Match each workplace ethical scenario with the most appropriate physician action or ethical principle.
- A physician observes a peer with alcohol on their breath, slurred speech, and an unsteady gait preparing to evaluate patients in the emergency department.Intervene immediately by notifying the clinical supervisor or department chief to prevent the individual from seeing patients.
- A physician in an independent private practice discovers that a partner has been intentionally and systematically submitting fraudulent billing claims to Medicare.Report the individual to the state medical board or appropriate legal authority, as this constitutes illegal activity.
- A general surgeon is interested in initiating a romantic relationship with a former patient on whom they performed an uncomplicated cholecystectomy one year ago.Ethically permissible, provided the therapeutic relationship has been formally terminated and there is no exploitation of vulnerability.
- A psychiatrist is interested in initiating a romantic relationship with a former patient whom they successfully treated for major depressive disorder five years ago.Ethically prohibited under all circumstances, due to the intense emotional dependence inherent to the prior therapeutic relationship.
- A resident is instructed by an attending to perform a medically contraindicated procedure. After the resident respectfully expresses concern, the attending threatens the resident with a poor evaluation.Escalate the issue through the formal institutional chain of command, prioritizing patient safety over hierarchical authority.
Answer
The scenarios match with guidelines emphasizing immediate patient safety for impaired physicians, reporting legal violations to authorities, escalating hierarchy conflicts, and distinguishing boundary rules between psychiatric and non-psychiatric patients.
Each correct match directly aligns with AMA Code of Medical Ethics and ACGME policies. Immediate patient harm requires immediate supervisory intervention. Fraud requires regulatory reporting. Romantic relationships with former patients are context-dependent, strictly prohibited in psychiatry but potentially permissible in other fields. Finally, hierarchical intimidation that threatens patient safety must be escalated through formal institutional channels.
Step-by-Step Solution
Key Concept
Professional Boundaries, Impairment, and Workplace Ethics