FM10.{1-6,16-17,20,22-24,28} | Medical Ethics & Professional Conduct — Practice Quiz

Correct. The four principles (Beauchamp and Childress, 'Principles of Biomedical Ethics', 1979): Autonomy, Beneficence, Non-maleficence, Justice. These are popularly called 'principlism' and underpin modern medical ethics globally.

Remember: ABCJ (Autonomy, Beneficence, Non-maleficence = 'do no harm', Justice). These arose from the Belmont Report (1979) but were systematised by Beauchamp & Childress — distinguish the two sources.

The four Beauchamp & Childress principles: Autonomy, Beneficence, Non-maleficence, Justice. 'Veracity' and 'fidelity' are sometimes listed as sub-principles — they are NOT part of the core four.

Correct. The National Medical Commission Act 2020 dissolved the Medical Council of India and created the NMC as the apex body for medical education and practice regulation in India.

NMC Act 2020: dissolved MCI, created NMC with 4 autonomous boards — UGMEB, PGMEB, MEAB, and Ethics and Medical Registration Board (EMRB). The EMRB handles professional misconduct.

The NMC Act 2020 replaced the Indian Medical Council Act 1956. The MCI was dissolved. Remember: NMC = 2020 (NOT 1956).

Correct. The MCI (now NMC) Regulations 2002 (Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations) constitute the binding code of ethics for all registered medical practitioners in India.

MCI (Professional Conduct, Etiquette and Ethics) Regulations 2002 — still operative under NMC. Key sections: duties to patients, registered practitioners, society. EMRB of NMC now enforces.

The binding code of medical ethics in India is the MCI (now NMC) Regulations 2002. IMA has its own guidelines but these are not legally binding.

Correct. In a life-threatening emergency where no other physician is available, an RMP CANNOT refuse to provide at least basic emergency care — this is an absolute ethical and legal duty. The doctor may then refer after stabilisation.

RMP's duty to attend: Cannot refuse a dying patient who has no alternative care. Can refuse: patient already under another RMP's care (routine), patient with whom relationship terminated, outside scope of competence (but must refer).

An RMP may refuse patients in several circumstances, but NEVER when there is a life-threatening emergency with no alternative care available. Emergency stabilisation is the absolute minimum duty.

Correct. The MCI/NMC Regulations explicitly prohibit accepting gifts, cash, hospitality, travel, or other benefits from pharmaceutical companies that may influence prescribing practices. This is classified as professional misconduct.

Professional misconduct under MCI/NMC Regulations 2002: accepting gifts/perks from pharma (specific regulation), adultery with patient, alcohol/drug addiction, unjustified certificate issuance, breach of confidentiality without legal justification.

Accepting pharma gifts/incentives that influence prescribing = professional misconduct under MCI/NMC Regulations. This is the specific provision, not a general ethics principle.

Correct. Therapeutic privilege (exception to informed consent) allows a physician to withhold information from a patient if full disclosure would cause significant psychological harm (e.g., panic leading to refusal of life-saving treatment). It is a limited, controversial exception, not a general right.

Therapeutic privilege requirements: (1) Specific information (not diagnosis in general). (2) Disclosure must cause significant direct harm. (3) Harm must outweigh benefit of disclosure. (4) Document the decision. Modern trend is against broad use.

Therapeutic privilege = limited right to withhold SPECIFIC harmful information — NOT a general licence to bypass consent. It must be used sparingly and documented.

Correct. The World Medical Association adopted the most recent revision of the Declaration of Geneva in October 2017 (Chicago), adding the statement 'I will attend to my own health, well-being, and abilities' — acknowledging physician wellness.

Key medical oaths timeline: Hippocratic Oath (ancient Greece) → Declaration of Geneva 1948 (WMA, modern version, revised 2017) → Declaration of Helsinki (research ethics, 1964) → Belmont Report (1979, research + clinical ethics).

Declaration of Geneva: originally adopted 1948 (as a modern Hippocratic Oath post-Nazi atrocities), revised multiple times. Most recent revision: 2017 (WMA General Assembly, Chicago). NOT 1948.

Correct. Justice in biomedical ethics = fair distribution — equal treatment of equals (formal justice), and equitable distribution of scarce resources (distributive justice). It operates at both the individual patient level and societal/policy level.

Types of justice in healthcare: (1) Distributive (fair allocation of resources). (2) Compensatory (fair remedy for harm). (3) Procedural (fair process for decisions). All fall under the umbrella of the justice principle.

Justice = fair distribution of benefits and burdens. Beneficence = do good. Non-maleficence = do no harm. Autonomy = patient's right to decide.

Correct. The Nuremberg Code (1947) emerged from the Nuremberg Doctors' Trial (1946-47), where 23 Nazi physicians were prosecuted for conducting cruel, non-consensual experiments on concentration camp prisoners. It established the first international code for human research ethics.

Research ethics timeline: Nazi experiments → Nuremberg Code (1947) → Tuskegee (1932-72) → Belmont Report (1979) → Declaration of Helsinki (1964, ongoing revisions). Each represents a major ethical failure that drove regulatory reform.

Nuremberg Code = Nazi physician trial (1947). Tuskegee syphilis study = led to the Belmont Report (1979). Declaration of Helsinki = broader research ethics (1964). Each scandal produced its own ethical code.

Correct. No doctor can or must guarantee a cure. Medical practice involves inherent uncertainties. The doctor's duty is to exercise reasonable care and skill — not to guarantee outcomes. A promise of cure can itself constitute professional misconduct.

Doctrine of informed consent + patient rights: right to information, right to refuse, right to second opinion, right to records, right to dignity and confidentiality. 'Guarantee of cure' is NOT a patient right — promising a cure can be construed as fraud.

Doctors cannot guarantee cures — this is not a patient right and no such obligation exists legally. However, patients DO have rights to information, second opinions, and their medical records.

Correct. Issuing a certificate without adequate examination is specifically listed as professional misconduct in the MCI/NMC Regulations. It is a regulatory offence regardless of whether harm occurred or money was exchanged.

Certificates are legal documents. Issuing a false/unsupported certificate exposes the doctor to: (1) Disciplinary action under NMC Regulations. (2) Civil liability if harm occurs. (3) Criminal prosecution under IPC Section 197 (false certificate).

Issuing a certificate without examination = professional misconduct per MCI Regulations 2002. No need for harm to occur or payment to be made — the act itself is the offence.

Correct. Any doctor wishing to practise medicine in India must be registered with either the National Medical Commission (NMC) or the relevant State Medical Council. Both maintain the National Medical Register.

Post-NMC Act 2020: National Medical Register maintained by NMC. Foreign-trained doctors must pass FMGE (Foreign Medical Graduate Examination) — now transitioning to NExT (National Exit Test) — before registration.

Registration with NMC or State Medical Council is mandatory for practice. IMA membership is voluntary. Foreign medical qualifications require NMC screening examination (FMGE/NExT) before registration.

Correct. 'Primum non nocere' means 'First, do no harm' — attributed to the Hippocratic tradition (though not verbatim in the original Oath). It is the Latin expression of the principle of non-maleficence.

Important Latin maxims in medical ethics: Primum non nocere (do no harm), Salus aegroti suprema lex (patient welfare supreme — paternalistic model), Voluntas aegroti suprema lex (patient will supreme — autonomy model). Modern ethics favours autonomy over paternalism.

Primum non nocere = first, do no harm. Salus aegroti suprema lex = the health of the patient is the supreme law. Voluntas aegroti suprema lex = the will of the patient is the supreme law (patient autonomy).