Medical Ethics, Law & Communication
AKT High-Yield Breakdown
Medical ethics and law underpins every clinical decision. The AKT tests ethical reasoning, the Mental Capacity Act 2005, consent principles, confidentiality and its exceptions, safeguarding frameworks, and communication skills. Expect scenario-based questions where the law and ethics interact with clinical judgment.
What You'll Learn
Master the four principles of medical ethics, the five-stage capacity test, Gillick competence, the exceptions to confidentiality, Mental Health Act sections, safeguarding adult and child principles, duty of candour, and the communication techniques tested in the clinical context.
Practise Medical Ethics, Law & Communication MCQs
From the Mental Capacity Act five principles and Gillick competence to confidentiality exceptions, safeguarding referral pathways, duty of candour, and SPIKES breaking-bad-news protocol — tackle focused MCQs across the full Ethics & Law curriculum.
The Four Principles of Medical Ethics
Beauchamp and Childress's four principles (principlism) provide the dominant framework for medical ethics in the UK. The AKT regularly presents conflicts between these principles and asks how to resolve them.
- Autonomy: the patient's right to make informed decisions about their own care; must be respected even when the clinician disagrees with the choice; requires information, capacity, and freedom from coercion
- Beneficence: the duty to act in the patient's best interest; goes beyond simply following patient wishes — requires active promotion of wellbeing
- Non-maleficence: the duty to avoid causing harm; "first, do no harm" — but harm is relative and must be weighed against benefit
- Justice: fair distribution of healthcare resources; treating like cases alike; the duty to consider the needs of the broader population, not just the individual
In AKT ethics scenarios: when autonomy conflicts with beneficence or non-maleficence, respect for autonomy generally takes precedence in a capacitous adult. When capacity is absent, best interests (beneficence/non-maleficence) take over — but best interests is NOT the same as what the clinician thinks is best medically.
Additional Ethical Concepts
- Double effect: an action with both a good intended effect and an unavoidable harmful side-effect is permissible if the harm is not intended and is proportionate (e.g. high-dose opioids in terminal care)
- Distributive justice: allocation of resources (e.g. organ transplantation, prioritisation in a pandemic)
- Veracity (truth-telling): duty to be honest with patients, including about mistakes (duty of candour)
- Fidelity: keeping promises and commitments made to patients
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