AMC MCQ Ethics Questions: 10 Free Practice MCQs
Ten AMC MCQ-style ethics questions with the answer and the reasoning behind it. They come from the AU.med bank, which has 40 ethics questions and many more across every topic.
1 / 10
A 78-year-old man with mild cognitive impairment is admitted with a fractured neck of femur. He can describe his home situation and the proposed operation but becomes confused at night.
Which approach does the Medical Board code of conduct support for decisions about his surgery?
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Answer: C. Reassess capacity and support him to participate in the decision
Why: The code of conduct section on patients who may have additional needs states that a doctor should ensure a patient decision-making capacity is reassessed when indicated, and should encourage supported decision-making so that patients with impaired capacity can participate as far as possible. It also notes that capacity and needs may fluctuate over time. Equating a cognitive diagnosis with incapacity, handing the whole decision to the family, or freezing all care pending a formal assessment all depart from that guidance.
- A. A diagnosis does not determine capacity, and the code requires capacity to be reassessed when indicated, noting that capacity and needs may fluctuate.
- B. The code encourages supported decision-making so the patient can participate as far as possible, rather than excluding him from the process.
- D. Reassessment should occur when indicated, but the code does not require all care to stop pending a formal assessment.
Sources: Medical Board of Australia, Good medical practice: a code of conduct for doctors in Australia (2020)
2 / 10
A 68-year-old man with terminal pancreatic cancer has severe pain. Concern is raised that escalating opioid doses for symptom control might shorten his life.
What position does the RACS position paper take on this issue?
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Answer: B. Relief of symptoms is acceptable but measures intended primarily to end life are not
Why: The RACS position paper states that providing appropriate pain relief to alleviate symptoms in patients facing life-limiting illness is consistent with a principled approach to end of life care, and recognises that palliative care given for the primary purpose of pain relief or symptom relief may occasionally hasten the death of a patient. It then states that RACS does not recognise any circumstances where palliative care may be used for the primary purpose of bringing about or accelerating death. Prohibiting any treatment that might shorten life, capping analgesia, or giving sedation specifically to end life all mistate that position.
- A. RACS recognises that palliative care provided for the primary purpose of pain relief or to alleviate symptoms may occasionally hasten death.
- C. Capping analgesia to protect life does not reflect the RACS position, which supports appropriate pain relief for patients facing life-limiting illness.
- D. RACS states that it recognises no circumstances in which palliative care may be used for the primary purpose of accelerating death.
Sources: Royal Australasian College of Surgeons, End of Life Care (POS-3191, 2024)
3 / 10
A 45-year-old man is brought to the emergency department after a motorcycle crash with an unstable pelvic fracture and deteriorating observations. He is unable to communicate and no family member is present.
According to the RACS position paper, what is the appropriate approach to consent for immediate life-saving surgery?
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Answer: A. Proceed with intervention and document the efforts made to obtain consent
Why: The RACS position paper states that in an emergency where immediate intervention is necessary to preserve life or prevent harm, it may not be possible to provide complete information or obtain written consent. In those circumstances consent should be sought from next of kin, family or those with power of attorney where practicable, and efforts to obtain consent should be documented. Delaying surgery for a tribunal order, asking a nurse to sign as if a substitute decision-maker, or relying on implied consent without any documentation do not meet that position.
- B. Waiting for a guardianship order would risk the patient's life, and the position paper expects intervention first with consent sought where practicable.
- C. A nurse is not a lawful substitute decision-maker, so this would not provide valid authority to proceed.
- D. Treatment may start on that basis, but RACS explicitly requires that efforts to obtain consent are documented.
Sources: Royal Australasian College of Surgeons, Informed consent (2019)
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4 / 10
An 82-year-old woman with widely metastatic cancer and a poor performance status is referred for major palliative resection. The surgical team considers the operation futile.
According to the RACS position paper, what should the team do?
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Answer: C. Provide information about alternative treatment options and support informed choice
Why: The RACS position paper on end of life care states that surgeons exercise professional judgement case by case to decide whether an intervention will improve a patient condition or be of little benefit, and that where they determine a procedure will be futile or of low efficacy, patients should be provided with information about alternative treatment options. Patients, families and carers should be equipped with the information needed to make informed choices. Proceeding solely on family request, refusing without discussion, or silently redirecting the referral do not meet that standard.
- A. Surgeons exercise professional judgement on a case-by-case basis, and family preference alone does not make a futile operation appropriate.
- B. Simply refusing leaves the patient and family without the information they need to make informed choices.
- D. Passing the referral on without explanation does not discharge the responsibility to inform the patient about alternatives.
Sources: Royal Australasian College of Surgeons, End of Life Care (POS-3191, 2024)
5 / 10
A GP receives a Facebook friend request from a 26-year-old male patient whom she has been treating for mild depression and hypertension.
According to the AHPRA medical board guidelines, what is the most appropriate action for the GP?
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Answer: C. Decline the request to maintain professional boundaries and discuss this at the next consultation if needed.
Why: AHPRA's social media guidelines emphasize maintaining clear professional boundaries. Accepting friend requests from current patients on personal social media accounts is a boundary violation that can compromise the therapeutic relationship.
- A. Accepting patient friend requests on personal accounts is a boundary violation.
- B. Transferring care immediately is unnecessary unless a significant boundary breach occurs.
- D. Personal social media should never be used for clinical consultations.
Sources: Medical Board of Australia: Guidelines for Registered Medical Practitioners
6 / 10
A 64-year-old woman with symptomatic gallstones asks her surgeon what will happen if she decides not to have an operation. The surgeon is working through the content of the consent discussion.
Which item does the RACS informed consent position paper list as part of the information that must be discussed?
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Answer: B. The likely consequences and risks of not choosing a diagnostic procedure or treatment
Why: The RACS position paper sets out a content list for the consent discussion, which includes the possible or likely nature of the illness, the proposed investigation and treatment, the expected benefits, common adverse effects and material risks, and the likely consequences and risks of not choosing a procedure or treatment. Restricting the discussion to benefits, quoting an institutional complication rate, or offering a guarantee of outcome are not among the listed elements. The paper is explicit that predicted outcomes and risks cannot be known with absolute certainty.
- A. Concentrating on benefits alone is incomplete, because the position paper lists the expected benefits alongside the possible adverse effects and material risks of the intervention.
- C. Unit audit figures may be useful, but the position paper content list does not require a doctor to quote an annual institutional complication rate.
- D. Complete information on predicted outcomes and risks cannot be determined with absolute certainty, so a guarantee of outcome is not part of a valid consent discussion.
Sources: Royal Australasian College of Surgeons, Informed consent (2019)
7 / 10
A 66-year-old man signs a standard consent form at the pre-admission clinic after being handed a generic information sheet. He later says he did not understand the risks of the planned procedure.
What does the RACS position paper say about a signature on a standard consent form?
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Answer: A. A patient signature alone is not conclusive proof that valid consent has been obtained
Why: The RACS position paper states that a patient signature alone on a consent form is not conclusive proof that valid consent has been obtained. It recommends a signed informed consent document with information specific to the patient that details what was discussed, and warns that standard consent forms and information sheets are best regarded as aids rather than sufficient evidence of consent on their own. Requiring witnesses, accepting a signed form as sufficient, or preferring a verbal process all misstate the RACS advice.
- B. The position paper notes that standard consent forms may not in themselves be enough to provide informed consent, even when properly completed.
- C. The paper does not require witnesses to the signature, and its concern is whether adequate information was given and understood.
- D. RACS recommends written confirmation of consent when practicable, so it does not prefer a purely verbal process.
Sources: Royal Australasian College of Surgeons, Informed consent (2019)
8 / 10
A 38-year-old man asks you to sign a sickness certificate backdating his absence by two weeks, for a period when you did not see him.
What does the Medical Board code of conduct require of a doctor signing a certificate in this situation?
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Answer: D. Decline to certify dates that your own assessment does not support
Why: The code of conduct states that doctors have been given authority to sign documents on the assumption that they will only sign statements they know, or reasonably believe, to be true. It requires being honest and not misleading when writing reports and certificates, signing only documents believed accurate, taking reasonable steps to verify content before signing, and not deliberately omitting relevant information. Signing as a favour, using a disclaimer about patient-reported dates, or refusing without explanation do not meet those obligations.
- A. The code requires doctors to be honest and not misleading when writing certificates and to sign only documents they believe to be accurate.
- B. A clarifying note does not cure a certificate the doctor does not believe to be accurate, and the code also requires reasonable steps to verify the content.
- C. A refusal without explanation does not address the underlying need, and doctors are expected to complete agreed documents within a reasonable and justifiable timeframe.
Sources: Medical Board of Australia, Good medical practice: a code of conduct for doctors in Australia (2020)
9 / 10
A 45-year-old man has repeatedly behaved aggressively towards your reception staff. You decide that you can no longer provide his care.
What does the Medical Board code of conduct require when ending a professional relationship with a patient?
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Answer: C. Inform him of the decision and help arrange continuing care
Why: The code of conduct recognises that in some circumstances the relationship between a doctor and patient may break down or become compromised, and that the doctor may need to end it. Good medical practice then involves ensuring the patient is adequately informed of the decision and facilitating arrangements for the continuing care of the patient, including passing on relevant clinical information. A same-day text, silent withdrawal, or keeping the patient nominally enrolled while refusing appointments do not satisfy those requirements.
- A. The code requires the patient to be adequately informed and arrangements made for continuing care, which a brief message on the day is unlikely to achieve.
- B. Ceasing care without explanation does not meet the code, which requires the patient to be adequately informed of the decision.
- D. Nominal retention without access to care is not a genuine arrangement for continuing care as described in the code.
Sources: Medical Board of Australia, Good medical practice: a code of conduct for doctors in Australia (2020)
10 / 10
A 79-year-old man with advanced heart failure and a recent decline in function is being cared for at home. His daughter asks what is meant by approaching the end of life.
How does the RACS position paper define approaching the end of life?
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Answer: E. When the patient is likely to die within the next 12 months
Why: The RACS position paper on end of life care states that people are approaching the end of life when they are likely to die within the next 12 months. It adds that end of life care is commonly associated with chronic and progressive decline in health and function with older age rather than sudden death, and includes physical, spiritual and psychosocial care as well as support for families and care of the body after death. A cancer diagnosis, an hours-long prognosis, cessation of curative treatment, or a request for palliative care do not match that definition.
- A. The definition rests on prognosis rather than a specific diagnosis, and end of life care commonly relates to chronic progressive decline in older age.
- B. The time frame given in the position paper is much longer, and care of the patient body after death is described separately.
- C. The position paper does not link the definition to a decision to stop curative treatment.
- D. A request for palliative care is a separate matter, and it is not the criterion used in the definition.
Sources: Royal Australasian College of Surgeons, End of Life Care (POS-3191, 2024)
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Exam-style questions written by MedHub for practice. They are not official exam questions.