ABPS Ethics & Professional Standards in Plastic Surgery 3 — Questions and Answers
Question 1: A patient consents to an abdominoplasty and, during surgery, the surgeon decides to also perform liposuction of the flanks without prior discussion. This represents a violation of:
- Beneficence only
- Informed consent and patient autonomy (Correct answer)
- The principle of nonmaleficence only
- Institutional credentialing standards
Correct answer: Informed consent and patient autonomy
Performing an undisclosed additional procedure violates informed consent because the patient had no opportunity to accept or refuse the flank liposuction.
Question 2: Which element is NOT required for a legally and ethically valid informed consent in plastic surgery?
- Description of the proposed procedure
- Patient's guarantee of a satisfactory result (Correct answer)
- Discussion of material risks and alternatives
- Confirmation that the patient understands the information
Correct answer: Patient's guarantee of a satisfactory result
Surgeons cannot ethically or legally guarantee outcomes; valid consent requires disclosure and comprehension, not outcome promises.
Question 3: A patient from another country presents requesting a procedure that is legal in their home country but not FDA-approved in the United States. The ethical standard requires the surgeon to:
- Perform it if the patient provides written acknowledgment of the regulatory difference
- Adhere to U.S. standards of care and FDA regulations regardless of the patient's origin (Correct answer)
- Defer to the patient's cultural norms as an expression of patient autonomy
- Perform it only if the procedure has been approved elsewhere by a recognized authority
Correct answer: Adhere to U.S. standards of care and FDA regulations regardless of the patient's origin
Surgeons practicing in the United States must follow FDA regulations and U.S. standards of care for all patients regardless of their country of origin.
Question 4: Regarding social media use, ABPS ethical standards require plastic surgeons to:
- Avoid all social media to prevent HIPAA violations
- Never respond to patient questions online under any circumstances
- Maintain patient confidentiality and avoid misleading promotional content (Correct answer)
- Use only platforms with built-in HIPAA-compliant encryption
Correct answer: Maintain patient confidentiality and avoid misleading promotional content
Surgeons may use social media but must protect patient confidentiality and ensure all promotional content is truthful and non-deceptive.
Question 5: A plastic surgeon notices a partner in their practice is impaired by alcohol during office hours. The first appropriate ethical action is to:
- Immediately report to the state medical board without speaking to the colleague
- Address the situation directly with the colleague and ensure no patients are harmed (Correct answer)
- Document the observations and wait to see if patients are injured
- Inform patients currently scheduled with the impaired physician
Correct answer: Address the situation directly with the colleague and ensure no patients are harmed
The immediate priority is patient safety by intervening with the colleague directly, followed by escalation through appropriate channels if the problem persists.
Question 6: A patient who is a minor requests augmentation rhinoplasty. Which scenario would be most ethically appropriate to proceed?
- The minor is 16, emotionally mature, and gives assent with parental consent after nasal growth is complete (Correct answer)
- The minor is 14 and parents provide full consent
- The minor is 17 and insists on surgery over parental objection
- The minor is 15 with a documented psychological evaluation supporting surgery
Correct answer: The minor is 16, emotionally mature, and gives assent with parental consent after nasal growth is complete
Rhinoplasty in minors requires nasal growth completion, parental consent, and patient assent, making an emotionally mature 16-year-old with nasal maturity the most appropriate candidate.
Question 7: In the context of the physician-patient relationship, sexual contact between a plastic surgeon and a current patient is:
- Acceptable if the patient initiates the contact
- Permissible after the surgical episode of care ends
- Always unethical due to the inherent power imbalance (Correct answer)
- Governed solely by state law and not professional ethics
Correct answer: Always unethical due to the inherent power imbalance
Sexual relationships with current or recent patients are universally condemned by professional ethics due to the inherent power differential in the physician-patient relationship.
ABPS Ethics & Professional Standards in Plastic Surgery 3
A patient consents to an abdominoplasty and, during surgery, the surgeon decides to also perform liposuction of the flanks without prior discussion.
This represents a violation of: