ABOG Professional Ethics & Standards 2 — Questions and Answers
Question 1: A patient with a life-threatening ectopic pregnancy refuses blood transfusion due to religious beliefs. She is conscious and competent. What is the most ethical course of action?
- Proceed with transfusion to save her life
- Respect her refusal and use blood-sparing techniques while treating the ectopic pregnancy (Correct answer)
- Obtain a court order to override her refusal
- Delay treatment until she changes her mind
Correct answer: Respect her refusal and use blood-sparing techniques while treating the ectopic pregnancy
A competent adult has the right to refuse any medical treatment, including blood transfusion, even if refusal may result in death.
Question 2: An OB/GYN discovers that a colleague has been sexually harassing residents. What is the most appropriate first step?
- Ignore the situation to avoid conflict
- Confront the colleague privately and warn them to stop
- Report the behavior to the department chair or appropriate institutional authority (Correct answer)
- Advise the residents to document and handle it themselves
Correct answer: Report the behavior to the department chair or appropriate institutional authority
Physicians have a professional obligation to report colleague misconduct that harms trainees or patients to appropriate institutional authorities.
Question 3: Which principle of bioethics requires a physician to act in the patient's best medical interest?
- Autonomy
- Justice
- Beneficence (Correct answer)
- Non-maleficence
Correct answer: Beneficence
Beneficence is the ethical principle that obligates physicians to act in ways that promote the well-being and best interests of the patient.
Question 4: A gynecologist is asked to perform a sterilization procedure on a 22-year-old nulliparous woman who has no medical indication. She is fully informed and insistent. What should the physician do?
- Refuse on the grounds that she is too young and may regret it
- Perform the procedure only if she has a partner's consent
- Counsel her thoroughly about permanence and alternatives, then respect her autonomous decision (Correct answer)
- Require a psychiatric evaluation before proceeding
Correct answer: Counsel her thoroughly about permanence and alternatives, then respect her autonomous decision
After thorough counseling about permanence and available alternatives, a competent adult's autonomous decision for sterilization must be respected.
Question 5: What does the ACOG concept of 'conscientious objection' require of an OB/GYN who declines to perform an abortion due to personal beliefs?
- No obligation beyond declining the procedure
- Referral to another provider who can offer the requested service (Correct answer)
- Disclosure of objection only after the patient has been accepted as a patient
- Permanent refusal to discuss abortion as a reproductive option
Correct answer: Referral to another provider who can offer the requested service
ACOG guidelines state that physicians who conscientiously object to a procedure must refer patients to a willing and able provider in a timely manner.
Question 6: An OB/GYN receives a gift worth $500 from a pharmaceutical representative. According to professional ethics guidelines, what should the physician do?
- Accept it as a token of appreciation for prescribing their products
- Accept it only if it benefits patients directly
- Decline the gift to avoid conflicts of interest (Correct answer)
- Accept it and disclose it to patients when prescribing that company's medications
Correct answer: Decline the gift to avoid conflicts of interest
Professional ethics guidelines prohibit accepting gifts from pharmaceutical companies as they create conflicts of interest that may compromise prescribing decisions.
Question 7: A pregnant patient discloses domestic violence to her OB/GYN. The physician is ethically obligated to:
- Report immediately to law enforcement without patient consent
- Document the disclosure and provide information about resources and safety planning (Correct answer)
- Contact the patient's partner for counseling
- Refer the patient to psychiatry and take no further action
Correct answer: Document the disclosure and provide information about resources and safety planning
ACOG recommends documenting the disclosure, screening sensitively, and providing information about community resources and safety planning while respecting patient autonomy.
ABOG Professional Ethics & Standards 2
A patient with a life-threatening ectopic pregnancy refuses blood transfusion due to religious beliefs.
She is conscious and competent.
What is the most ethical course of action?