Ethical reasoning stations appear in every Australian medical school interview, and they are the stations candidates most often misunderstand. The interviewer is not looking for the right answer; most of the scenarios have no single right answer. They are scoring whether you can see the principles at stake, the people affected, the options available, and whether you can choose one and defend it while acknowledging the other side. This guide covers the scenarios that recur and a structure that shows that reasoning.
The scenarios
- A friend asks you to share your answers in an assessment.
- A patient refuses a treatment that would save their life.
- Should a doctor tell a patient's family about a diagnosis the patient wants kept private?
- Is it fair that some people can pay for faster treatment?
- A classmate is struggling and you suspect they are cheating to keep up.
- A patient asks you, a medical student, for your opinion on their treatment.
- A doctor is tired and makes a small mistake nobody notices.
- Should doctors be allowed to refuse to perform procedures they object to?
- A hospital has one bed and two patients who need it.
A structure that shows reasoning
Name the question. Restate it in your own words so the interviewer knows you have understood it.
Name the principles. Honesty, fairness, the person's right to decide for themselves, the duty not to harm, the duty to help, confidentiality, the good of others. Most scenarios have two or three in tension, and naming the tension is the first mark.
Name the people. Who is affected, and how? The friend, the patient, the family, the other patients, the profession, you.
Name the options. Two or three, with what each would mean for the people affected.
Choose, and say why. Interviewers score a choice defended more than a survey without one. Say which principle you are weighting more heavily and why.
Acknowledge the other side. Say what someone who chose differently would argue, and why you still hold your view. This is the mark most candidates miss.
Say what you would actually do, including the first step and who you would talk to.
The scenarios worked
The friend asking for answers. The principles: honesty and fairness against loyalty. The people: the friend, the other students, the institution, you. The options: share, refuse, refuse and offer to help them study. The choice: refuse, because sharing is dishonest and unfair to the others, and offer help, because the friendship matters. The other side: loyalty is real and the friend may be desperate. The first step: a conversation about why they are struggling.
The patient refusing life saving treatment. The principles: the person's right to decide against the duty to help. The people: the patient, the family, the doctor. The options: respect the refusal, try to persuade, override. The choice: respect it if the patient understands and decides freely, while exploring why and offering alternatives, because a competent adult's decision about their own body is theirs. The other side: the doctor's distress and the family's. What you would do: find out why, make sure they understand, involve the senior, and stay with them.
Paying for faster treatment. The principles: fairness against freedom and the practical reality of a mixed system. A view, with an acknowledgement that reasonable people disagree, and a sentence on what the public system should guarantee.
The traps
A verdict with no reasoning. Pretending the question is easy. Refusing to choose. Moralising about the people in the scenario. Claiming you would never face such a dilemma. And not listening to the interviewer's follow up, which is usually "and what if they insisted?" or "what would you say to the other person?".
Role plays with an ethical edge
Some stations combine ethics with a role play: the friend is in the room asking for the answers. Then the structure is the same but delivered as a conversation: listen, acknowledge, explain your reasons kindly, hold the line, and offer what you can.
Preparing
Take one scenario a day for three weeks and reason through it aloud with the structure, against an eight minute clock, with someone who asks "and if they insisted?". Read a short introduction to medical ethics so the principles are familiar. Then practise choosing, because the choice defended is the mark.