What is the doctrine of double effect?

An action with a foreseen harmful effect is permissible if the act is good or neutral, the intent is the good effect, the bad effect is not the means to the good, and there is proportionate reason (e.g., opioids for terminal pain that may hasten death).

What are the elements required for valid informed consent?

Disclosure of relevant information, patient comprehension, decision-making capacity, voluntariness (no coercion), and the patient's authorization/agreement.

What are the four components used to assess decision-making capacity?

Understanding the information, Appreciating how it applies to oneself, Reasoning about treatment options, and clearly Communicating/Expressing a choice.

What is the distinction between 'capacity' and 'competence'?

Capacity is a clinical, decision- and time-specific determination made by physicians; competence is a global legal status determined by a court.

What are the recognized exceptions to obtaining informed consent before treatment?

Emergency (implied consent), waiver by the patient, lack of capacity (use surrogate), legally mandated treatment, and therapeutic privilege (rare).

What is the standard hierarchy of surrogate decision-makers when a patient lacks capacity and has no advance directive?

Typically: legally appointed guardian/healthcare proxy, then spouse, adult children, parents, adult siblings, then other relatives (varies by jurisdiction).

What is the difference between substituted judgment and the best-interest standard?

Substituted judgment decides as the patient would have wanted based on known values; best-interest standard is used when prior wishes are unknown, choosing what most reasonable people would want.

What are the principal HIPAA-recognized situations permitting disclosure of protected health information without patient authorization?

Treatment, payment, and healthcare operations (TPO), plus public health reporting, court orders, and duty-to-warn/protect situations.

What did the Tarasoff ruling establish for clinicians?

A duty to protect/warn identifiable third parties when a patient poses a serious, credible threat of violence to them, overriding confidentiality.

Name common conditions that physicians are legally mandated to report regardless of patient confidentiality.

Certain communicable/infectious diseases, suspected child or elder abuse, gunshot/stab wounds, and specific impairments affecting driving (jurisdiction-dependent).

🇺🇸 Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) · flashcards

Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) Clinical Skills, Ethics, and Professional Practice Flashcards

56 question-and-answer cards covering Clinical Skills, Ethics, and Professional Practice as it is examined in Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA). 24 of them are printed below, taken from across the deck — no signup, no paywall on the preview.

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24 sample cards from the Clinical Skills, Ethics, and Professional Practice deck

Sampled from the end of the deck, so these are different cards from the ones shown on the syllabus page.

What is the doctrine of double effect?
An action with a foreseen harmful effect is permissible if the act is good or neutral, the intent is the good effect, the bad effect is not the means to the good, and there is proportionate reason (e.g., opioids for terminal pain that may hasten death).
What are the elements required for valid informed consent?
Disclosure of relevant information, patient comprehension, decision-making capacity, voluntariness (no coercion), and the patient's authorization/agreement.
What are the four components used to assess decision-making capacity?
Understanding the information, Appreciating how it applies to oneself, Reasoning about treatment options, and clearly Communicating/Expressing a choice.
What is the distinction between 'capacity' and 'competence'?
Capacity is a clinical, decision- and time-specific determination made by physicians; competence is a global legal status determined by a court.
What are the recognized exceptions to obtaining informed consent before treatment?
Emergency (implied consent), waiver by the patient, lack of capacity (use surrogate), legally mandated treatment, and therapeutic privilege (rare).
What is the standard hierarchy of surrogate decision-makers when a patient lacks capacity and has no advance directive?
Typically: legally appointed guardian/healthcare proxy, then spouse, adult children, parents, adult siblings, then other relatives (varies by jurisdiction).
What is the difference between substituted judgment and the best-interest standard?
Substituted judgment decides as the patient would have wanted based on known values; best-interest standard is used when prior wishes are unknown, choosing what most reasonable people would want.
What are the principal HIPAA-recognized situations permitting disclosure of protected health information without patient authorization?
Treatment, payment, and healthcare operations (TPO), plus public health reporting, court orders, and duty-to-warn/protect situations.
What did the Tarasoff ruling establish for clinicians?
A duty to protect/warn identifiable third parties when a patient poses a serious, credible threat of violence to them, overriding confidentiality.
Name common conditions that physicians are legally mandated to report regardless of patient confidentiality.
Certain communicable/infectious diseases, suspected child or elder abuse, gunshot/stab wounds, and specific impairments affecting driving (jurisdiction-dependent).
What is the difference between an exception for a mature minor and the emancipated minor doctrine?
Emancipated minors (married, military, self-supporting, or court-declared) consent as adults for all care; mature minors may consent to specific care (e.g., STI, contraception, mental health) based on demonstrated maturity and state law.
Distinguish an advance directive, a living will, and a durable power of attorney for healthcare.
Advance directive is the umbrella term; a living will specifies desired treatments if incapacitated; a durable power of attorney/healthcare proxy designates a person to make decisions.
What is the ethical and legal distinction between withholding/withdrawing life-sustaining treatment and physician-assisted suicide/euthanasia?
Withholding/withdrawing honors patient autonomy to refuse treatment and lets the underlying disease cause death (legal); assisted suicide/euthanasia involves providing or administering means to actively cause death (legality varies, prohibited in most states).
What is the goal and focus of palliative care versus hospice care?
Palliative care relieves symptoms and improves quality of life at any disease stage alongside curative treatment; hospice is palliative care for patients with a prognosis of ~6 months or less who forgo curative treatment.
What is medical futility and how does it affect treatment obligations?
Futility describes interventions that cannot achieve the intended physiologic goal or meaningful benefit; physicians are not ethically obligated to provide truly futile treatment, though conflict resolution and communication are required.
What are the core elements of medical professionalism per the ABIM/ACP Physician Charter?
Three principles—primacy of patient welfare, patient autonomy, and social justice—plus commitments such as competence, honesty, confidentiality, appropriate relations, and maintaining trust.
What is the 'Swiss cheese model' of patient safety?
Accidents result when multiple latent and active failures (holes in successive defensive layers) align, allowing a hazard to pass through; safety improves by adding/strengthening defensive layers.
Differentiate the IOM/STEEEP six aims of healthcare quality.
Care should be Safe, Timely, Effective, Efficient, Equitable, and Patient-centered.
What is the difference between a sentinel event and a near miss in patient safety?
A sentinel event is an unexpected occurrence causing death or serious harm requiring immediate investigation (root cause analysis); a near miss is an error caught before reaching/harming the patient.
What are the levels of evidence in evidence-based medicine, from strongest to weakest?
Systematic reviews/meta-analyses of RCTs > individual RCTs > cohort studies > case-control studies > case series/reports > expert opinion.
What are the five steps of practicing evidence-based medicine?
Ask (form a PICO question), Acquire (search evidence), Appraise (critically evaluate), Apply (integrate with expertise and patient values), and Assess (evaluate outcomes).
What does the PICO framework stand for in forming a clinical question?
Population/Patient, Intervention, Comparison, Outcome.
How is the number needed to treat (NNT) calculated and interpreted?
NNT = 1 / absolute risk reduction; it is the number of patients who must be treated to prevent one additional bad outcome (lower NNT = more effective).
What is the difference between relative risk reduction and absolute risk reduction?
Absolute risk reduction = control event rate − treatment event rate; relative risk reduction = ARR / control event rate (RRR can exaggerate small absolute benefits).

What this deck covers

The Clinical Skills, Ethics, and Professional Practice deck follows the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) Clinical Skills, Ethics, and Professional Practice syllabus — 4 chapters and 15 topics — so questions land on material that is genuinely examinable rather than trivia around it. That works out to roughly 14.0 cards per chapter.

Answers are written to be recallable, not just readable — averaging about 172 characters, which is long enough to carry the reasoning and short enough to say out loud.

A deck like this earns its keep on the second and third pass. Read the syllabus first so you know the shape of the subject, then use the cards to find the specific facts that have not stuck.

Clinical Skills, Ethics, and Professional Practice flashcards FAQ

How many Clinical Skills, Ethics, and Professional Practice flashcards are in this Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) deck?

56 cards. This page previews 24 of them, sampled evenly across the deck so you can judge the difficulty before installing anything.

Are these Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) flashcards free?

Yes. The preview here is free to read with no signup, and the full 56-card deck is free inside the Examius app.

What do the Clinical Skills, Ethics, and Professional Practice cards cover?

They follow the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) Clinical Skills, Ethics, and Professional Practice syllabus — 4 chapters and 15 topics — so the questions track what is actually examinable.

How should I use these flashcards?

Read the syllabus first so you know the shape of the subject, then drill the deck. Examius schedules each card with spaced repetition, so cards you keep missing come back sooner and ones you know drift further apart.