PLAB 2 ethical dilemma stations: a complete guide

Ethical dilemma stations test whether you can reason through a difficult situation and communicate it sensitively — not just whether you know a rule. They commonly involve capacity, confidentiality, consent, safeguarding, or competing duties such as a patient’s autonomy versus public safety.

The principles to keep in mind

• Autonomy — respect a capacitous patient’s right to make their own decisions.
• Capacity — assess it properly before deciding someone cannot choose for themselves.
• Confidentiality — protect information, disclosing only with consent or clear justification.
• Best interests — for those who lack capacity, decide in their best interests.
• Public interest and safeguarding — sometimes a duty to others must be weighed.

A structure for ethics stations

1. Explore the situation and the person’s understanding and concerns.
2. Identify the competing principles at play.
3. Explain the relevant rules and your reasoning, in plain language.
4. Find the least restrictive, safest course, respecting autonomy where possible.
5. Document, signpost support, and escalate or seek senior advice if needed.

Common dilemmas

Confidentiality versus public safety (for example, fitness to drive), assessing capacity to refuse treatment, Gillick competence and contraception in under-16s, and best-interests decisions for patients who lack capacity all recur in PLAB 2.

Common pitfalls

• Confusing an unwise decision with a lack of capacity.
• Being coercive rather than respecting autonomy.
• Forgetting the safeguarding dimension.
• Stating rules without explaining your reasoning to the person.

Practise ethics stations on ZWIP — from DVLA confidentiality to capacity and Gillick competence — and use the feedback to sharpen both your reasoning and how you communicate it.