ethical questions

How to Approach Ethical Scenarios in a PA School Interview

When preparing for a PA school interview, you can probably guess the questions you are most likely to be asked. These include traditional ("Why do you want to become a PA?") and behavioral/situational ("Tell me about a time when...") questions. 

However, anticipating ethical questions that may be posed during an interview is a bit tougher. So, instead of preparing for specific questions, it's more helpful to use a system that can work for any moral dilemma presented. 

In this post, you'll learn a simple formula to help you answer any ethical scenario asked of you in a PA school interview. 

1. Go to the source

Most ethical dilemmas posed in a PA school interview are presented as situational questions. With these types of questions, you are typically given a scenario where you are interacting with a patient or colleague. The question then centers on what actions you would take in the given scenario. 

Here is one I like to use during Mock interview prep sessions:

A 70-year-old Mandarin-speaking man comes to your office for treatment of his prostate cancer. He does not speak English and his family informs you that he has not been told of his diagnosis. They ask that you provide him treatment but keep from telling him of his true diagnosis. What do you do?

The first step you should take is speaking with the individual(s) at the root of the issue. Unless there is an extreme case (like a provider smothering patients in their sleep), discussing the issue with those involved should be your first move. 

Addressing the problem directly, rather than going over someone's head, shows maturity and demonstrates respect for others. This approach is reflective of the actions you should take as a provider, whether it's with a patient, caregiver, or colleague. 


Your questions and exploration will vary based on the scenario presented, but your first step should always be to approach the primary player. 



2. Discuss your ideal solution

Your ideal solution would be a simple discussion with those involved in the scenario. 

In this case, the players at the heart of the issue are the family members rather than the patient. Your best option would be to talk them out of their request. 

You would start by asking questions about their concerns: 
What does your father think he is here for?
How do you think he would react to the diagnosis?
Has anyone close to him had cancer before? 
Are you concerned that he would refuse treatment?

You can also elaborate any additional steps that may help to facilitate the conversation, like involving their father in the discussion or asking a social worker for assistance.



3. Explain your ideal outcome

After your discussion with the individual(s) at the heart of the issue, you should explain the ideal outcome of your conversation.

Your optimal result will usually be that the person sees the light and agrees to do the right thing. Your ideal outcome protects the confidentiality, health, or well-being of your patient while talking the individual at the heart of the issue (whether it's the patient or someone else) into a better choice. 

In our scenario, the family may explain that they believe their father will become depressed at learning of his diagnosis. Ideally, after speaking to them about the importance of his awareness of his diagnosis, they would agree. With the assistance of a non-family-member interpreter, you could then explain the diagnosis and recommended treatment course to the patient. 


4. Detail your contingency plan

Every answer to an ethical question should outline a contingency plan. As part of your response, you should explain how you plan to protect your patient and their rights if your ideal solution does not work. 


If the behavior in a scenario is reportable, you should describe how you would report it. A contingency plan may involve alerting law enforcement, notifying a public health department, or reporting a coworker to a supervisor.


In our scenario, plan B would involve to reinforcing the patient's autonomy and authority to make decisions for his care. The contingency plan would involve putting the patient first regardless of the other players involved. 


If the family was adamant that the patient should stay in the dark about his cancer, we'd explain that our duty was to the patient. We'd be obligated to respect the patient's choices for his care, and to do that, the patient would need to be informed. Even if the family was against it, we would use a professional Mandarin interpreter to notify the patient of his diagnosis and treatment options.


You can conquer nearly any ethical question for a PA school interview using this framework. Go directly to the person involved, discuss your ideal solution and outcome, and lay out your plan B to formulate strong answers to ethical dilemmas. 


By using this approach, you can skip trying to cram for every potential ethical question out there for your PA school interview. Focus on the format of your response, and you can sail through any ethical question that may come your way.