Medical Ethics Interview Questions

Ethical considerations are a vital part of medicine. These are dilemmas that every medical professional will face in their career. Understanding and grappling with these ethical dilemmas are not only crucial for practicing physicians but also for aspiring medical professionals entering the field. Therefore, medical schools will test candidates on their knowledge of the basic ethical principles. You may also be asked what is the most appropriate action in certain situations. Let’s delve into some common medical ethics interview questions and explore how to approach them thoughtfully.

Scenario-based Questions

Example

You are a junior doctor in A&E when a patient becomes unresponsive. You read in their notes that they have a DNACPR in place. Their family however are asking you to continue to do chest compressions. What would you do in this scenario?

Approach

In any scenario question, begin by defining the topic. DNACPR (Do not attempt cardiopulmonary resuscitation) is a form the patient signs that in case they have a cardiac arrest or die suddenly, then healthcare professionals must not perform CPR. However, it isn’t legally binding so it can be overridden if appropriate.

The ethical pillars of autonomy, beneficence, non-maleficence and justice can be considered.

• Autonomy – the patient has chosen to sign the DNACPR which is their choice and as a doctor, you must respect
• Beneficence – in most cases, the patient has very little chance of surviving even with DNACPR so you must assess what is in the patient’s best interests
• Non-maleficence – performing CPR can break ribs and may not treat the patient so this does have its harms
• Justice – putting the patient on life support after CPR can consume resources that aren’t of benefit. This may mean compromising the health of other patients who may benefit from this.

To conclude, end your answer by giving your final opinion on what you would do.

Informed Consent

Example

What does informed consent mean to you?

Approach

There are 3 Cs of medical ethics: consent, competence and confidentiality. Informed consent must be gained from the patient before any procedure or treatment. The word “informed” means the patient must be aware of the treatment, side effects and reasons behind it. The word “consent” means they must agree to it, willingly, without any coercion. Consent can be given by nodding, orally or written.

Resource Allocation

Example

Two patients require an organ transplant. However, you only have the resources for one organ transplant. Patient A is 60-year-old woman who is a widow, has children aged 40 and 35 and has been a smoker. Patient B is a 25-year-old woman with a husband and 2 year old son. Which patient would you allocate the organ to and why?

Approach

In these type of dilemmas, the interviewer expects you to weight out the factors and make an informed decision. No answer is incorrect as long as you have your reasoning. You should compare factors such as:

• Age
• QALYs – Quality Adjusted Life Years which means how many years the patient’s life can be extended by.
• Dependants – the family members reliant on the patient such as children.
• Lifestyle factors – make sure to never hold lifestyle factors like smoking against the patient. You have to respect the patient’s choices and be empathetic towards to them.

Professional Integrity and Conflicts of Interest

Example

What would you if you your friend, who is also a medical student, asks you to sign in for a mandatory lecture?

Approach

This is a classic scenario to test your professionalism and integrity. Professionalism is a major quality that the GMC requires all medical students and healthcare professionals to embody. In this situation, you will need to act with integrity but also display empathy.

Make it clear in your answer that you would NOT sign in for your friend. However, make sure to not turn down your friend in a disrespectful way. Instead, you should ask your friend the reason behind their absence and check if they are struggling. Advise them to speak with the coordinator or pastoral support if needed.

It is also a boost if you speak about the importance of professionalism in medical school. It means to be honest, respectful and responsible at all times.

Cultural Competence and Diversity

Example

Dr X has a patient who is requesting a procedure. Dr X is of catholic belief and does not agree with this practice. How should Dr X respond to this patient?

Approach

Healthcare providers may need to navigate situations where their own cultural beliefs conflict with the patient’s beliefs or vice-versa. As a medical professional, you need to be respectful of the patient’s beliefs if they are autonomous. You must not let your personal beliefs come in the way.

In this situation, Dr X should behave in the patient’s best interests and see whether the procedure is appropriate for the patient. Therefore, the medical need will override cultural beliefs.

End-of-Life Care

Example

As a consultant, how would you approach end-of-life care whilst also respecting the patient’s dignity and their family’s wishes?

Approach

End-of-life care is a medical branch that faces ethical dilemmas quite often. It is vital for you to be compassionate to the patient and their family’s emotions whilst also acting in the patient’s best interests. So what is end-of-life care?

End-of-life care is when the patient is suffering from an incurable disease and has limited time left. Families are often torn between the decision to continue life support or to withdraw it. As a medical professional, you need to consider both sides of the coin.

Firstly, consider wishes of the patient (if the patient has the capacity to make their own autonomous decisions). If not, then you need to discuss it with whoever has their medical power of Attorney. This decision must be made by effectively communicating with their family members. According to the ethical pillars, removing life support may relieve their suffering which would be most beneficial. It would also align with the pillar of justice as it enables a fair distribution of resources.

Lastly, provide your own opinion on what you would do. Remember to always leave your opinion till the end.

Abortion

Example

Do you think abortion should be allowed?

Approach

This is a typical example of a disguised medical ethics question. Interviewers may not ask you directly to explore the ethical considerations of abortion but you need to be aware of this. In this type of opinion-based question, we recommend the diamond approach. This is where you structure the answer in 4 parts:

• Introduce the topic = give the definition of abortion

• Explore the pros = 2 arguments for abortion
• Explore the cons = 2 arguments against abortion
• Give your opinion = conclude your answer

Example Answer:

Abortion is the termination of pregnancy before 24 weeks.

The positives and negatives of abortion must be considered for me to make a decision. One argument for abortion is that if it is the woman’s choice to abort, then we must respect the patient’s autonomy. Autonomy is the ethical pillar that every competent patient has the right to their medical decisions. Another argument for abortion is that an abortion may prevent any health risks for the mother. Therefore, as a medical professional, we need to always act for the benefit of our patients. Beneficence is another ethical pillar which means to “do good.”

On the other hand, an abortion may be immoral because it is putting an end to a potential life. This may be going against the ethical pillar of non-maleficence which means to “do no harm.” An abortion may also cause psychological distress for the mother.

In conclusion, I believe abortion should be allowed as it promotes patient autonomy and is in the best interests of the patient.

Euthanasia

Example

Can you explore the ethical considerations of euthanasia?

Approach

This question also includes a very similar approach to the question regarding abortion. You need to be aware of the definition of euthanasia: killing of a patient suffering from an incurable disease.

Your answer must include at least 2 key points for both sides of the argument.

Arguments for euthanasia:

• Patient autonomy must be respected – they have a right to their own life
• Beneficence – killing them will put an end to their suffering
• Justice – patients on life support may be considered as a “burden on the health care system” as it could be used on patients with curable conditions

Arguments against euthanasia:

• Religious beliefs
• A medical professional’s duty is to preserve life

Always remember to conclude your answer by giving your opinion (if asked in the question).

Patient Confidentiality

Example

A patient needs to avoid sexual contact for a period of time post-treatment and inform their previous sexual partners. However, they do not feel comfortable in discussing this diagnosis with their partners. As a physician and considering the principles of medical ethics, what would you do?

Approach

Confidentiality is one of the 3Cs of medical ethics (consent, confidentiality, competence). It means withholding any information about the patient from anyone except the patient and their medical team. This is vital as it maintains the patient’s trust in the medical professional. In most situations, it must not be breached. However, there are exceptions.

Confidentiality can be broken if:

• the patient is at risk to themself
• the patient is at risk to another person
• it is a risk to the wider public
• it is required by law

In this case, if the patient does not inform their sexual partners, then it poses a risk to the partners. So you should strongly advise them to tell their partners. Otherwise, confidentiality will need to be breached. Also, confidentiality must be broken appropriately so you must only tell the people who need to know.

Medical School Interview Tuition

Interviews are one of the most important parts of medical school applications. For most medical schools, your interview performance will be the sole decider of whether you receive an offer or not. Having said that, ethics are part of most interviews whether it is an MMI station or in a panel interview. We recommend booking in with a medicine interview tutor to get the most realistic preparation for interviews. An interview tutor will expose you to more ethical dilemmas and give personalized teaching and feedback on the questions. This will help you to gain interview confidence and the knowledge you need to stand out. Once you feel prepared, we also advise you to practice your answers in a mock MMI circuit.