Ethics · Advanced · Ethics

Son Requesting Information About Mother

Practise this PLAB 2 ethics station on Urinary Sepsis. 8-minute voice AI simulation with feedback on all 3 marking domains.

Clinical scenario

You are an FY2 doctor in a general medical ward. You receive a telephone call from Mr Samuel Sanders, who introduces himself as the son of Mrs Patricia Sanders, currently an inpatient in your ward. He says he is a consultant surgeon at another hospital and wants detailed information about his mother's condition, current medications, test results, and prognosis. He says it will help him provide better family support and that she would want him to have this information. Mrs Sanders has not provided written consent for disclosure to her son. Please discuss this request.

Background notes: PMH: Hypertension, Type 2 diabetes, Osteoarthritis (knees), Widow, Lives alone with twice weekly cleaner

What this station tests

  • Confidentiality cannot be verified over the phone: identity cannot be confirmed remotely
  • Professional status does not override confidentiality: a consultant surgeon is still a family member calling
  • Patient consent must be documented: check whether she has consented to information sharing
  • Practical solution: check with the patient and call back, rather than refusing outright
  • Standing firm politely under pressure: not being intimidated while remaining professional

How to use your 8 minutes

  • 0-1 min — Introduction: Introduce yourself. Establish the ethical issue and your role.
  • 1-3 min — Explore Perspective: Listen to patient/relative perspective. Understand their reasoning and concerns.
  • 3-5 min — Ethical Framework: Apply ethical principles: autonomy, beneficence, non-maleficence, justice. Reference relevant guidelines (GMC, Mental Capacity Act).
  • 5-7 min — Negotiate and Plan: Find common ground. Explain your professional obligations. Involve MDT where appropriate. Document plan.
  • 7-8 min — Closing: Summarise agreed position. Outline next steps. Offer further discussion.

Consultation approach

The opening

A telephone request for patient information tests confidentiality. Mr Samuel Sanders calls claiming to be the son of a patient (Margaret Sanders) admitted with sepsis. He is a consultant surgeon and uses his professional status to pressure for information. Open with: 'Thank you for calling. Before I can discuss anything, I need to verify your identity and your mother's consent.'

Core approach

You cannot verify identity over the phone. He claims to be her son and a consultant surgeon, but you cannot confirm this. He may be who he says he is, or he may not. Professional status does not override confidentiality procedures.

Check: has the patient given consent for information to be shared with this person? Is there a named next of kin documented? Has she specifically consented to telephone updates? If yes and he can confirm identifying details (date of birth, address, ward): you may share a general update. If no consent documented: you cannot share clinical information regardless of his claimed relationship.

He may become frustrated or use his professional authority to pressure you. Stand firm politely: 'I understand your concern, and I appreciate you are worried about your mother. But I have a duty to protect her confidentiality. I would be happy to share information when I can confirm she has consented.'

Closing and safety netting

Offer a practical solution. 'I can check with your mother whether she is happy for me to speak to you, and then call you back.' This protects confidentiality while being helpful. If the patient lacks capacity: information can be shared with the next of kin in the patient's best interests, but this must be documented.

Do not be intimidated by professional status. A consultant surgeon is still a member of the public when calling about a family member. The rules apply equally. Document the call, what was requested, and what was shared.

How examiners mark this station

Examiners will assess your ethical reasoning and interpersonal skills. Domain 2 (Clinical Management) is primary: marks for applying an ethical framework, referencing relevant legislation and guidelines, and reaching a reasoned position. Domain 3 (Interpersonal Skills) is equally weighted: marks for non-judgmental exploration, empathic communication, and negotiation skills. Domain 1 (Data Gathering) assesses your ability to fully explore the situation before forming a view.

Domain 1 (Supporting)

Scores well: Identity verification attempted. Consent documentation checked. Next of kin status confirmed.

Costs marks: Not checking consent. Not attempting verification.

Domain 2 (Primary focus)

Scores well: Confidentiality maintained. Practical solution offered (check and call back). Call documented. Not intimidated by professional pressure.

Costs marks: Sharing information without consent. Being intimidated. Not documenting.

Domain 3 (Primary focus)

Scores well: Polite but firm. Acknowledging his concern. Explaining the rationale. Offering a solution not just a refusal.

Costs marks: Being rude. Being intimidated. Not offering a solution. Not explaining why.

Common examiner feedback (and how to fix it)

Did not demonstrate adequate ethical reasoning or application of relevant guidelines

Fix: Structure your response around the four ethical pillars (autonomy, beneficence, non-maleficence, justice). Reference specific guidelines (GMC, Mental Capacity Act) where relevant.

Did not sufficiently recognise or respond to the patient's feelings, concerns, or expectations

Fix: Acknowledge the emotional weight of the situation early. Show that you understand why this is difficult before applying ethical reasoning.

Common mistakes in this station

  1. Sharing information because he is a doctor: his professional status is irrelevant to his rights as a family member
  2. Sharing information because he sounds genuine: identity cannot be verified over the phone
  3. Being unnecessarily obstructive: offer to check consent and call back rather than simply refusing

Resitting PLAB 2?

If you have found ethics stations difficult, focus on learning a clear ethical framework (the four pillars) and practising how to apply it conversationally rather than reciting principles. Examiners reward candidates who can explore the tension between competing ethical principles while remaining empathic and non-judgmental.

Example opening

Thank you for coming in to speak with me. My name is Dr [Name]. I understand there is something important we need to discuss. Could you tell me your understanding of the situation?

Frequently asked questions

What is the right way to handle the urinary sepsis scenario in this station?

A telephone request for patient information tests confidentiality. Mr Samuel Sanders calls claiming to be the son of a patient (Margaret Sanders) admitted with sepsis. He is a consultant surgeon and uses his professional status to pressure for information.

Where are marks won and lost in this urinary sepsis station?

Examiners reward: Identity verification attempted. Consent documentation checked. Next of kin status confirmed. Candidates are penalised for: Not checking consent. Not attempting verification.

Where do candidates most often go wrong in this station?

Sharing information because he is a doctor: his professional status is irrelevant to his rights as a family member.

Can I do well in this station without real-world experience of urinary sepsis?

Structure beats experience here. Focus on professional status does not override confidentiality: a consultant surgeon is still a family member calling. Use the domain breakdown on this page to target your preparation, then practise the station aloud so your structure survives exam pressure.

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