonomy and the future child's interests (sometimes called the right to an open future).
  3. 3Explore the couple's reasons with curiosity instead of assumptions.
  4. 4Check the law and clinic policy where you practice. If you decline on conscience, say so openly and explain the options.
  5. 5Recommend an ethics consultation, then give your reasoned position.

  What makes it work

  • It shows cultural humility without dodging a position.
  • Naming the principles makes the reasoning easy to follow.

  Avoid

  • Calling deafness simply a defect.
  • Ending on "it depends" with no view.

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

  A Jehovah's Witness patient refuses a blood transfusion they need to survive. What do you do?

  Autonomy and consent · Cultural humility · Communication

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  1. 1A competent adult can refuse even life-saving treatment. Your job is to make sure the refusal is informed, voluntary and consistent with their values.
  2. 2Talk with them privately to check for pressure from family or community.
  3. 3Explore what they will accept: bloodless surgery techniques, cell salvage, iron, medicines that boost blood production.
  4. 4Document the conversation and their decision clearly, and keep caring for them fully.
  5. 5Note how it differs for a child or for an unconscious patient without an advance directive.

  What makes it work

  • It respects autonomy while doing everything else possible.
  • Showing the contrast with a child proves you understand the limits.

  Avoid

  • Trying to persuade them out of their faith.
  • Treating the refusal as a reason to step back from their care.

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• EthicsAdvanced·MMI 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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  1. 1The child's best interests come first. Parents' right to refuse has limits when a child's life is at risk.
  2. 2Approach the mother with empathy, explore her beliefs and offer every acceptable alternative that is medically safe.
  3. 3Involve the senior physician, ethics and the hospital's legal team early. Courts can authorize treatment.
  4. 4In a true emergency, treat to save the child's life as the law allows.
  5. 5Protect 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.

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• EthicsAdvanced·MMI 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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  1. 1Notice the age. At 12, sexual activity is a safeguarding concern in most places, so the child's safety comes first.
  2. 2Before she shares more, explain honestly what you can keep private and what you can't.
  3. 3Talk gently and privately: who she is involved with, whether she feels safe, any signs of coercion or abuse.
  4. 4Follow mandatory reporting duties where they apply, with your supervisor and child protection services.
  5. 5Still 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.

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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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  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

  A patient with severe depression and no terminal illness asks for medical assistance in dying. It's legal where you work. What do you do?

  Autonomy and consent · Empathy · Patient safety

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  1. 1Respond with compassion. Take the request seriously as an expression of suffering, and assess suicide risk now.
  2. 2Assess capacity carefully: depression can affect decisions, but it does not automatically remove capacity.
  3. 3Review treatment so far and offer the best available psychiatric care. Many jurisdictions require this before mental illness alone can qualify.
  4. 4Follow the legal process: safeguards, independent assessments, waiting periods, multidisciplinary review.
  5. 5Be open about your own values; if you object, refer without obstructing.

  What makes it work

  • It treats the person, not just the request.
  • It shows you know the extra safeguards for mental illness.

  Avoid

  • Dismissing the request outright, or approving it without assessment.

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• EthicsAdvanced·MMI station · MD, DO

  A patient asks you to amputate their perfectly healthy leg because it "doesn't feel like theirs." Do you?

  Autonomy and consent · Empathy · Critical thinking

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  1. 1Recognize body integrity dysphoria: a real, distressing condition, not a whim.
  2. 2Weigh autonomy against nonmaleficence. Doctors are not obliged to perform procedures that cause serious harm without clear benefit.
  3. 3Explore their experience, assess capacity, and refer for psychiatric support. Check for any risk of self-harm.
  4. 4Decline the surgery for now, kindly and clearly, and stay involved in their care.

  What makes it work

  • It treats the patient's distress as real while holding a clear line.

  Avoid

  • Mocking the request or ending the visit.

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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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  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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• EthicsIntermediate·MMI station · MD, DO, PA

  A family begs you not to tell their grandmother she has cancer because "it'll kill her faster." What do you do?

  Autonomy and consent · Cultural humility · Communication

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  1. 1Listen to the family first: their fear and any cultural norms around sharing bad news.
  2. 2Explain that the information belongs to the patient, and that you won't lie to her.
  3. 3Ask the grandmother how much she wants to know and who she wants involved. Some people choose to let family decide.
  4. 4Share news at her pace, with the family present if she wishes, and plan support together.

  What makes it work

  • Asking the patient what she wants resolves the dilemma respectfully.
  • It honors culture without giving up honesty.

  Avoid

  • Telling her bluntly against the family's wishes without asking her first.

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

  A dying patient asks you to pray with them. You're not religious. What do you do?

  Empathy · Cultural humility · Communication

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  1. 1Respond to the need behind the request: comfort and connection at the end of life.
  2. 2You can be present respectfully, by staying quietly, holding their hand or listening, without claiming a belief you don't hold.
  3. 3Offer the chaplain or their own faith leader.
  4. 4Keep your own views out of it; this moment is about them.

  What makes it work

  • Presence over performance: honest and kind at once.

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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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  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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• EthicsAdvanced·MMI station · PA

  As a PA, you notice your supervising physician seems impaired during a shift. What do you do?

  Patient safety · Professionalism · Integrity

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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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• EthicsIntermediate·MMI station · Dental

  A patient insists on a cosmetic procedure you believe is unnecessary and could damage healthy teeth. They've already paid in full. What do you do?

  Autonomy and consent · Integrity · Communication

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  1. 1Understand their goal: what do they want to change about their smile, and why now?
  2. 2Explain the risks honestly: removing healthy tooth structure is irreversible.
  3. 3Offer conservative alternatives that meet the goal, such as whitening, bonding or orthodontics.
  4. 4If you still believe it causes harm, decline and refund. Payment doesn't change your duty.
  5. 5Document the discussion.

  What makes it work

  • It separates the patient's goal from the procedure they asked for.
  • Being clear about the payment shows integrity.

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

  A patient confides they stopped taking prescribed medications due to religious beliefs, but asks you not to tell the physician. Their condition is worsening. How do you respond?

  Confidentiality · Autonomy and consent · Patient safety

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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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• EthicsAdvanced·MMI station · Pharmacy

  A pharmacist has a personal objection to dispensing a legal medication. How should that be handled so the patient still gets care?

  Integrity · Autonomy and consent · Equity and access

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  1. 1Name both values: the pharmacist's conscience and the patient's right to timely, legal care.
  2. 2The key principle: an objection must never become a barrier. The patient leaves with the medication or a guaranteed path to it.
  3. 3Plan ahead: tell the employer in advance and arrange another pharmacist on shift or a warm referral nearby.
  4. 4Treat the patient with dignity: no lecturing, no delay, no judgment.
  5. 5Note that laws and board rules vary by state.

  What makes it work

  • It resolves the tension with a practical system, not a slogan.

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• EthicsAdvanced·MMI station · PT

  A clinic owner tells you to let PTAs do most of your work so you can take on more evaluations. You know this is wrong. What do you do?

  Integrity · Professionalism · Patient safety

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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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• EthicsAdvanced·MMI station · Vet

  A farmer asks you to euthanize a healthy lamb because it isn't growing fast enough to be profitable. The animal isn't suffering. What do you do?

  Integrity · Critical thinking

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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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• EthicsIntermediate·MMI station · Vet

  A cat needs emergency surgery to survive, but the owner can't afford it and declines treatment. The cat will suffer without intervention. How do you handle this?

  Empathy · Equity and access · Communication

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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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• EthicsAdvanced·MMI 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

  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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