An unconscious 30-year-old man is brought to casualty after a road crash. CT shows a large, enlarging extradural haematoma. No relatives or friends can be traced, and the neurosurgeon decides to operate at once. What is the legal position on consent?

Emergency surgery in good faith is protected without consent

Surgery must wait for a magistrate's permission

The hospital superintendent's consent is mandatory

Surgery must wait until the police give consent

A 58-year-old man dies after a post-operative bleed that the duty doctor in a private hospital failed to detect for several hours. His son files a police complaint against the doctor. For the doctor to be held criminally liable for the death, what must be shown?

Gross negligence or recklessness on his part

A poor outcome after his treatment

An error of judgment in a difficult case

Any departure from the best possible practice

A general practitioner in Lucknow receives a fixed percentage of the bill from a diagnostic centre for every patient he sends there for scans. He says the scans were needed in every case. How is his conduct regarded under the medical ethics regulations?

Professional misconduct, as a commission

A civil wrong only, not misconduct

Acceptable, as the scans were needed

Acceptable, if patients are told later

A 38-year-old bus driver of the state transport corporation has had two generalised seizures in a month, and his EEG is abnormal. He refuses to tell his employer and plans to drive his usual route next week. Counselling has failed. What should his doctor do?

Inform the employer, as a privileged communication

Write to the passengers' association

Inform the police and ask for his arrest

Keep silent, since confidentiality is absolute

Medical ethics, consent, negligence and the NMC code

27 NEET-PG practice questions on Medical ethics, consent, negligence and the NMC code, part of Forensic Medicine. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
An unconscious 30-year-old man is brought to casualty after a road crash. CT shows a large, enlarging extradural haematoma. No relatives or friends can be traced, and the neurosurgeon decides to operate at once. What is the legal position on consent?
1. ASurgery must wait for a magistrate's permission
2. BThe hospital superintendent's consent is mandatory
3. CSurgery must wait until the police give consent
4. DEmergency surgery in good faith is protected without consent
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Answer: D · Emergency surgery in good faith is protected without consent
In an emergency, when the patient cannot consent and no guardian can be reached in time, a doctor may act without consent, in good faith, for the patient's benefit. Indian criminal law protects such acts (the good-faith exception formerly in Section 92 IPC, carried into the BNS). In Parmanand Katara v Union of India (1989), the Supreme Court held that every doctor must give immediate aid to an injured person without waiting for police formalities. The notes should record the emergency, the attempts to reach relatives and the reasons for operating.
- A: No magistrate's permission is needed for emergency treatment.
- B: Administrative approval is not a legal requirement for emergency surgery.
- C: The police cannot consent for a patient, and the delay could cost his life.
Question 2 · Easy
A 42-year-old woman has had pelvic pain since a hysterectomy at a private nursing home eight months ago. A CT scan shows the radio-opaque marker of a surgical sponge in her pelvis. In her complaint of negligence, which doctrine relieves her of proving exactly how the error happened?
1. AVolenti non fit injuria
2. BNovus actus interveniens
3. CRespondeat superior
4. DRes ipsa loquitur
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Answer: D · Res ipsa loquitur
Res ipsa loquitur, 'the thing speaks for itself', applies when the injury would not ordinarily happen without negligence, the cause was under the defendant's control, and the patient did not contribute to it. A sponge left in the abdomen is the classic example, along with surgery on the wrong side or the wrong patient. The burden then shifts to the doctor or hospital to explain the event. Sponge and instrument counts at closure, with radio-opaque sponges, prevent this error.
- A: Volenti non fit injuria is a defence based on the patient accepting a known risk.
- B: Novus actus interveniens is a new intervening act that breaks the chain of causation.
- C: Respondeat superior makes an employer liable for an employee; it does not remove the need for proof.
Question 3 · Medium
A 58-year-old man dies after a post-operative bleed that the duty doctor in a private hospital failed to detect for several hours. His son files a police complaint against the doctor. For the doctor to be held criminally liable for the death, what must be shown?
1. AGross negligence or recklessness on his part
2. BA poor outcome after his treatment
3. CAn error of judgment in a difficult case
4. DAny departure from the best possible practice
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Answer: A · Gross negligence or recklessness on his part
In Jacob Mathew v State of Punjab (2005), the Supreme Court held that criminal liability of a doctor for a patient's death needs negligence of a high degree, gross negligence or recklessness, not the simple lack of care that is enough for civil liability. A private criminal complaint against a doctor should be supported by the credible opinion of another competent doctor, and doctors should not be arrested as a matter of routine. A poor outcome or an honest error of judgment is not negligence by itself. Civil liability uses the lower standard of a reasonably competent doctor (the Bolam test).
- B: A bad outcome alone does not prove negligence.
- C: An honest error of judgment within accepted practice is not negligence, let alone criminal negligence.
- D: The standard is reasonable care, not the best possible practice.
Question 4 · Medium
A general practitioner in Lucknow receives a fixed percentage of the bill from a diagnostic centre for every patient he sends there for scans. He says the scans were needed in every case. How is his conduct regarded under the medical ethics regulations?
1. AProfessional misconduct, as a commission
2. BA civil wrong only, not misconduct
3. CAcceptable, as the scans were needed
4. DAcceptable, if patients are told later
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Answer: A · Professional misconduct, as a commission
Giving or receiving a commission, rebate or gift for referring patients (fee-splitting) is professional misconduct under the IMC Professional Conduct Regulations, 2002, whether or not the referral was clinically justified. It gives a financial motive to order tests and erodes patients' trust. The State Medical Council can warn the doctor or remove his name from the register for a period or permanently. Referrals must rest on clinical need alone.
- B: It is a specific form of professional misconduct, punishable by the medical council.
- C: Clinical need does not make a referral commission acceptable.
- D: Telling patients afterwards does not make fee-splitting ethical.
Question 5 · Medium
A 38-year-old bus driver of the state transport corporation has had two generalised seizures in a month, and his EEG is abnormal. He refuses to tell his employer and plans to drive his usual route next week. Counselling has failed. What should his doctor do?
1. AInform the employer, as a privileged communication
2. BWrite to the passengers' association
3. CInform the police and ask for his arrest
4. DKeep silent, since confidentiality is absolute
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Answer: A · Inform the employer, as a privileged communication
Privileged communication is a statement made in good faith by a doctor to a person or authority with a corresponding legal, social or moral duty to receive it, in order to protect others. A driver with uncontrolled seizures endangers the public, so the doctor may inform the employer after trying to persuade the patient himself. The disclosure is limited to what is needed, made only to the proper authority, and recorded in the notes. It is protected because it is made without malice and in the public interest.
- B: Passengers' groups have no duty to act on it, so telling them is an unjustified disclosure.
- C: Arrest has no place for a medical condition; the employer controls his driving duties.
- D: Confidentiality yields when silence puts identifiable others at serious risk.
Question 6 · Medium
A 33-year-old woman's chest X-ray report noting a nodule is filed without the doctor reading it. Two months later the nodule is reviewed, found to be a benign hamartoma, and needs no treatment. She files a complaint of negligence. Why will her claim most likely fail?
1. AMissing a report is not a breach of duty
2. BShe did not obtain an expert's opinion
3. CShe suffered no damage from the lapse
4. DThe doctor owed her no duty of care
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Question 7 · Hard
A 45-year-old woman dies on the operating table in a district hospital after a resident anaesthetist mixes up the oxygen and nitrous oxide cylinders on the anaesthesia machine. An expert committee finds gross negligence. Under which provision of the BNS, and with what maximum imprisonment, can the doctor be tried?
1. ASection 105; up to 10 years and fine
2. BSection 106(2); up to 10 years and fine
3. CSection 106(1); up to 2 years and fine
4. DSection 106(1); up to 5 years and fine
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Question 8 · Hard
A 35-year-old woman signs consent for a diagnostic laparoscopy for chronic pelvic pain. Under anaesthesia the surgeon finds severe endometriosis with chocolate cysts in both ovaries. A postgraduate discussing the case lists four statements: 1. Her consent for the diagnostic procedure does not cover removing her uterus and ovaries now. 2. Her husband's consent, taken in the waiting room, is enough to proceed. 3. A form signed for 'any procedure the surgeon thinks fit' would not make such removal valid. 4. Extending surgery without fresh consent is justified only to save life or prevent serious immediate harm. Which statements are correct?
1. A1 and 4 only
2. B3 and 4 only
3. C1, 2 and 3 only
4. D1, 3 and 4 only
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Question 9 · Medium
A 29-year-old man diagnosed HIV-positive at an ICTC says he will marry next month and refuses to tell his fiancée. Repeated counselling has not changed his mind. Which course is consistent with the Supreme Court's ruling in Mr X v Hospital Z?
1. ADisclose his status to her to protect her health
2. BInform her parents and the local panchayat
3. CTell her only after the marriage has taken place
4. DKeep silent; his right to privacy is absolute
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Question 10 · Medium
In a corporate hospital, a staff nurse gives concentrated potassium chloride as an undiluted IV bolus instead of an infusion, and the patient dies. The family sues the hospital as well as the nurse. On what basis is the hospital liable for her act?
1. AVicarious liability for its employee
2. BNovus actus interveniens by the nurse
3. CContributory negligence of the patient
4. DRes ipsa loquitur for its premises
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Question 11 · Hard
A 50-year-old farmer is operated on, free of charge, at a government district hospital where every patient is treated free. He alleges negligence and wants to file a complaint before the District Consumer Disputes Redressal Commission. What is the likely outcome of the complaint?
1. AMaintainable, as every medical service is covered
2. BNot maintainable; only a criminal case is possible
3. CNot maintainable; he may file a civil suit instead
4. DMaintainable, as the State pays the surgeon's salary
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Question 12 · Medium
A 25-year-old man with a fractured tibia in an above-knee cast is told in writing to return at once if his toes become swollen, blue or numb. These signs appear on the second day, but he waits four days before returning, by which time there is ischaemic damage. In his suit against the orthopaedic surgeon, which defence is available?
1. ATherapeutic privilege
2. BRes ipsa loquitur
3. CVicarious liability
4. DContributory negligence
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Question 13 · Easy
A 60-year-old man discharged after a coronary angioplasty from a private hospital in Pune asks the hospital in writing for copies of his indoor case records, to get a second opinion. Under the IMC (Professional Conduct, Etiquette and Ethics) Regulations, 2002, within what time must the copies be given?
1. AWithin 15 days
2. BWithin 72 hours
3. CWithin 30 days
4. DWithin 7 days
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Question 14 · Medium
A woman in Thiruvananthapuram complains that her doctor examined her intimately without a chaperone and made improper remarks. She wishes to complain of professional misconduct. Under the National Medical Commission Act, 2019, which body hears the complaint first?
1. AThe State Medical Council
2. BThe National Medical Commission itself
3. CThe District Consumer Commission
4. DThe Ethics and Medical Registration Board
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Question 15 · Medium
The family of a 78-year-old man in a persistent vegetative state for two years after a massive stroke asks the ICU team in Delhi to withdraw his ventilator. He had signed a living will before his illness. The ICU registrar notes four points: 1. A lethal injection at the family's request would be lawful if a medical board approves. 2. The Supreme Court recognised advance directives and passive euthanasia in Common Cause v Union of India (2018). 3. His living will cannot be acted on because he is unable to confirm it now. 4. Withdrawal of life support follows review by medical boards as laid down by the Supreme Court. Which points are correct?
1. A2, 3 and 4 only
2. B2 and 4 only
3. C1 and 2 only
4. D1, 2 and 4 only
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Question 16 · Easy
In a crowded medicine OPD, a 45-year-old man is told that his blood pressure will be checked. Without saying anything, he rolls up his sleeve and holds out his arm. What type of consent has he given?
1. AExpress oral consent
2. BImplied consent
3. CPresumed emergency consent
4. DInformed written consent
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Question 17 · Hard
After a patient dies on the second day following an emergency laparotomy at a private hospital in Thiruvananthapuram, his son files an FIR alleging that the surgeon's negligence caused the death. The police inspector, who has never handled such a case, phones the district medical officer and asks how he should proceed. The surgeon is fully registered, and the case sheet shows the operation was indicated and the post-operative care documented. Following the Supreme Court's guidelines, what should the police do first?
1. ATransfer the case to the consumer commission
2. BObtain an independent medical opinion before proceeding
3. CArrest the surgeon, as the offence is cognisable
4. DClose the FIR, as doctors cannot be prosecuted
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Question 18 · Medium
An inquiry by the State Medical Council finds that a doctor in Thrissur issued false fitness certificates to bus drivers for money. The council removes his name from the medical register for 5 years. What is this action called?
1. APenal erasure
2. BCensure
3. CAdministrative erasure
4. DWarning notice
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Question 19 · Medium
A negligence suit is filed against an orthopaedic surgeon in Kozhikode who fixed a fractured tibia with an intramedullary nail; the bone united late. Expert witnesses state that a responsible body of orthopaedic surgeons would have chosen the same method, although some prefer plating. The court holds that he must be judged by the standard of an ordinary competent surgeon of his speciality, not the best in the field. Which test has the court applied?
1. ARes ipsa loquitur
2. BBolam test
3. CEggshell skull rule
4. DDoctrine of common knowledge
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Question 20 · Easy
Before a planned laparoscopic cholecystectomy at a district hospital, the surgeon sits with a farmer and his wife and explains the operation in Malayalam, using a diagram. The farmer then signs the consent form. For his consent to count as informed consent, what must the surgeon have told him?
1. AOnly the expected benefits of the operation
2. BOnly the surgeon's fees and his success rate
3. CThe nature, risks and alternatives of the operation
4. DOnly those risks that are likely to happen
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Question 21 · Hard
A single schoolteacher in her forties with chronic pelvic pain signs a consent form for 'diagnostic and operative laparoscopy' at a private hospital in Kochi. Under general anaesthesia, the gynaecologist finds extensive endometriosis. Believing it is in her best interest, he steps out, takes the consent of her mother waiting outside, and performs a total abdominal hysterectomy with removal of both ovaries. She had never been told of this possibility before surgery. There was no bleeding or other emergency during the laparoscopy. When she recovers, she files a complaint. What is the legal position?
1. AUnauthorised: she alone could consent to that surgery
2. BValid, because he acted in good faith for her benefit
3. CValid, because her mother gave consent
4. DValid, because the form included operative laparoscopy
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Question 22 · Medium
During a properly indicated contrast-enhanced CT at a medical college, a patient with no history of allergy and no risk factors develops sudden anaphylaxis despite standard precautions. The radiology team gives IM adrenaline at once and resuscitates him correctly, but he has a hypoxic brain injury. His family alleges negligence. How is this event best described?
1. AMedical maloccurrence
2. BMedical negligence
3. CContributory negligence
4. DCorporate negligence
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Question 23 · Easy
A radiologist pays a general practitioner a fixed commission for every patient he refers for an MRI scan. What is this unethical practice called?
1. ADichotomy (fee splitting)
2. BTouting
3. CCovering for an unqualified person
4. DGhost surgery
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Question 24 · Medium
On a school trip to Munnar, a boy falls from a rock and has an open fracture of the forearm with brisk bleeding. His parents cannot be reached by phone for several hours. At the taluk hospital, the class teacher in charge of the group signs the consent for wound debridement and fixation under anaesthesia. On what legal principle does the teacher's consent rest?
1. AImplied consent
2. BProxy consent by the police
3. CTherapeutic privilege
4. DLoco parentis
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Question 25 · Medium
Biopsy shows advanced pancreatic cancer in a retired bank officer who has severe anxiety and attempted suicide 3 weeks ago. His psychiatrist warns that full disclosure at once may provoke another attempt. The oncologist decides, for now, to withhold the detailed prognosis, to tell him in stages as his mood is treated, and to record his reasons in the case sheet. Which principle allows this?
1. ATherapeutic privilege
2. BTherapeutic waiver
3. CDoctrine of informed refusal
4. DPrivileged communication
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Medical ethics, consent, negligence and the NMC code

An unconscious 30-year-old man is brought to casualty after a road crash. CT shows a large, enlarging extradural haematoma. No relatives or friends can be traced, and the neurosurgeon decides to operate at once. What is the legal position on consent?

A 42-year-old woman has had pelvic pain since a hysterectomy at a private nursing home eight months ago. A CT scan shows the radio-opaque marker of a surgical sponge in her pelvis. In her complaint of negligence, which doctrine relieves her of proving exactly how the error happened?

A 58-year-old man dies after a post-operative bleed that the duty doctor in a private hospital failed to detect for several hours. His son files a police complaint against the doctor. For the doctor to be held criminally liable for the death, what must be shown?

A general practitioner in Lucknow receives a fixed percentage of the bill from a diagnostic centre for every patient he sends there for scans. He says the scans were needed in every case. How is his conduct regarded under the medical ethics regulations?

A 38-year-old bus driver of the state transport corporation has had two generalised seizures in a month, and his EEG is abnormal. He refuses to tell his employer and plans to drive his usual route next week. Counselling has failed. What should his doctor do?

A 33-year-old woman's chest X-ray report noting a nodule is filed without the doctor reading it. Two months later the nodule is reviewed, found to be a benign hamartoma, and needs no treatment. She files a complaint of negligence. Why will her claim most likely fail?

A 29-year-old man diagnosed HIV-positive at an ICTC says he will marry next month and refuses to tell his fiancée. Repeated counselling has not changed his mind. Which course is consistent with the Supreme Court's ruling in Mr X v Hospital Z?

In a corporate hospital, a staff nurse gives concentrated potassium chloride as an undiluted IV bolus instead of an infusion, and the patient dies. The family sues the hospital as well as the nurse. On what basis is the hospital liable for her act?

A 50-year-old farmer is operated on, free of charge, at a government district hospital where every patient is treated free. He alleges negligence and wants to file a complaint before the District Consumer Disputes Redressal Commission. What is the likely outcome of the complaint?

A woman in Thiruvananthapuram complains that her doctor examined her intimately without a chaperone and made improper remarks. She wishes to complain of professional misconduct. Under the National Medical Commission Act, 2019, which body hears the complaint first?

In a crowded medicine OPD, a 45-year-old man is told that his blood pressure will be checked. Without saying anything, he rolls up his sleeve and holds out his arm. What type of consent has he given?

An inquiry by the State Medical Council finds that a doctor in Thrissur issued false fitness certificates to bus drivers for money. The council removes his name from the medical register for 5 years. What is this action called?

Before a planned laparoscopic cholecystectomy at a district hospital, the surgeon sits with a farmer and his wife and explains the operation in Malayalam, using a diagram. The farmer then signs the consent form. For his consent to count as informed consent, what must the surgeon have told him?

A radiologist pays a general practitioner a fixed commission for every patient he refers for an MRI scan. What is this unethical practice called?