Trusted UCAT prep.

Sample MMI medical interview question: an ethical dilemma.


Does patient confidentiality always prevail?


You have been working at Pinehills Prison and Corrections Centre as the in-house physician for approximately six months. Being a physician in a prison has required you to slowly build a sense of trust with the inmates (many of whom suffer from serious psychological illness) over a long period of time. The process has been arduous and often emotionally draining, but you finally feel like you are building a positive rapport with the some of the inmates and have seen a steady improvement in both their physical and mental health as a result of your ongoing appointments.

During your most recent routine visit you notice that one of your patients, Allen, has drugs on his person as well as a knife and other contraband. Possession of contraband in prison is illegal yet, the drugs and contraband pose no direct threat to the other prisoners or prison staff. However, the knife, in conjunction with the aggressive mindset of your patient, poses a very real threat, if not probable risk, to other individuals in the prison. You know that reporting Allen for all of this contraband will almost certainly destroy the trust that he has learned to place in your medical expertise and also runs the risks of generating and spreading distrust towards you among other inmates. 

Do you report the drugs, knife and other contraband or should patient confidentiality prevail ?

A suggested answer will be posted later this week by MedEntry. Want to have your own say? Get involved in our discussion and comment on our MedEntry facebook page or MedEntry LMS forum. 


Sample answer to MMI medical interview question: an ethical dilemma.

Patient confidentiality 

A predetermined covenant of confidentiality characterizes the physician-patient relationship. Professional communications between physicians and patients are statutorily protected as confidential. A routine physical examination is part of the confidential communication, like information obtained by taking a medical history and data entered in the patient’s health record. Health professionals have an interest in maintaining confidentiality so that patients will feel comfortable in revealing personal but necessary information. Prisoners do not possess full constitutional rights to privacy, but they generally retain rights to privacy when there is a special relationship between communicants, such as the physician-patient relationship. In fact, respect for confidentiality is particularly important in a prison hospital setting, in which patients feel distrust because physicians are often employed by the incarcerating institution.

Clinical autonomy

Clinical autonomy for health professionals in the prison setting is essential for good medical practice. Physicians working in prisons also retain the privilege of confidential interactions with patients, although the prison authorities may try to pressure doctors to supply information. Even if physicians are employed by the prison, their first responsibility is to their patients. The circumstances in which to give privileged information to prison authorities remains the physician’s decision.

Possession of illegal goods vs. patient confidentiality 

The finding that contraband detected during an examination has the appearance of drugs and paraphernalia, like all results of the examination, is privileged information to be treated confidentially. The right to privacy supersedes a duty to report the discovery because there is no imminent threat to others. In contrast, the weapon harbored by the prisoner represents an imminent threat to other prisoners and to prison staff. Thus, upon discovering a sequestered weapon during the course of a routine examination, the physician has a ‘duty to warn’. According to case law, when the physician believes that a significant threat of harm exists, the duty to warn takes precedence over the patient’s right to privacy.
The case of prisoner Allen raises the issue of the point at which to draw the line between the duty to protect the public and the duty to protect patients’ privacy. Although legal guidelines can assist the physician in making the choice, the health professional must rely on a guiding principle of the medical profession: Where no danger to others exists, patients come first.
The possibility of discovering contraband during routine examinations of prisoner patients reinforces the need for informed consent at several stages. First, prisoner patients should be evaluated and treated only after they provide informed consent, unless they are incompetent. Before an X-ray is taken, they should be informed that it can demonstrate metal and other foreign bodies, and their agreement to the procedure should be obtained. Second, if a concealed weapon is discovered during a routine examination, the prisoner patient should be informed that the discovery will be reported and given the opportunity to surrender the weapon to authorities before more forcible means are taken to remove it. If Prisoner A is harboring drugs and a needle, drug use is quite possibly contributing to A’s health problem. It is the physician’s responsibility to educate A about the potential harm of drug use.
Thus, the ideal solution would be to deal with the knife separately from the drugs and other contraband.


C. Levine, Cases in Bioethics.


Re-sitting UCAT
NOT ALL ENTRY TESTS EQUAL, Medical Observer (16 Fe...

By accepting you will be accessing a service provided by a third-party external to

Receive the latest UCAT news and tips in your inbox

Sign up for the MedEntry Newsletter

UCAT Memes Charity Partner ucat guessing Psychometric tests Provisional Entry UCAT Abstract Reasoning UCAT tips UCAT Registration UCAT Preparation Courses mmi scoring MedEntry LMS Update English LMS Forums Year 12 UCAT Applications TAC Application UCAT workshop UCAT Tips Rural Students UCAT Forums Coronavirus OLP Updates UCAT Tutor UCAT Anxiety Medicine at UNSW UCAT VR Video Blog UCAT Exam UCAT Test UCAT Free Trial Medical Entrance Graduate entry medicine UCAT speed reading COVID-19 University fees UCAT Video Guides ucat secrets Situational Judgement Test First year of Medicine medical entry Sample Interview Questions UCAT Registrations Multistation Mini Interviews 2020 UCAT Registrations Probability MedEntry UCAT 2020 Tips LMS Updates ucat Decision making UCAT Trainer UCAT Date Time Management UCAT Books UCAT Practice UCAT Test Venue UCAT 2021 UCAT 2019 UCAT 2020 UNSW Bond University Medicine MedEntry Community Page UCAT Training UCAT weekly classes ucat mindet UCAT exam News Multiple Choice UCAT 2020 Registrations mmi ethical dilemma ucat mindset Medical Interview MedEntry Calculator University Entrance UCAT Advice ucat motivation UCAT Booking UCAT Skill Trainers Work Experience AR Trainer UCAT Key Dates UCAT Results Medical Interview Training UCAT Scores UCAT Practice Test Free UCAT Practice Exam mmi sample question UCAT Timing Resilience UCAT Prep UCAT Preparation Process of Elimination Careers Teachers Percentage questions Interview Bond Psychometric tests Studying Medicine Distributed Practice Medicine at Sydney University Medicine Medicine at Melbourne Medicine preferencing Active learning UCATSEN MedEntry Free Trial Medicine Application advice Pearson VUE UCAT Venue ucat tuition UCAT advice ucat tutoring Bonded Medical Program HPAT Preparation Charity UCAT Health USyd Future UCAT Students UCAT Exam Tips UCAT Study Which Uni? UCAT Test Date HPAT Ethical Dilemma Questions UCAT Test Tips UCAT App Medicine at Monash UCAT Course Study Tips mmi sample answer Free UCAT Prep Counting Problems UCAT Experience MMI UCAT Stress Sample MMI Venn Diagrams UCAT Situational Judgement Test MedEntry Skills Trainer University Rankings Interview Questions UCAT Question Bank Discrimination Forums GAMSAT UCAT Noteboard UCAT Coaching UCAT Calculator Speed Reading in UCAT LMS Update

trhdtre tre