Ethical questions in medical school interviews are extremely common, but they can all be approached in a fair similar way.
In this guide, I will be talking to you about the way I think you should structure your medical school interview questions when it comes to ethical dilemmas and scenarios.
Written by Rozh Akram
How To Answer Ethical Questions In Medicine Interviews
In case you didn’t know, this is what we refer to when talking about ethics:
Ethics – moral principles that govern a person’s behaviour or the conducting of an activity.
It’s a fact that there are countless different questions you could be asked during your medical school interview in regard to ethics and ethical scenarios. This could be anything from consent to abortion, euthanasia to specific cases like the case of Alife Evans.
Despite all of these potential questions, I feel that there are ways to tackle them in a consistent manner that will always lead to a clear, quality answer.
Explain Your Understanding
With any interview question, apart from the personal questions (Why medicine? Tell me about teamwork? etc), I think it’s a good idea to start off by explaining what you understand about the topic in question. In this case, what do you understand about the ethical dilemma that’s in front of you?
Provide Balanced Arguments
After the baseline of your understanding is established, try to give a balanced argument to both sides of the equation. Most ethical dilemmas are about controversy, and not being black and white, therefore it is imperative that you are able to address both sides of the argument equally and show that you can empathise with both parties in the scenario presented to you.
This is important to do because, in medicine, you will very rarely see anything (or anyone making any decisions) that is a clean cut or is black and white. Rather, everyone will have a very valid point from either side of what they are talking about, and sometimes, it is your job as a doctor to be able to draw the line.
Using your ethical and medical understanding of the scenario is important, as this is where leadership comes in. More interestingly (and trust me you will sound smarter if you use key skills required in the role of a doctor) this is also where teamwork comes as you will not be making any decisions solely on your own, since you never practise medicine in isolation.
Make A Decision
After you give a balanced argument, it is imperative that you are able to sum up your answer and give a definite answer, because the harsh reality of medicine is that you will have to make difficult decisions. You will not be able to please everyone, which is why empathy is so important.
To give a definite answer, for some people, it is good if they have a religious or a strongly moral point of view that they can use to justify their decision and personal view. For most people, it is more a matter of using your previous arguments for both sides, to make a decision and choose one side.
It rarely matters what your decision is, so don’t panic or change your mind if you feel you’ve said the wrong thing. The important thing is that you’ve justified your point clearly and convincingly so that others may understand your reasoning, even if they don’t agree with you. Communication is key!
Additional Advice
➡️ As with every medical school interview, it’s important that you are able to signpost your answer to help the interviewer follow your answer.
➡️ With ethical dilemmas, it’s good to talk about how you’d convey empathy. For example, you could raise your eyebrows and try and speak slowly if there is an actor patient. Or, you could tell the interviewer that you would do that if you had a real-life patient.
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Ethical Principles in Medicine
Now I will be telling you about some things you can use to give a balanced argument. These are all ethical principles that are vital during decision-making processes in medicine, so be sure to remember these after your interviews:
Additional Advice
These are the four pillars that make up any ethical decision making in medicine:
- Beneficence - The idea that your actions should in fact be in favour of benefiting your patients.
- Non-Maleficence - Your actions must not harm your patient and everyone else.
- Autonomy - The patient should have the ultimate decision over their body.
- Justice - You must be fair and think about everything and everyone.
Utilitarianism
The idea that your actions should benefit the greatest number of people.
Mental Capacity
For consent and autonomy to be valid, capacity needs to be present. Capacity is tested under the Mental Capacity Act 2005:
- Everyone is assumed to have capacity unless its proven otherwise.
- A person needs to be able to understand and comprehend the information given to them.
- A person needs to be able to use that information as part of the decision-making.
- A person needs to be able to communicate that decision to us, and every effort must be made to accommodate for this.
In the event that a patient does not have capacity, the decision made on their behalf must be in their best interest.
Gillick Competence
The scale used to test if someone under the age of 16 has capacity to be making decisions for themselves.
Fraser Guidelines
Guidelines used to provide sexual health advice for people under the age of 16 without needed parental consent.
There are plenty more ethical considerations that need to be understood in medicine, but these ones are more likely to come up in interviews due to their less complex nature. You can learn more about these in our Guide to Medical Ethics.
Example Ethical Interview Question
Now it’s time to put this into practice by looking at an example ethical question in the context of a med school interview.
“A 14-year-old girl comes to your clinic requesting contraception. She does not want her parents to know about it. How would you handle this situation?”
Model Ethical Answer
Understanding the Ethical Dilemma
First, I would start by explaining that this scenario presents a common ethical dilemma in medicine, where the patient’s autonomy and right to confidentiality may conflict with the need to protect their welfare and the involvement of their parents.
The dilemma is balancing the young patient’s right to make decisions about her own body and the potential consequences of those decisions, with the responsibility to ensure her safety and well-being.
Balanced Argument
To approach this dilemma, I would consider several ethical principles and guidelines:
- Autonomy: The patient has the right to make decisions about her own health. This is particularly important in sexual health matters, where privacy is a significant concern.
- Beneficence: My actions should benefit the patient. Providing contraception might protect her from the potential risks associated with unprotected sex, such as unwanted pregnancy or sexually transmitted infections.
- Non-Maleficence: I must ensure that my actions do not harm the patient. While respecting her autonomy, I also need to consider the possible risks of her not involving her parents, who might offer support.
- Justice: I need to be fair and consider what is in the best interest of the patient while also considering societal implications, such as the legal requirements around consent and confidentiality for minors.
In addition to these principles, I would consider Gillick Competence to assess whether the 14-year-old has the capacity to make this decision on her own. This involves evaluating whether she understands the implications of her decision and can use the information to make a reasoned choice.
Finally, Fraser Guidelines would guide me in deciding whether to provide contraception without parental consent. According to these guidelines, if she understands the advice, cannot be persuaded to involve her parents, is likely to continue sexual activity with or without contraception, and her health might suffer without it, then it may be appropriate to provide contraception.
Definite Answer
After considering both sides, I would decide that if the patient is deemed Gillick competent and meets the criteria outlined by the Fraser Guidelines, I would provide her with the contraception.
I would document the decision-making process thoroughly, ensure that she understands the importance of safe sexual practices, and encourage her to speak to a trusted adult, even if it’s not her parents. Ultimately, protecting her confidentiality while ensuring her safety would be my priority, as it aligns with the ethical principles and legal guidelines in place.
Of course, every scenario will be different, but this is a highly effective way to approach questions like this in a fair and detailed way. From here, I’d suggest practising this technique with as many unique ethical scenarios as you can find, including the ones available on 6med.co.uk! If you want to learn more about structuring general interview answers, our guide to Medicine Interview Answer Structuring is perfect for you!
If you want to learn more about medicine interviews (including 240 unique interview questions), check out our free interview guides. For more in-depth support, including one-to-one tuition with medicine experts, explore our Interview Tutoring Bundles and Medicine Mastery Bundles today or book a free consultation to speak with our team.
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