Non-clinical psychosocial topics tested on USMLE Step 1 including physician-patient ethics, informed consent, and health care delivery concepts, distinct from clinical psychiatric diagnosis.
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- What are the four required elements of valid informed consent?
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Disclosure of information, patient understanding, voluntariness, and decision-making capacity.- Under what circumstance can a physician treat a patient without obtaining informed consent?
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A life-threatening emergency in which the patient cannot give consent and no surrogate is available.- What is therapeutic privilege?
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Withholding certain information from a patient when disclosing it would likely cause serious psychological harm.- What happens to the informed consent requirement if a patient explicitly waives their right to be informed?
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The physician may proceed with treatment without giving the usual detailed disclosure.- Who gives informed consent for a patient who lacks decision-making capacity and has no advance directive?
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A surrogate decision-maker, typically a legally authorized family member.- Who determines whether a patient has decision-making capacity?
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The treating physician.- Who determines whether a patient is legally competent?
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A judge, in a court of law.- List the criteria that make a minor legally emancipated.
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Being married, serving in the military, being self-supporting and living independently, or having a child of their own.- For which categories of care can a minor consent to treatment without parental involvement?
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Sexually transmitted infections, pregnancy-related care, substance abuse treatment, and emergency care.- When a patient has no advance directive, who is generally first in line to act as surrogate decision-maker?
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The patient's spouse.- What is a living will?
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A written advance directive stating what treatments a patient does or does not want if they become unable to communicate.- What is a durable power of attorney for health care?
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A legal document naming a specific person to make medical decisions for a patient who becomes incapacitated.- What does the Tarasoff ruling establish about a therapist's duty when a patient makes a credible threat against an identifiable person?
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The therapist has a duty to warn and protect the identified potential victim, which can override confidentiality.- Is suspected child abuse an exception to physician-patient confidentiality?
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Yes, physicians are legally required to report suspected child abuse regardless of patient consent.- What is the ethical principle of beneficence?
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The obligation to act in the best interest of the patient.
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