MCCQE Part I Ethics Questions: 10 Free Practice MCQs

Ten MCCQE Part I-style ethics questions with the answer and the reasoning behind it. They come from the CA.med bank, which has 50 ethics questions and many more across every topic.

1. 1 / 10

   A 16-year-old patient presents to the emergency department with a broken arm. The patient's parents are not available, and the patient refuses to provide their contact information. The patient is deemed capable of making their own decisions regarding their care.

   What is the most appropriate course of action regarding informed consent for this patient's treatment?

   • A. Obtain consent from the patient themselves
   • B. Obtain consent from the patient's parents as soon as possible
   • C. Delay treatment until the patient's parents are available
   • D. Obtain consent from the hospital's administration
   Show answer

   Answer: A. Obtain consent from the patient themselves

   Why: In Canada, individuals who are deemed capable of making their own decisions regarding their care have the right to provide informed consent. The Canadian Paediatric Society (CPS) recommends that capable minors be involved in decision-making regarding their care. In this scenario, the patient is 16 years old and deemed capable, so their consent should be obtained for treatment.

   • B. The patient is capable of making their own decisions, and their consent should be obtained.
   • C. Delaying treatment could result in harm to the patient, and their capable consent should be obtained.
   • D. The hospital's administration is not responsible for providing informed consent for the patient's treatment.

   Sources: Canadian Paediatric Society (CPS)

2. 2 / 10

   A 40-year-old patient presents to the clinic with a complex medical condition, requiring a multidisciplinary approach to care. The patient's primary care physician refers them to a specialist, who orders a series of tests and procedures. The patient's personal health information is shared among the healthcare team members, including the specialist and other healthcare professionals.

   What is the most appropriate way to share the patient's personal health information among the healthcare team members?

   • A. Share the patient's personal health information only with healthcare team members who have a legitimate need to know.
   • B. Share the patient's personal health information with all healthcare team members, regardless of their role in the patient's care.
   • C. Obtain the patient's consent before sharing their personal health information with any healthcare team members.
   • D. Share the patient's personal health information with the patient's family members or friends.
   Show answer

   Answer: A. Share the patient's personal health information only with healthcare team members who have a legitimate need to know.

   Why: The Canadian Medical Protective Association (CMPA) recommends sharing personal health information only with healthcare team members who have a legitimate need to know. This approach helps to maintain confidentiality and protect the patient's personal health information. The CMPA also provides guidance on obtaining patient consent and sharing personal health information with family members or friends.

   • B. Sharing personal health information with all healthcare team members may not be necessary or appropriate.
   • C. While patient consent is important, it may not be necessary to obtain consent before sharing personal health information with healthcare team members who have a legitimate need to know.
   • D. Sharing personal health information with family members or friends may not be appropriate or necessary.

   Sources: Canadian Medical Protective Association (CMPA)

3. 3 / 10

   A 30-year-old patient presents to the clinic for a routine check-up. The patient is considering starting a new medication for their hypertension, but is unsure about the potential side effects. The healthcare provider explains the benefits and risks of the medication, but does not provide any written information.

   What should the healthcare provider do to ensure the patient provides informed consent?

   • A. Only discuss the benefits of the medication, as the patient may be overwhelmed by too much information.
   • B. Have the patient sign a consent form without fully explaining the medication's benefits and risks.
   • C. Delay discussing the medication's benefits and risks until the patient has started taking it.
   • D. Provide the patient with written information about the medication, including its benefits and risks.
   Show answer

   Answer: D. Provide the patient with written information about the medication, including its benefits and risks.

   Why: The healthcare provider should provide the patient with written information about the medication, including its benefits and risks, to ensure the patient is fully informed and able to provide informed consent. This is in line with the Canadian guidelines on informed consent.

   • A. This option is incorrect, as the patient has the right to be fully informed about the medication, including its potential risks.
   • B. This option is incorrect, as the patient must be fully informed before providing consent.
   • C. This option is incorrect, as the patient must be fully informed before starting the medication.

   Sources: Canadian Guidelines on Informed Consent

4. Like these? CA.med has 1055 more, plus timed mock exams. Free to start: App Store · Google Play

5. 4 / 10

   A 40-year-old patient with a rare genetic disorder is approached by a researcher to participate in a clinical trial for a new treatment. The patient is interested in participating but has concerns about the potential risks and benefits of the treatment.

   What information should the researcher provide to the patient to ensure informed consent?

   • A. Only the potential benefits of the treatment
   • B. The potential risks and benefits of the treatment, as well as alternative treatment options
   • C. The results of previous clinical trials for the treatment
   • D. The cost of the treatment and the patient's insurance coverage after the trial ends
   Show answer

   Answer: B. The potential risks and benefits of the treatment, as well as alternative treatment options

   Why: The researcher must provide the patient with a comprehensive overview of the treatment, including the potential risks and benefits, as well as alternative treatment options. This information will enable the patient to make an informed decision about participating in the clinical trial.

   • A. The researcher must provide the patient with a balanced view of the potential risks and benefits of the treatment.
   • C. While the results of previous clinical trials may be relevant, they are not the only information that the researcher must provide to the patient.
   • D. The cost of the treatment and the patient's insurance coverage are not directly relevant to the patient's decision to participate in the clinical trial.

   Sources: Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans

6. 5 / 10

   A 35-year-old woman is approached by a researcher to participate in a clinical trial for a new medication. The researcher explains the potential benefits and risks of the medication, but the woman is unsure if she wants to participate. She asks the researcher if her personal health information will be kept confidential.

   What is the researcher's obligation regarding the woman's personal health information in the context of the clinical trial?

   • A. Obtain informed consent before enrollment and explain data collection, access, safeguards and confidentiality limits.
   • B. Promise that no study information will ever be shared with the sponsor or regulators, even when the consent form describes access.
   • C. Share identifiable records with other researchers whenever it would be scientifically useful.
   • D. Skip discussion of study risks because she is asking only about confidentiality.
   Show answer

   Answer: A. Obtain informed consent before enrollment and explain data collection, access, safeguards and confidentiality limits.

   Why: Before enrollment, the researcher must obtain free, informed and ongoing consent. The consent discussion should describe the information collected, its uses, who may access it, how it will be protected and any reasonably foreseeable limits to confidentiality. A blanket promise of anonymity is inappropriate if identifiable information will be accessed by the sponsor or regulators.

   • B. Absolute secrecy cannot be promised when the consent documents describe permitted sponsor, REB or regulatory access and applicable disclosure duties.
   • C. Identifiable data cannot be freely shared; any use or disclosure must follow consent, ethics approval and applicable privacy law.
   • D. Consent must cover material study risks and other relevant information, not just privacy concerns.

   Sources: Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans, TCPS 2 (2022), chapters 3, 5 and 11

7. 6 / 10

   A 25-year-old woman is being treated for a mental health condition. She has requested that her healthcare provider keep her personal health information confidential, but her family is asking for updates on her condition.

   What is the healthcare provider's obligation regarding the woman's personal health information?

   • A. Provide the family with an update because relatives are automatically entitled to information about an adult patient's care.
   • B. Share the information with any clinician without regard to the patient's stated confidentiality request.
   • C. Do not disclose the patient's information to family without her consent unless a specific legal authority or exception applies.
   • D. Avoid explaining confidentiality rights because disclosure decisions are entirely the provider's choice.
   Show answer

   Answer: C. Do not disclose the patient's information to family without her consent unless a specific legal authority or exception applies.

   Why: A capable adult controls disclosure of personal health information to family, subject to specific legal exceptions. Since this patient has explicitly requested confidentiality, the provider should not provide family updates without her consent. Explain the limits of confidentiality and any applicable circle-of-care rules to the patient.

   • A. Family relationship alone does not give relatives a general right to receive a capable adult's personal health information.
   • B. Information sharing within the circle of care has legal limits and must respect applicable patient wishes and privacy rules.
   • D. The patient should be told how her information is handled and what choices and legal limits apply.

   Sources: Ontario Personal Health Information Protection Act, 2004, sections 18 and 29

8. 7 / 10

   A 75-year-old man with dementia is admitted with a hip fracture. After a decision-specific capacity assessment, he cannot understand or appreciate the information needed to consent to surgery. He has not appointed an attorney for personal care. The operation can be planned safely after identifying a substitute decision-maker.

   What is the healthcare provider's obligation regarding the man's care and treatment?

   • A. Ask the patient to consent to surgery despite the documented finding that he lacks capacity for this decision.
   • B. Find the highest-ranked available substitute under provincial law and obtain consent based on the patient’s wishes or best interests.
   • C. Choose whichever relative is present, regardless of the statutory hierarchy or the patient's wishes.
   • D. Obtain a court order before providing any treatment to a patient found incapable.
   Show answer

   Answer: B. Find the highest-ranked available substitute under provincial law and obtain consent based on the patient’s wishes or best interests.

   Why: Capacity is specific to the treatment decision and should be assessed before seeking substitute consent. In Ontario, the Health Care Consent Act sets a hierarchy of substitute decision-makers; the highest-ranked available and qualified person decides, following the patient's applicable prior capable wishes or, if none apply, the patient's best interests. A family member's presence alone does not establish authority.

   • A. A patient who is incapable for this treatment cannot provide legally valid consent, although the team should continue to involve him as much as possible.
   • C. A relative is not automatically authorized simply because they are present; the applicable statutory hierarchy determines who may decide.
   • D. A court order is not routinely required when a valid substitute decision-maker can consent under provincial law.

   Sources: Ontario Health Care Consent Act, 1996, sections 10, 20 and 21

9. 8 / 10

   A 64-year-old with a serious and incurable physical illness asks about MAID. She says she understands the process and wants to explore eligibility, but no formal assessments have taken place. What is the physician's obligation?

   What is the healthcare provider's obligation regarding the woman's request for MAID?

   • A. Answer questions, assess the request and safeguards, and refer effectively if unable or unwilling to participate.
   • B. Provide MAID immediately because the patient says the request is voluntary and has already met the criteria.
   • C. Refuse the request and end the therapeutic relationship without arranging follow-up.
   • D. Obtain a court order before any MAID eligibility assessment can occur.
   Show answer

   Answer: A. Answer questions, assess the request and safeguards, and refer effectively if unable or unwilling to participate.

   Why: A request for MAID must be handled under the current federal eligibility criteria and procedural safeguards, which include independent assessment and informed, voluntary consent. A clinician who is unwilling to participate cannot be compelled to provide MAID, but professional standards require an effective referral and continued care unrelated to the request. The old Bill C-14 framework has since been amended.

   • B. A voluntary request alone is insufficient; eligibility, independent assessments and all applicable safeguards must be completed first.
   • C. A clinician may decline to provide MAID, but applicable professional standards require an effective referral and continued unrelated care.
   • D. A court order is not a routine prerequisite; statutory eligibility and safeguard assessments govern the process.

   Sources: Criminal Code, sections 241.1 to 241.4; Health Canada, Model Practice Standard for Medical Assistance in Dying, 2023

10. 9 / 10

    A 60-year-old man with a terminal illness is considering medical assistance in dying. He has been experiencing significant pain and suffering, but his condition is not immediately life-threatening.

    What is the primary consideration for determining the man's eligibility for medical assistance in dying?

    • A. The man's age and diagnosis are the primary considerations.
    • B. The man's capacity to make an informed decision and his suffering are the primary considerations.
    • C. The man's financial situation and social support are the primary considerations.
    • D. The man's prognosis and life expectancy are the primary considerations.
    Show answer

    Answer: B. The man's capacity to make an informed decision and his suffering are the primary considerations.

    Why: The primary consideration for determining the man's eligibility for medical assistance in dying is his capacity to make an informed decision and his suffering, as per Bill C-14. This means that the healthcare provider must assess the man's ability to understand the implications of his decision and ensure that he is experiencing significant pain and suffering.

    • A. Age and diagnosis alone do not grant eligibility for MAID; autonomous decision-making capacity and enduring, intolerable suffering from a grievous, irremediable medical condition are required.
    • C. Financial status and social support are social determinants of care, not legal eligibility criteria for medical assistance in dying under Bill C-14.
    • D. While prognosis is part of assessing a grievous condition, exact life expectancy is not the primary determinant compared to decision-making capacity and intolerable suffering.

    Sources: Bill C-14

11. 10 / 10

    A 75-year-old with advanced cancer is receiving palliative care. The patient agrees that the team may discuss the illness and care plan with their spouse, who says they feel overwhelmed and do not know what to expect. What is the most appropriate initial support?

    What should the physician do first to support the spouse?

    • A. With permission, explain the care plan, answer questions and connect the spouse with caregiver support.
    • B. Refer the spouse directly to a bereavement group without discussing current caregiving needs.
    • C. Arrange psychiatric treatment for the spouse before explaining the care plan.
    • D. Withhold all information from the spouse even though the patient has authorized discussion.
    Show answer

    Answer: A. With permission, explain the care plan, answer questions and connect the spouse with caregiver support.

    Why: Ask the patient what may be shared, then explain the care plan and likely needs in language the spouse can understand. Explore practical concerns and offer palliative care social work, caregiver resources or counselling as appropriate. Bereavement services can be offered when relevant, but do not replace support during caregiving.

    • B. Bereavement support may help later, but the spouse is currently asking for help while the patient is alive and needs immediate information and caregiver support.
    • C. A mental health referral may be useful if distress warrants it, but it does not replace answering the spouse's questions and assessing support needs.
    • D. The patient has permitted this discussion, so a blanket refusal would prevent appropriate family support and communication.

    Sources: Canadian Hospice Palliative Care Association, Model for Palliative Care in Canada, 2019

Exam-style questions written by MedHub for practice. They are not official exam questions.