Bioethics
Bioethics questions are almost guaranteed to appear in your medical school interview. These questions mainly revolve around the four pillars of medical ethics, it is very important you familiarise yourself with the four pillars before practising. A good rule of thumb for answering ethics question is give an answer that most people would agree upon. Bioethics question is all about controversies and the right answer to controversies is the one that the majority stands by.
Blend in, there is no need to stand out
Give the most appropriate answer
Understand the four pillars of medical ethics well
What are the four pillars of medical ethics? What does each of them mean?
There is no excuse for not knowing the answer to this question. The entire sector of bioethics revolves around these four pillars, you should know them like the back of your hand.
Beneficence: Doing good
Non-Maleficence: Do no harm to patients
Autonomy: Giving patients freedom to make informed decision and decide what they want
Justice: Ensuring fairness
Apart from the four pillars of medical ethics, can you name another pillar that is equally as important?
Confidentiality. This is another very important pillar in medical ethics. You should first name this pillar, follow by description what this pillar means, finally ending with explaining why this pillar is extremely important. Confidentiality is protecting the information that patients provide to you. This includes not disclosing it to anyone without the patient's consent, including their family members. This is important not only because patients have the right to privacy, also because there is a trust built between patients and doctors. This trust is what allows the patient to freely tell you everything they know, allowing you to make the most accurate diagnosis possible. Breaking this trust by violating his or her privacy may prevent them from withholding crucial information in the future (Such as having taken drugs or carrying some underlying disease), hindering your diagnosis.
Under what circumstances can patient confidentiality be breached?
You should be cautious when answering this question. It is best to start of by highlighting the importance of patient confidentiality, maintaining that it should not be breached under most circumstances. You can then move on to discuss possible scenarios that you might consider breaching confidentiality. This includes carrying a highly contagious airborne disease and refusing to go into quarantine when it is required by authorities, being psychologically unstable with risk of harming those around them etc. In general, if the patient is likely to cause harm to those around them, you may have to consider breaching patient's confidentiality in order to protect others.
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What would you do if a patient request euthanasia?
You should first note that euthanasia or physician-assisted suicide is completely illegal in Hong Kong and cannot be performed under any circumstances. You should therefore reject the request and to honest to your patient about such laws. However, do note the difference between euthanasia and DNR (Do not resuscitate). DNR are patient requesting that they are not to be saved even if it is possible when they are in critical condition, this is different from euthanasia which involves actively administering a lethal dose to a patient. DNR are completely legal and you are, in fact, required to follow a DNR to respect a patient's autonomy.
Do you support a vaccine passport? What pillars of medical ethics will you consider?
To start off, you should discuss what exactly is a vaccine passport. A vaccine passport is a policy that requires you to be fully vaccinated in order to leave or enter a certain country. Take covid-19 for example, many countries requires you to be vaccinated with covid-19 vaccines before being allowed to enter the country. Pillars supporting this policy includes "Beneficence" to protect the people in your country, while pillar against includes people should have the "Autonomy" to choose if they want to be vaccinated and "Justice" if some countries do not offer free vaccination and the person in question cannot afford it. Make sure to give detailed explanation as to why the pillars of medical ethics led you to come to your conclusion of for or against the argument. You should also acknowledge that there are reason for the other side of the argument as well and refrain from being too "harsh" on the other side. Afterall, this is a controversial topic and you do not know what your interviewers may support.
Do you agree with physician-assisted suicide?
This question may sound similar to that mentioned above, however, note that this question is asking whether you SUPPORT euthanasia, not asking whether you would perform it. This is an open-ended question. You are welcome to asking either side of the argument. It is best to mention both sides of the argument then give reasons according to the pillars of medical ethics why you think your reason trumps that of your proponents. Reasons for supporting euthanasia includes "Autonomy" and "Beneficence", while reasons against it includes "Non-maleficence".
Do you support abortion?
You should start off by mentioning that this is a highly debated topic and there are valid reasons for both sides of the argument. You should then give one reason against your stance and one to two reason(s) for your stance. Finally, you should summarize by saying why you believe you reason outweighs that of the proponent's according to the pillars of medical ethics. Reasons for supporting abortion includes respecting the autonomy of the mother and "Beneficence" to the mother while reasons for not support include "Non-maleficence" not wanting to harm a life.
However, It is also important to mention that there are situations where abortion may be necessary due to potential dangers to the mother's life or severe fetal abnormalities. In cases where continuing the pregnancy poses a significant risk to the mother's health or life, an abortion to protect the mother's well-being. Similarly, if a fetus is diagnosed with severe genetic disorders or abnormalities that would significantly impact their quality of life, or that they will die within days or weeks upon birth, abortion may also have to be performed. In these scenarios, you are required support abortion as it is just the right thing to do, adhering to both Beneficence and Non-maleficence.
Should public hospitals fund the treatment for smokers?
You may be tempted to say no, however keep in mind the "Justice" pillar in medical ethics. Justice demands fairness for all people, disregarding their age, habits or any other factors you may be tempted to consider. In fact, this is not an open-ended the question, you are required to support the question and provide reasons as to your "decision". First, as mentioned above, Justice means that all patients should be treated equally and receive required medical attention. Moreover, if you do not support the funding of treatment for smokers, where would you draw the line? Would you reject surgery to a patient who broke his leg in a football match? Football are very prone to bone injury yet people still play it knowing the risk, sounds similar to smoking right? In reality you cannot draw the line as to what kind of treatment a public hospital should fund, it should a relief that "Justice" is a medical ethics pillar to save us the trouble of an unsolvable dilemma.
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