Prep RoomSign inStart free

Med-legal & ethics questions.

79 med-legal & ethics questions from the bank, ready to practice out loud.

Practice med-legal & ethics

Learn the ideas first · free with an account

Confidentiality and its limitsInformed consent: the elements that make it validSTAR and CARL: structuring your storyDecision-making capacity: the four abilitiesDocumentation that stands up laterGiving a number you are not sure ofWho decides when the patient can't: surrogates and advance directivesWhen to call ethics — and when not to

All 79 questions

Informed consent for elective surgeryWalk me through how you'd structure the informed-consent conversation for an elective surgery with serious but rare complications.Informed consent processMid–senior
Decision capacity versus legal competenceWalk me through the distinction between decision-making capacity and legal competence, and how each affects your next move.Capacity vs competenceMid–senior
Surrogate overriding patient's prior wishesWalk me through how you'd handle a situation where the surrogate decision-maker is making choices the patient previously stated they wouldn't want.Surrogate decision MakingSenior–leadership
Documenting high-stakes patient decisionsA discussion with a patient about a high-stakes decision could be med-legal evidence later. Walk me through what you document.DocumentationMid–senior
Escalating to ethics consultationWalk me through how you'd decide whether a case should be escalated to ethics consultation rather than handled in the team.When to involve ethics committeeSenior–leadership
Uncertain patient understanding of consentA patient signed the consent form but the team is unsure whether they understood. Walk me through your response.Informed consent processSenior–leadership
Dementia patient procedure refusalA patient with dementia wants to refuse a procedure on a day when they appear lucid. Walk me through your response.Capacity vs competenceSenior–leadership
Disagreeing surrogate decision-makersA patient has two children acting as surrogates and they disagree. Walk me through your approach.Surrogate decision MakingSenior–leadership
Documentation when patient may sueWalk me through what changes about your documentation when a patient has expressed they may sue.DocumentationSenior–leadership
Illegal aid in dying requestA patient requests aid in dying in a jurisdiction where it isn't legal. Walk me through your response.When to involve ethics committeeSenior–leadership
Consenting an anxious patientWalk me through how you'd consent a patient who is highly anxious and asks you to 'just do whatever you think is best'.Informed consent processMid–senior
Psychiatric patient refusing medicationA psychiatric inpatient is refusing medication. Walk me through how you'd think about the next steps.Capacity vs competenceSenior–leadership
Disagreement between proxy and familyA patient's spouse is the listed health-care proxy, but the adult children disagree with their decisions. Walk me through your approach.Surrogate decision MakingSenior–leadership
Documenting disagreement with colleagueWalk me through how you'd document a disagreement with a colleague's clinical plan.DocumentationSenior–leadership
Family requesting futile interventionsA family is requesting interventions you believe are futile. Walk me through your approach.When to involve ethics committeeSenior–leadership
Emergency consent without familyWalk me through how you'd handle consent in an emergent situation where the patient can't communicate and no family is available.Informed consent processSenior–leadership
Assessing capacity for advance directiveA patient with mild cognitive impairment wants to update their advance directive. Walk me through how you'd assess their ability to do so.Capacity vs competenceSenior–leadership
Deciding for incapacitated patientA patient is incapacitated and has no advance directive and no clear surrogate. Walk me through how to make decisions.Surrogate decision MakingSenior–leadership
Documentation with public health reportingWalk me through what changes about how you document when a case involves a public-health reporting requirement.DocumentationMid–senior
Legal but ethically uncertain decisionWalk me through how you'd handle a clinical decision that is legal but feels ethically uncertain.When to involve ethics committeeSenior–leadership
Documenting refusal of recommended careWalk me through how you'd document refusal of recommended care for a patient who is mentally capacitated.Informed consent processMid–senior
Patient signs out against adviceA patient signs out against medical advice. Walk me through how you'd approach the situation.Capacity vs competenceMid–senior
Living will versus surrogate wishesWalk me through how you'd handle a case where the patient's living will conflicts with the surrogate's current wishes.Surrogate decision MakingSenior–leadership
Documenting hostile family interactionWalk me through documenting a difficult interaction with a family member who became hostile during a meeting.DocumentationMid–senior
Ethics involvement in end-of-life discussionWalk me through whether you'd involve ethics in a routine but emotionally charged end-of-life discussion.When to involve ethics committeeSenior–leadership
Trial consent with recommendationWalk me through how you'd handle consent for a clinical trial when the patient asks 'what would you recommend?'Informed consent processSenior–leadership
Pediatric patient disagreeing with parentsA pediatric patient is making a healthcare request their parents don't agree with. Walk me through your assessment.Capacity vs competenceSenior–leadership
Supporting struggling surrogatesWalk me through what you'd say to a surrogate who's clearly struggling with the responsibility of making decisions.Surrogate decision MakingSenior–leadership
Documenting self-harm statement and refusalWalk me through what you should document when a patient verbalizes thoughts of self-harm but declines further intervention.DocumentationSenior–leadership
Colleague making unethical decisionWalk me through your approach when a colleague is making a clinical decision you believe is unethical.When to involve ethics committeeSenior–leadership
Explaining informed consent to patientA patient asks you what 'informed consent' means before a procedure. Walk me through what you'd explain to them.Informed consent processEntry–mid
Transfusion refusal capacity assessmentWalk me through how you'd assess whether a patient has decision-making capacity for a blood transfusion they're refusing.Capacity vs competenceEntry–mid
Orienting healthcare proxy to roleA patient's healthcare proxy arrives but hasn't been involved in care discussions yet. Walk me through how you'd orient them to their role.Surrogate decision MakingEntry–mid
Documenting after informed consentWalk me through what you'd document immediately after obtaining informed consent for a procedure.DocumentationEntry–mid
When to request ethics consultationYour attending asks you when an ethics consult might be helpful. Walk me through what situations you'd mention.When to involve ethics committeeEntry–mid
Patient withdrawing consent after procedureA patient consented to a procedure yesterday but today says they've changed their mind. Walk me through your response.Informed consent processEntry–mid
Healthcare proxy versus power of attorneyWalk me through the difference between a healthcare proxy and a medical power of attorney, and when each becomes active.Surrogate decision MakingEntry–mid
Cognitive impairment and decision capacityA patient scores poorly on a cognitive screen but is insisting they want to make their own medical decisions. Walk me through your thinking.Capacity vs competenceEntry–mid
Documenting patient questions during consentWalk me through what you'd document when a patient asks multiple questions during consent and you answer each one.DocumentationEntry–mid
Family meeting ethics consultation triggerA nurse tells you a family meeting is 'getting complicated' and suggests calling ethics. Walk me through how you'd evaluate whether that's needed.When to involve ethics committeeEntry–mid
Explaining cardiac catheterization risksWalk me through how you'd explain risks and benefits to a patient with limited health literacy who needs a cardiac catheterization.Informed consent processEntry–mid
Family preference without advance directiveA patient's adult daughter says 'Mom would want everything done' but there's no written advance directive. Walk me through how you'd proceed.Surrogate decision MakingEntry–mid
Correcting AI-generated documentation errorYou signed a note drafted by an ambient AI scribe, and a day later you notice it attributed a symptom to the patient that they never reported. Walk me through how you correct the record.DocumentationMid–senior
Disclosing AI's role in diagnosisAn AI tool helped flag the lesion on your patient's imaging and shaped your recommendation. Walk me through how you'd decide what, if anything, to tell the patient about the AI's role.Informed consent processSenior–leadership
Patient requests omitting alcohol useA patient asks you to leave their alcohol use out of the chart because they're worried about insurance and their employer. Walk me through your response and what you document.DocumentationMid–senior
Telehealth consent for in-person procedureYou're consenting a patient over a telehealth video visit for a procedure that will happen in person next week. Walk me through what changes about the consent process and how you document it.Informed consent processMid–senior
Assessing capacity by telehealthYou need to assess decision-making capacity for a treatment refusal, but the patient is only available by telehealth video. Walk me through what you can establish remotely and when you'd insist on an in-person assessment.Capacity vs competenceSenior–leadership
Patient portal access changing documentationYour patients now read their notes and lab results in the portal the moment they're released, often before you can call. Walk me through how that changes what and how you document.DocumentationMid–senior
AI second opinion disagreementA family presents an AI-generated 'second opinion' and demands a treatment your team believes isn't indicated. Walk me through how you'd decide whether this is a communication problem or an ethics-consult problem.When to involve ethics committeeSenior–leadership
Patient recording consent discussionA patient pulls out their phone and asks to record the consent discussion for a major surgery. Walk me through your response and the considerations behind it.Informed consent processMid–senior
Digital evidence of patient wishesAn incapacitated patient has no advance directive, but the surrogate produces text messages in which the patient described what they'd want. Walk me through how you'd weigh that informal digital evidence.Surrogate decision MakingSenior–leadership
App reliance and decision-making capacityA patient refuses a recommended workup because an AI symptom checker told them it's nothing serious. Does relying on the app mean they lack capacity? Walk me through your thinking.Capacity vs competenceEntry–mid
Trainee participation in surgical consentResidents and trainees will participate meaningfully in a patient's surgery. Walk me through what you'd tell the patient about that during consent.Informed consent processEntry–mid
Team member moral objectionA team member declines on moral grounds to participate in a legal, clinically appropriate procedure. Walk me through how you'd handle it and when it becomes a question for ethics rather than staffing.When to involve ethics committeeSenior–leadership
Conflicting advance directives in recordsA patient's family arrives with a notarized advance directive that contradicts the preferences documented in your hospital's electronic health record. Walk me through your approach.Surrogate decision MakingMid–senior
Consent when patient researched protocolYou're obtaining consent for a clinical trial and the patient asks detailed questions that suggest they may have looked up the protocol online. Walk me through how this changes your consent process.Informed consent processEntry–senior
Fluctuating capacity AMA decisionA patient with fluctuating capacity due to hepatic encephalopathy wants to leave against medical advice during a lucid interval. Walk me through how you assess and document this situation.Capacity vs competenceMid–senior
Informed consent with language barriersWalk me through how you'd handle informed consent for an emergency procedure when the patient speaks limited English and no professional interpreter is immediately available.Informed consent processEntry–mid
Co-signing note without documented consentA colleague asks you to co-sign a procedure note because they forgot to document informed consent before an urgent intervention. Walk me through your response.DocumentationMid–leadership
Capacity assessment with suspected coercionWalk me through how you'd approach capacity assessment for a Jehovah's Witness patient refusing blood transfusion when the team suspects coercion from family members.Capacity vs competenceMid–senior
Proxy decision with threatened litigationA patient's healthcare proxy is making decisions consistent with the advance directive, but the patient's sibling threatens legal action. Walk me through how you'd handle this.Surrogate decision MakingSenior–leadership
Documenting refusal of recommended treatmentWalk me through what you document when a patient with capacity refuses a recommended treatment and you're concerned this could lead to significant harm.DocumentationEntry–mid
Minor seeking confidential reproductive careA minor patient is requesting confidential reproductive healthcare in a state where parental notification laws recently changed. Walk me through your approach.Informed consent processMid–senior
Escalating futile life support decisionsWalk me through how you'd decide whether to escalate to the ethics committee when a patient's family is requesting continued life support that the clinical team believes is futile.When to involve ethics committeeMid–leadership
Patient requests undocumented concernsA patient tells you they understand the risks of surgery but asks you not to document certain concerns they've shared because of insurance worries. Walk me through your response.DocumentationEntry–senior
Capacity assessment in severe depressionWalk me through how you assess decision-making capacity in a patient with severe depression who is refusing a potentially life-saving medical intervention unrelated to their psychiatric condition.Capacity vs competenceMid–senior
Co-decision-makers with one unreachableA patient's spouse and adult child are both listed as co-decision-makers in the advance directive, but one is present and the other is unreachable. Walk me through your approach to urgent decisions.Surrogate decision MakingMid–senior
Consent disclosure of below-average outcomesWalk me through how you'd structure the informed consent conversation for a procedure where your personal success rate is below the institutional average.Informed consent processSenior–leadership
Passive agreement without deliberationA patient with borderline capacity is agreeing to everything you suggest without asking questions or deliberating. Walk me through how you'd assess whether this constitutes valid consent.Capacity vs competenceEntry–mid
Litigation threat escalation pathWalk me through when you'd involve the ethics committee versus risk management versus legal counsel when a family is threatening litigation over ongoing care decisions.When to involve ethics committeeSenior–leadership
Patient alleging inadequate informed consentA patient underwent a procedure and is now alleging they weren't informed of a complication that is documented in the signed consent form. Walk me through your next steps.DocumentationMid–leadership
Guardian conflicts with prior wishesWalk me through how you'd handle a situation where a guardian appointed by the court is making healthcare decisions that conflict with what the patient expressed before losing capacity.Surrogate decision MakingSenior–leadership
Consent for medical education participationA patient is consenting to participate in a medical education session with trainees. Walk me through what elements are legally and ethically required in this consent process.Informed consent processEntry–mid
Capacity refusal driven by delusionsWalk me through your approach when a patient with schizophrenia refuses antipsychotic medication but appears to have capacity to refuse, yet the refusal seems driven by delusional thinking.Capacity vs competenceSenior–leadership
Outdated proxy with incapacitated patientA patient's durable power of attorney for healthcare was executed ten years ago and names someone the patient now says they distrust. The patient lacks capacity to execute a new document. Walk me through your approach.Surrogate decision MakingMid–leadership
Disagreeing on capacity assessmentWalk me through what triggers your decision to seek ethics consultation when you disagree with a senior colleague's assessment of a patient's decision-making capacity.When to involve ethics committeeMid–senior
Incomplete understanding pre-operativelyA patient agreed to a procedure, but during your final pre-operative check they mention a concern that suggests incomplete understanding of a key risk. Walk me through your response.Informed consent processEntry–mid
Documenting uncertain but capableWalk me through how you'd document a capacity evaluation when you conclude the patient has capacity but you're uncertain the outcome is in their best interest.DocumentationMid–senior
Emancipated minor with insistent parentsA teenage patient has legal capacity to consent in your jurisdiction but their parents are insisting on being present for all consent discussions. Walk me through how you'd handle this.Informed consent processMid–senior