A hypertensive patient asks you to choose his treatment without disclosing potential side-effects of different options as that would only make him anxious, he claims. Which medical and ethical issues would you investigate before proceeding?

This question tests Oxbridge interview skills, mainly in area of Medicine. Purpose of the tutor is to guide the student through the dilemma and provide factual information or leading questions when stuck. This is akin to the structure of most Oxbridge interviews. Important points to discuss:

1. Mechanisms of common anti-hypertensive drugs (reduced afterload/vasodilation, reduced cardiac contractility, reduced circulatory volume)
2. Likely side-effects that these drugs might cause and how they might affect different people's quality of life and/or co-morbidities (e.g. postural hypotension, erectile dysfunction, electrolyte disturbances)
3. In light of that: The issue of consent when information is inadequate. Can the patient truly understand what is being omitted?
4. Patient autonomy and preference maximising medication choice (whilst not making them anxious) would involve an investigation into patient's lifestyle and personal preferences, e.g. sex life, how active they are, do they have other conditions, do they life with someone who can help them in case of an accident.
5. Considering all of the above, would you feel confident prescribing a standard set of first-line medications for hypertension?