The Casper® exam is designed to test your ability to make appropriate decisions and use sound judgment. A lot of your decision making capabilities are based on who you are as a person and your values, but there are some core principles that we will cover that you can consider when making important decisions.

As you move along your medical training, you will be immersed further into the fundamentals of ethical decision making, and how it relates to your practice as a physician and your patients. For now, let’s cover the basics and discuss how you can utilize these for Casper®!

There are four principles of medical ethics:

1. Autonomy. The principle of autonomy refers to an individual’s right to make decisions for themselves. Though there are many complexities to this principle, the key is that decisions made by individuals should be done so without coercion or undue influence.

For example: If a patient is deciding to have a particular medical treatment, it is the physician’s responsibility to educate the patient on the procedure, and its associated risks and benefits, however it is the patient’s choice to have the procedure or not.

The physician may not pressure the patient, or force him/her to have the procedure.

How this can be incorporated with Casper®: Many Casper® scenarios will not be medically related but have to do with everyday situations that people may face. During the exam, you can utilize the principle of autonomy by never forcing or demanding an individual to make a decision. Instead, you can educate, encourage, and help them to a particular decision.

2. Beneficence. Beneficence is the ultimate principle of practicing as a physician.
This is always trying to do good for patients. This principle implies that a physician will always work in the best interest of the patient.

Example: A patient needs an operation. There are two ways that a physician can perform the operation and the physician must choose which procedure is best. One way that the physician can determine the course of action is to pick the procedure that is intended to provide the most benefit, while minimizing harm to the patient.

How this can be incorporated with Casper®: Similar to working in the patient’s best interest, try to always answer the question in the best interest of the individual that is the subject of the scenario. If there is a way that you can help or assist the individual, then that is always the best course of action.

3. Non-maleficence. ‘First, do no harm.’ Most pre-meds have heard this excerpt from
the Hippocratic oath and this is really what the principle of nonmaleficence embodies. Physicians should never harm their patients. This principle goes hand in hand with beneficence as physicians should always work in the best interest of their patients while not causing harm.

Example: A patient comes to the doctor’s office for symptoms of the common cold and wants antibiotics. The physician does not believe antibiotics will help the patient. Although the patient wants the medicine, the physician does not provide them because taking the medication could actually cause harm by unnecessary side effects.

How this can be incorporated with Casper®: Use non-maleficence along with beneficence. As you are trying to help the individual in the scenario make the best decision, try to help them with a decision that will also not hurt them.

4. Justice. Justice is the fourth principle of medical ethics but is likely the one
that is most obscure for the Casper® exam. Justice, in a medical setting, refers to the
equal treatment of every individual.

Example: An emergency room physician is seeing patients and a homeless patient without medical insurance comes in for care. Using the principle of justice, the physician must see the patient and treat him regardless of his socioeconomic status and lack of insurance.

How this can be incorporated with Casper®: Think of treating every individual fairly. For instance, if the scenario involves resolving conflict between multiple people, treat them equally and do not give preference to one individual.