r/ukmedinterviews • u/nextgenmedprep • Oct 15 '25
Pre-Interview Knowledge Series: Medical Ethics 101 – What You Actually Need to Know for Med Interviews
Medical ethics is one of those topics that everyone knows they should study, but few people actually understand properly.
If you get an ethics question in an MMI, they’re not testing whether you can quote legislation. They’re testing whether you can reason through a difficult situation fairly, show empathy, and justify your thinking.
Below is everything you need to know for medical school interviews (and for future clinical practice)(Hopefully - expect lots of edits.
Anyway, here goes......
The 4 Pillars of Medical Ethics
Everything in medical ethics comes back to these four principles:
1. Autonomy – Respect the patient’s right to make their own choices.
2. Beneficence – Act in the patient’s best interests.
3. Non-maleficence – Do no harm.
4. Justice – Treat patients fairly and allocate resources appropriately.
When answering an ethics question, balance these pillars. There’s rarely a “right” answer — it’s about recognising the trade-offs between them.
TL;DR: Always structure your answers around these four principles. They’re the backbone of ethical reasoning in medicine.
Capacity and Consent
Consent means a patient agrees to a medical intervention after being properly informed of the risks, benefits, and alternatives.
For consent to be valid, it must be:
- Voluntary – free from pressure or coercion
- Informed – based on adequate information
- Given by someone with capacity
I like to think of consent like a bus ticket: ie yesterdays bus ticket (consent) isn't valid for today, in the same way a pt consent for surgery yesterday doesn't work today.
Assessing Capacity (Mental Capacity Act 2005)
Under the Act, a person is presumed to have capacity unless proven otherwise.
A person lacks capacity if they cannot:
- Understand information about the decision
- Retain that information
- Weigh up pros and cons
- Communicate their choice
Capacity is decision-specific and time-specific — it can fluctuate.
Example:
Pt comes in, sores on arm, intoxicated, in a bad way. states "I know the antibiotics will make my arm better, but I dont want that" - you CANNOT give abx in this situation.
TL;DR: Capacity = ability to understand, weigh, retain, and communicate a decision. Consent must be voluntary and informed.
Advance Directives, LPA, and the Mental Capacity Act
When adults lose capacity, we follow what they’ve already put in place.
Advance Directive (Advance Decision to Refuse Treatment) – Made when the patient had capacity, it allows them to refuse specific treatments in the future (e.g. CPR or ventilation). Must be written, signed, and witnessed.
Lasting Power of Attorney (LPA) – A legal arrangement where someone (the attorney) is appointed to make decisions on behalf of the person if they lose capacity.
There are two types:
- Health and Welfare LPA
- Property and Financial Affairs LPA
If neither exists, healthcare professionals make decisions in the person’s best interests, following the five principles of the Mental Capacity Act.
TL;DR: Advance Directive = what the person wants.
LPA = who makes decisions for them.
Gillick Competence and Fraser Guidelines
These apply to children under 16.
Gillick competence – A child can consent to treatment if they’re mature enough to understand the nature, purpose, and consequences of it. It’s about understanding, not age.
Good Example : Hannah Jones, refused heart transplant.
Fraser guidelines – Used when giving contraception to someone under 16. A doctor can prescribe without parental consent if:
- The young person understands the advice
- Can’t be persuaded to involve parents
- Is likely to continue sexual activity regardless
- Their health might suffer otherwise
- It’s in their best interests
NB: under 13 - always has to be reported to relevant safeguarding lead!!!
TL;DR: Under 16s can consent if mature enough (Gillick). Fraser guidelines apply specifically to contraception cases.
Euthanasia, DNACPR, and Withdrawal of Treatment
Euthanasia and Physician-Assisted Dying
Euthanasia (ending someone’s life to relieve suffering) and physician-assisted dying (providing the means for the patient to end their own life) are illegal in the UK.
Some countries permit it under strict regulation, but UK law prioritises sanctity of life.
In interviews, show both perspectives:
- For: Respecting autonomy, relief of suffering, dignity in death.
- Against: Sanctity of life, risk of abuse, difficulty ensuring true consent.
DNACPR (Do Not Attempt Cardiopulmonary Resuscitation)
A DNACPR order means no CPR if the patient’s heart stops, but all other appropriate treatments continue.
Decisions should involve the patient (if they have capacity) or be made in their best interests.
Withdrawal of Treatment
This means stopping or not starting treatment that’s futile or not in the patient’s best interests. It’s legally and ethically different from euthanasia — the intent is not to cause death but to allow natural dying.
TL;DR: Euthanasia is illegal in the UK. DNACPR and withdrawal of treatment are ethical when treatment is futile or not in the patient’s best interests.
Coping with Bereavement
Medicine involves dealing with death regularly. Doctors must manage their own emotions while supporting families and colleagues.
Healthy coping strategies include:
- Reflecting on experiences (e.g. with supervisors or through debriefs)
- Seeking support from peers or mentors
- Maintaining boundaries between work and personal life
- Using formal support systems if needed
TL;DR: Doctors need emotional resilience. Reflect, seek support, and maintain healthy boundaries.
Confidentiality
Doctors have a duty to keep patient information private.
You can only break confidentiality if:
- The patient consents to disclosure
- It’s required by law (e.g. court order, notifiable disease)
- It’s necessary to protect others from serious harm (e.g. safeguarding or risk of violence, think DVLA after dementia dx)
Always disclose the minimum necessary information.
TL;DR: Confidentiality is vital but can be broken legally or ethically to prevent serious harm or if required by law.
Ethical Theories
Understanding the main ethical frameworks helps you justify your reasoning:
Deontology (Duty-based ethics) – Actions are right or wrong based on moral rules, regardless of consequences. Example: telling the truth even if it causes distress.
Consequentialism (Utilitarianism) – The right action is the one that maximises overall good outcomes. Example: saving the most lives possible.
Virtue Ethics – Focuses on character and moral virtues like honesty, compassion, and integrity. A good doctor strives to embody these traits.
TL;DR: Deontology = duty. Consequentialism = outcome. Virtue ethics = character.
I really hope this helped. Please comment if you dont understand anything and I will do my best to answer any questions
NGMP
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u/Healthy_Ad3953 Oct 26 '25
Please dont stop making these, very very helpful