Behavioral Science & Ethics USMLE Step 1 Practice Question
A 28-year-old man with no prior psychiatric history is admitted to the psychiatric unit with acute-onset psychosis manifesting as command hallucinations and paranoid delusions. He refuses all antipsychotic medications, insisting that he is not ill and that the 'treatment' is a conspiracy to control him. Medical evaluation reveals no acute medical contraindications to antipsychotic therapy. The patient is not imminently dangerous to himself or others, has capacity to refuse treatment by legal standards in his state, and has not been adjudicated incompetent. His parents request that the treatment team administer medications against his will to expedite recovery. Which of the following ethical principles is most directly in tension with the parents' request?
Answer choices
- ABeneficence—the obligation to act in the patient's best medical interest
- BJustice—the fair distribution of healthcare resources among patients
- CNon-maleficence—the commitment to minimize harm from medical interventions
- DAutonomy—the right of a competent individual to self-determination and bodily integrityCorrect answer
- EPaternalism—the obligation of physicians to override patient preferences when medically justified
- FFidelity—the duty to maintain confidentiality and keep commitments to the patient
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