The Medical Board of Australia’s Good Medical Practice: A Code of Conduct for Doctors in Australia) sets the standard for the profession. Confident you are across it? Test your knowledge with a few common ethical questions doctors face.
Please note down all answers that apply. You can check the right answers at the bottom of the page.
1. What does the Code say about providing care for those close to you?
(a) If it’s agreed by both parties, then it’s fine to proceed.
(b) It should be avoided wherever possible when there is a close personal relationship.
(c) It’s OK if it’s unavoidable, for example, in an emergency.
(d) It’s OK if you remember to make notes.
2. When a complaint is made by a patient, you should:
(a) Acknowledge the patient’s right to complain.
(b) Reflect on what lead to the complaint, the circumstances of the complaint and how you may be able to change your practice in future to address this (if relevant).
(c) Direct the patient straight to HCCC and Medical Council of NSW without delay.
(d) Refuse to speak with the patient until you have spoken to your medical indemnity insurer.
3. Informed consent involves:
(a) Ensuring the patient has signed any paperwork necessary, whether or not you have confirmed their understanding.
(b) Explaining any risks to the patient.
(c) Providing information to patients that will help them make decisions about their care, in a way that they can understand.
(d) Allowing the patient to ask questions either during the consultation or at a follow up time.
4. The doctor-patient relationship:
(a) Can become so close that doctors see patients outside of their practice in a social setting.
(b) Is based on trust and open, respectful communication.
(c) Can become a sexual relationship if both parties agree.
(d) Has an inherent power imbalance that practitioners need to be aware of.
5. Good patient care should involve:
(a) Referring a patient on if you aren’t confident in your ability to treat the issue.
(b) Supporting the patient’s right to a second opinion.
(c) Taking steps to alleviate the patient’s distress, whether a cure is available or not.
(d) All the above.
6. When treating children and young people, doctors should:
(a) Have their parent or guardian make decisions on their behalf.
(b) Notify authorities if they feel their young patient is at risk.
(c) Preference non-pharmacological treatment.
(d) Treat them with respect, listen to their views and provide information in a way they can understand.
Question 1: Both B and C are correct. While it is allowable to treat those close to you in an emergency, the Code and the Medical Council both reinforce the importance of avoiding this where possible to avoid clouded judgement due to personal involvement and a tendency toward not making sufficient notes that would allow another practitioner to take over. (See section 4.15)
Practitioners are also strongly discouraged from self-prescribing and self-referring and instead are encouraged to have their own GP who can provide regular management and independent oversight of medical issues.
Question 2: A and B are correct. Receiving a complaint can be a highly charged emotional situation. However, patients absolutely do have the right to complain. While you may see the situation that lead to the complaint differently, good doctors take the opportunity to reflect on the situation with insight, examining their role in the situation and what learnings may emerge to improve their care in future. (See section 4.12)
Question 3: C and D are correct. While it is essential that patients have the risks of any procedure or treatment explained to them, it is good medical practice to ensure that costs and benefits are also shared. Best practice informed consent allows the patient to ask questions and ensures that information is provided in a way that they can understand. Informed consent should also be documented, but will not always require paperwork and irrespective, will require patients to have a comprehensive understanding before signing anything. (See section 4.5)
Question 4: B and D are correct. A positive doctor-patient relationship is founded on treating the patient with respect and as an individual. Doctors should encourage patients to be responsible for their own health and support them to make informed decisions. Confidentiality and compassion are also key to a positive, ongoing relationship. (See section 4.2)
Question 5: All the above. All these elements are critical to providing your patients with appropriate care. It is essential to remain within your defined scope of practice and experience, maintain a high level of clinical knowledge and keep adequate records. However, patients also need a practitioner who can communicate empathetically and effectively, present them with their recommended treatment options and be able justify this recommendation. Naturally, patients are entitled to seek a second opinion and are also entitled to be told when your own views do not align with that of the rest of the profession. (See section 3.2)
Question 6: Answer B and D. As mandatory reporters, doctors must be alert to their legal requirement to make notifications when they consider a young patient’s safety may be at risk. However, the relationship with children and young people is more complex than this. As with adults, the relationship is firmly based in treating them with the respect they deserve. Children’s thoughts and opinions must be considered and incorporated into their treatment taking into consideration the Gillick Principle relating to the “mature minor”.(See section 4.6)
Want to explore further? Visit the Medical Board of Australia's Good Medical Practice: A Code of Conduct for Doctors in Australia.