Source / episode info

• **Episode:**276
• **Title:**Divine Intervention Episode 276 – USMLE Nov 2020 Changes Series 6: Professionalism/Ethics.
• **Published:**2020-12-02
• Source:Episode page

One-liner

This episode provides an exhaustive review of medical ethics for board exams, covering the four core principles (Beneficence, Non-maleficence, Autonomy, Justice), mandatory reporting requirements (infectious disease, impairment), end-of-life decision-making (Living Will supremacy), and professional conduct pitfalls (financial conflicts, error disclosure).

High-yield summary

• Four Ethical Principles: Beneficence (acting in patient's best interest), Non-maleficence (do no harm), Autonomy (respecting patient choice), and Justice (equitable care regardless of status).
• Infectious Disease Care: A physician is ethically bound to treat a communicable disease (e.g., COVID-19, TB) if appropriate Personal Protective Equipment (PPE) and infection control measures are available; refusal is only justified when precautions are unavailable.
• End-of-Life Decisions: The patient's explicit wishes documented in a Living Will supersede family objections or lack of documentation. If no Living Will exists, gather more information from the patient/family regarding their wishes before making decisions.
• Professional Boundaries & Conflicts: Never accept payments for referrals, gifts from pharmaceutical companies, or financial interests in facilities; always disclose medical errors to the patient, apologize, and outline a corrective plan.
• Mandatory Reporting: Must report communicable diseases (e.g., TB) to the employer/health department, impaired colleagues immediately to appropriate authorities, and impairing conditions (seizures, arrhythmias) to the DMV for public safety.
• General Board Knowledge Pearls:
• Renal Physiology: Type 2 Renal Tubular Acidosis (RTA) is often associated with carbonic anhydrase inhibitors and causes hypokalemic non-anion gap metabolic acidosis.
• Hematology: Autoimmune Hemolytic Anemia (AIHA) diagnosis requires a Direct Coombs Test (DAT).
• Cardiology/Pharmacology: Warfarin dosing is monitored using PT/INR, not aPTT. COX-2 selective inhibitors do NOT provide aspirin-like antiplatelet benefits.

Learning objectives

• State and apply the four core ethical principles in clinical decision-making.
• Determine when a physician is ethically obligated to provide care despite infectious disease status, given available precautions.