Behavioral Science & Ethics USMLE Step 1 Practice Question
A 35-year-old woman presents to her primary care physician with a blood pressure of 162/98 mmHg. She has no prior history of hypertension and denies headaches, chest pain, or dyspnea. Physical examination is unremarkable. Laboratory studies show normal renal function and electrolytes. The patient reports that she cannot afford the standard first-line antihypertensive medication due to lack of insurance, but a generic alternative with less robust clinical trial data in her demographic is available at no cost through a community health program. The physician is considering prescribing the generic alternative despite limited evidence specific to this patient's population, reasoning that treatment with an imperfect medication is better than no treatment given the patient's financial constraints and increased cardiovascular risk. Which of the following ethical principles most directly supports this prescribing decision?
Answer choices
- AAutonomy, because the patient has the right to choose any medication regardless of evidence quality
- BNon-maleficence, because avoiding the standard medication prevents potential side effects
- CBeneficence constrained by justice, because the physician balances individual patient benefit against resource limitations and fair accessCorrect answer
- DPaternalism, because the physician is making a unilateral decision based solely on what he/she believes is medically best
- EStrict adherence to evidence-based guidelines, because FDA-approved medications should never be deviated from
- FUtilitarianism, because maximizing the total number of treated patients justifies prescribing suboptimal therapy
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