SMLE Ethics MCQs: Practice Questions With Explanations

Sample SMLE MCQs from Ethics — an 84-question domain in HighYield's SMLE bank without a dedicated practice post yet — covering informed consent, confidentiality and patient autonomy.

Ethics is an 84-question domain in HighYield's SMLE question bank that doesn't yet have a dedicated practice post. Below is a sample set of Ethics MCQs covering the core bioethics principles tested in clinical-vignette form.

Core Principles

1. A physician recommends a treatment because it offers the patient the greatest benefit. This reflects the principle of:

A) Non-maleficence
B) Beneficence ✅
C) Justice
D) Autonomy

2. A physician avoids prescribing a drug likely to cause serious harm, even if it might help. This reflects:

A) Beneficence
B) Non-maleficence ✅
C) Autonomy
D) Fidelity

3. Allocating a scarce ICU bed based on fair, consistent criteria rather than personal preference reflects the principle of:

A) Autonomy
B) Beneficence
C) Justice ✅
D) Non-maleficence

Informed Consent & Autonomy

4. For consent to a procedure to be valid, it must be voluntary, informed, and given by a patient who:

A) Is a legal adult only
B) Has decision-making capacity ✅
C) Has a family member present
D) Has signed a prior general consent form

5. A capable adult patient refuses a recommended, life-saving treatment. The physician should:

A) Proceed with treatment regardless
B) Respect the refusal after confirming understanding and capacity ✅
C) Ask the family to override the decision
D) Discharge the patient immediately

6. Decision-making capacity for a specific treatment decision requires the patient to demonstrate all of the following EXCEPT:

A) Understanding the relevant information
B) Appreciating the consequences of the decision
C) Reasoning through the options
D) Agreeing with the physician's recommendation ✅

Confidentiality

7. Patient confidentiality may ethically be breached without consent when:

A) A family member simply asks for an update
B) There is a serious, identifiable risk of harm to a third party ✅
C) An insurance company requests records
D) A journalist requests comment

8. A minor requests treatment for a sexually transmitted infection without parental knowledge. The most appropriate initial approach is to:

A) Refuse treatment without parental consent
B) Assess the minor's maturity and capacity to consent to this specific treatment ✅
C) Notify the parents immediately regardless
D) Defer entirely to hospital policy without clinical assessment

End-of-Life & Truth-Telling

9. A terminally ill, capable patient asks not to be told further details about a poor prognosis. The physician should:

A) Disclose full details regardless of the patient's wishes
B) Respect the patient's request while remaining open to revisiting it ✅
C) Tell only the family instead
D) Avoid the conversation entirely going forward

10. Withdrawing a life-sustaining treatment at a capable patient's informed request is ethically and legally distinct from euthanasia because:

A) It is never permissible
B) It respects patient autonomy and allows an underlying disease to take its course ✅
C) It requires no consent
D) It is only permissible for unconscious patients

Prepare with HighYield

HighYield's SMLE question bank covers Ethics alongside Internal Medicine, Pediatrics, General Surgery and every other domain tested on the exam, with every question explained. For the full breakdown of eligibility, syllabus weighting and scoring, see our SMLE Exam Full Guide. Your first 20 questions are free.