HRS 4000 Quizzes

Interventions are sometimes said to be extraordinary as opposed to ordinary as a way to justify withholding them in an ethical way.

True

Paternalism usually limits a patient's autonomy, even when it is justified.

True

Patient harm may result from the publication of falsified or fabricated data.

True

Pressure to be candid and honest with patients, and specific patients' rights and responsibilities, are both arguments for disclosing difficult news to patients.

True

The Teleologic Theory focuses on the assessment of the ends or consequences to determine right or wrong.

True

The individualism underlying some approaches to autonomy can cause problems with some cultures which are more community-oriented.

True

The principles of autonomy and authority can coexist.

True

Ethical challenges in healthcare require careful identification of which of the following components?

whether some of all of the three are involved

Which of the following are considerations for the ethical use of cadaveric specimens in human research? (Select all that apply.)

whether the donor gave autonomous consent before death treatment of the body during testing the age of the donor at the time of death

A moral agent is anyone ___________.

who is responsible for the course of action taken

In this case, which of the following people are faced with an ethical problem? (Select all that apply.)

Mr. Martin's physicians Mary Martin Mr. Martins family New England Sinai Hospital Administration

Mr. Parker, was admitted to the hospital after a car accident in a permanent vegetative state. His physician, Dr. Grey, thinks he would be a great candidate for the hospital's body donation program upon his death and encourages his family to donate his body for research purposes. Dr. Grey suggests that the family's medical expenses could be reduced with the donation. What is(are) the problem(s) in this scenario? (Select all that apply.)

Mr. Parker's right to autonomous donation is being violated Mr. Parker is incapacitated and cannot make an autonomous choice

Mary is a researcher and physical therapist in a large university hospital. During data collection, Mary forgot to record the age of her subject. But because she is a medical professional within the system, she has access to the patient's electronic medical record and can look up her subject's date of birth. Even though Mary is not treating this patient, is it ethical for her to gather this information from her subject's EMR?

NO: Mary is not involved in her subject's health care and this would be a breach in confidentiality

One of the ethical challenges with this sort of research is called the humanitarian misconception. This is a specific case of the more general therapeutic misconception. Which of the following statements most accurately describes the humanitarian misconception?

Participants believing that to receive humanitarian aid they must participate in research.

Which theory is more often employed with organizational decision-making?

all of these reasons may lead to the conscientious objection being refused

Which of the following is not an advantage of in vivo human research?

allows for strict control by study design

Which document would have provided the best chance of avoiding this case from becoming an ethical problem to begin with?

an advanced directive

One component of informed consent is the subject's participation must be voluntary. Which ethical principle is upheld by this component?

autonomy

All forms of human research raise ethical issues. These are particularly challenging in humanitarian settings. Present a general ethical argument that either supports or rejects doing research in humanitarian settings. In your answer, use the research project described in this case as an example and use at least 2 ethical principles or concepts to either support or reject the importance of conducting humanitarian research.

A general ethical argument, that rejects doing research in humanitarian settings, is that when a disaster has hit a place that ends up in need of aid/help from anyone willing to give; the researcher is usually seen as the enemy by not following the Beneficence principle of doing "good" for someone. Instead of helping in that setting, they tend to offend those who were affected/those who were in a time of need. Rather than fostering that calm space of help for the subjects, and not ignoring the Nonmaleficence principle, of not harming those who are affected, the researchers often do so and cross that principle by making those involved feel like a "research subject" and their feelings may be harmed.

Which of the following is not a reason someone might falsify data?

ALL of these are reasons for falsification Reasons: not wanting a hypothesis to be wrong obtaining funding for research pride in one's work aiming to please

What two conditions are required for the existence of autonomy?

agency & liberty

Which of the following statements best reflect the principle of nonmaleficence?

do not harm anyone

Sound clinical reasoning integrates what 3 components? (Select the 3 that apply.)

evidence-based practice client's/patient's preferences, beliefs, & values clinical expertise

What is the goal of the Animal Welfare Act and the three Rs?

humane care of the animals

Why would special considerations be necessary for children, those with developmental disability, and those with diminished mental capacity when it comes to their participation in health research?

these populations are considered vulnerable because they may not be able to understand the details of research participation or have sufficient competence to give truly informed consent

Informed consent is regarded as a central ethical issue in research. Give three different ethical reasons as to why informed consent is regarded so highly and use a couple of sentences for each reason to justify it ethically (2 points each). Make sure each of your justifications includes ethical principles or ideas.

1. Three different ethical reasons as to why informed consent is regarded so highly because (1) It is ethically required for any research to inform the participant of their rights, the aim of the research, and gives them a sense of security. This is ethical because it ensures safety, to the participant and gives them a choice if they want to participate or not. The principles of Nonmaleficence, not doing harm to the subject and Beneficence, doing good to the subject. (2) It also allows there to be an open ongoing interaction between the participant and the researcher. It is ethically important because communication is very important in any experiment. It allows information to be conveyed much easier and allows research to be smoother. (3) Lastly, the subject will not be confused what the study if for/what it will be used for. This is ethical because the subject will not be mislead ant any point and will ensure that the subject truly understands the study. They will understand that they can back out if they want and all autonomy is allowed in this situation. The subject will be making their own decision if they will participate or not.

A living will is an example of:

Advanced Directive

Humane care refers to actions taken to ensure that animals are treated according to high ethical and scientific standards when used for research.

True

The __________ Theory focuses on duties.

Deontologic

A mentor helps in the development of clinical competence, but rarely is of any benefit in developing as a moral agent.

False

Advanced directives are helpful for individuals deemed never competent.

False

Because the administration of a placebo drug/treatment involves deception, it is always unethical to use in patient care.

False

Competence usually refers to clinical judgement while capacity more often refers to legal judgement.

False

Daffy Duck is a nurse at the Looney Tunes hospital. His dear friend Bugs Bunny has been admitted to the hospital. Although he is not directly involved in Bugs Bunny's care, Daffy decides to check on his friend through the electronic medial record system. This was not a breach of confidentiality because they are really good friends.

False

Every account of ethical misconduct is caught and punished by an external review committee.

False

Study approval is required prior to starting research on anonymous data.

False

During your first day working in an intensive care unit (ICU), the parents of a patient come to you upset. They are really dissatisfied with how their daughter is being cared for. They want her transferred to another hospital immediately. You are not sure what to do, but you think something is not being done correctly. But it's your first day, and you're not really cure what you should do. Which prototype of ethical problems best describes this scenario?

Moral distress Type B

A reliable general test that can be used to figure out if a team member should be given certain types of information about a patient is called the:

Need to Know Test

Dr. Watson is proposing a research study to his university's Institutional Review Board. The IRB requires that Dr. Watson provide a rationale for why his study will have greater benefits than risks to the potential subjects. What ethical theory is the IRB using to protect the subjects?

Utilitarian (Teleologic)

Some people on your research team (let's call them Group A) are worried about the ethics of doing any research in a refugee camp where people are confined and suffering. Others (Group B) reply that the positive benefits which will come for many refugees outweighs the ethical concerns of Group A. The ethical theory being used by Group B most closely aligns with:

Utilitarianism

Shared decision making is a term in healthcare that reminds us that ethical communication is:

a 2-way process between the healthcare professional and patient

The administrative team at a local hospital must decide between funding a community nutrition education program for people at risk of developing diabetes OR funding a nutrition intervention for people diagnosed with diabetes. Which ethical principle should be central to their deliberations about how best to allocate the limited funding available?

justice

Which of the following is not an advantage of in situ human research?

majority of donors are elderly

Dr. Jameson, a principal investigator, wants to study the effects of spinal cord injury on muscle function. Instead of using mice for the study, she decides to use OpenSim software to perform a simulation of muscle function after spinal cord injury. Which animal welfare guideline is she following in this example?

absolute replacement

Which of the following are potential motivators for scientific misconduct? (Select all that apply.)

aiming to please amplification of analysis pride publication bias money

Which of the following is an appropriate role that emotions can play in ethical decision making:

alerting you to a situation requiring action

Which of the following can be sources of confidential information about a patient?

all of these

Why is it important to evaluate the process and outcome?

all of these are are reasons it is important

Which of the following is not a potential consequence of the use of a placebo?

all of these are potential consequences

How does low health literacy pose a problem to informed consent?

all of these are problems

Which of the following is(are) a(n) argument(s) for the moral status of an animal?

an animal has the capacity to enjoy life/feel pleasure an animal has the capacity to suffer/feel pain

Which of the following are reasons that breaking a confidence is necessary (and legal)? (Select all that apply.)

an emergent situation in which keeping the confidence will harm the patient a court order the patient is suicidal the patient is incapacitated and a 3rd party needs to be informed so they may become the patient's decision maker

When clinicians provide access to lethal medications which patients intend to take themselves to cause their death, this is called:

assisted suicide

Why is it important to explore practical alternatives to an ethical problem? In this question, there could be more than 1 right answer, so check all that are correct.

being in a stressful situation may make it seem like our options are limited there may be a better solution you haven't thought of yet

Kerry is a research associate tasked with keeping the key to coded subject data protected and maintained throughout the duration of the study. What data protection method is the research team employing?

confidential

Professionals become aware of when their personal ethics clash with professional or organizational ethics because of their:

conscience

Which group(s) of individuals is/are considered a vulnerable population(s)? (Select all that apply.)

children economically disadvantaged people persons illiterate in English prisoners

A medical student explains to her attending physician how she used available research evidence to recommend a particular treatment for her patient. This is an example of what type of reasoning?

clinical reasoning

Complex professional problems often have 3 components:

clinical, legal, ethical

Dr. Eli is testing the efficacy of a new blood pressure medication. The experimental group has members with more positive results than the standard treatment group, but the difference isn't statistically significant. In an effort to boost the strength of the results he sees, he added results for 6 more subjects (who were not actually enrolled in the study) in each group. What type of scientific misconduct is this?

data fabrication

What type(s) of scientific misconduct was(were) committed in the Wakefield publication? (Select all that apply.)

falsification of data fabrication of data

Which of the following conditions would be part of using the principle of double effect to ethically justify giving a dying patient morphine to relieve intense pain, even if this might cause the patient's breathing to be depressed? Check all that apply.

giving morphine is not morally problematic in itself depression of respiration is not required to bring pain relief the clinician intends to relieve the patient's pain the pain relief is more significant than any risk of depressed respiration

The Principle of Material Cooperation is based on the importance of which concept in ethics?

intention

What might be a legitimate reason that a caring response feels burdensome?

it can feel overwhelming to care so deeply all of the time

Why is identifying the type of ethical problem important?

it will guide you as you analyze the situation and decide what course of action is best

The absence of due care is known as:

negligence

Patient-centered care ___________________________.

is tailored to the individual

Which of the following is not an ethical principle that informs the ethical basis of conducting good science?

maleficence that justifies some harm

This question has 4 parts. Who would you want to talk to as you gather more information about the case? (1) Pick one person/source of information (it could be a database) and (2) explain why you think he/she/it will provide information relevant to the ethics of this case. (3) Include an example of one specific question you would ask and (4) how you think the answer will help you with the ethical analysis.

1. I would love to talk to Scott Martins wife because she would be able to describe the case rules/law/ethics that the physicians have given her and the options she has in terms. 2. The physicians wouldn't be able to tell me any case details due to patient confidentiality. So I believe talking to Scotts wife would be the best option because she would be open and willing to talk to a healthcare professional seeking to help and evaluate there case. 3. One questions I would ask: "If your bills will be paid entirely by Blue Cross/Blue Shield will you keep Scott on the artificial feeding tube?" 4. Sometime medical costs often lead people to having huge debt and they have to make life ending decisions for the sake of their families future. If Blue Cross/Blue Shield cover these costs for more time Mary Martin might change her decision to pull the plug.

This question has 3 components. Using the details provided in the case and considering the questions in the Research Ethics Tool, identify (1) one aspect of this research project that you see as raising serious ethical concerns. (2) Explain -- using ethical principles and concepts -- why you think this is an ethical problem. (3) Discuss either how you think this ethical problem could be resolved ethically OR why you think it cannot be resolved and that the research will have to be done differently (or not at all).

1. One aspect of this research project that I see that raises serious ethical concerns are the researchers conducting this experiments moral. Their moral may be questioned by those who they are questioning. Their intention may seem as if their efforts of giving care are false. Considering the fact that, these individuals, who are being experimented on, come from impoverished communities; they might feel overwhelmed and upset by those researchers are not offering efforts to improve their living conditions. 2. This is a ethical problem because it violates beneficence and justice. By not doing good to all parties included, and not being fair to all the groups, in hopes of helping their own research efforts. 3. This ethical problem can be resolved ethically by the research group first offering the community help to rebuild the happiness of those who inhabit. The care that will be given will seem genuine and will allow those to feel comfortable with the research team. By conducted the research/questionnaires after the help has been provided by the team they must offer all groups some type of incentive rather big or small.

This question has 2 components. One way to address ethical issues in a research project is to actively consult with the community where participants reside to get their views on and concerns about the research. (1) Propose a way that this could be done in this research study and (2) give two ethical issues that could be addressed through this approach

1. One way to address the ethical issues in this research project, while actively consulting with the participants in this study, is for researchers to ensure their standardized questionnaires are thoughtful and logical; considering the situation. Having a bad questionnaire can be seen as unethical and poorly conceived by those who take it so trying to include questions at the beginning that tend to the communities well being will be seen as a caring act. The participants may feel "more at a at home", and will be much more receptive with the research being done. 2. Two ethical issues that can be addressed through this approach is beneficence, by ensuring good is done to those who are involved in the experiment when taking the standardized questionnaire and Nonmaleficence, by no harm being done to those who are involved in the research study itself.

This question has 2 components. Trust is a very important part of research. Using your imagination, (1) speculate about why the residents of these camps might be distrustful of this research project. (2) Provide one example of something that could be done to improve trust regarding this research.

1. Residents of these camps may be distrustful of this research project because they might feel defeated as this crisis of refugees has struck. They might be even more bothered by the standardized questionnaires being handing out rather than immediate help being given by those who were deployed to this country. 2. One example of something that could be done to improve the trust in this research is bringing emotion and fostering relationships within the community. Expressing true care and showing someones true moral really builds a trusting relationship between a group of people.

When beneficence clashes with autonomy, a solution can always be found in which all the clinicians and patients involved will be completely satisfied.

False

What alternative to removing the feeding tube (Mrs. Martin's option) or continuing it indefinitely (the hospital's option) can you think of (e.g., alternative treatment plans, ethical approaches, or decision-making strategies, etc.)? Provide only 1 alternative and then explain why you think this would be ethically preferable to the options in the case. (This question could be taken in many directions. We are looking for your critical/ethical, out-of-the-box thinking here. Be sure to use ethical conepts to justify your answer. To give a really good answer, we would expect several sentences, not just a couple.)

A alternative treatment would to give a time limit for how much longer the treatment should be prolonged. The treatment should be based off of the hospitals recommendations and what they think is a viable amount of time for Scott to live. This option that would be best fit for Scott I think would ethical preferable because it would limit the costs that the hospital would be charging Martins family, if Blue Shield doesn't cover the costs. It would be better than the hospitals option for their indefinite care because it would cut costs down for the hospital to be spending from their end; and it would give Scott a chance to get better in the time allotted for the hospitals to try different treatments rather than him going through the same old routine forever.

Sherlock Holmes needs to solve an ethical problem. What is the first step he should take?

Gather the facts

A new drug has been introduced to the market but is in very scarce supply. Dr. Grave knows of a study that is currently using the drug. Dr. Grave tampers with his patient's information so that she can be admitted into the study and receive the new drug (even though she does not meet the study's inclusion criteria). What are the potential consequences of Dr. Grave's actions?

Dr. Grave's patient may experience a negative reaction to the drug because it was not intended for her specific population Dr. Grave may lose the respect and trust of his colleagues and patient if they find out the results of the study are now confounded a patient who did meet the inclusion criteria cannot be admitted because Dr. Grave's patient took that spot

Dr. Grey is conducting a research study and is having trouble recruiting enough subjects. Her study has two groups: a treatment group and a control (no treatment) group. Dr. Grey has a patient who desperately needs the treatment. She encourages her patient to participate in the study knowing that the patient could be randomly assigned to either the the treatment group or the no treatment group. Because Dr. Grey needs more subjects, her actions are ethical even though her patient may not get the required treatment.

False

Good communication in healthcare depends purely on ensuring that accurate information is presented to patients in unemotional language.

False

In Step 5 of the 6-Step Process, consciously deciding not to act is the same thing as failing to follow the most ethical course of action.

False

Moral distress is usually experienced in the same way by an individual and by a team when facing an ethical dilemma.

False

Steve is 12 years old and his mother signs him up to participate in a research study. His mother signs the parental permission form but Steve refuses to sign the informed assent form. Because Steve is a minor and his mother signed on his behalf, he must participate in the research study.

False

The ultimate responsibility for ensuring informed consent rests on the Institutional Review Board (IRB) which approved the study.

False

Which ethical approach or theory would you use to analyze this situation and why? Pick one approach or theory (even if you might use more than one) and provide 2-3 sentences to explain why you picked this one for this case.

The ethical theory I would use to analyze this situation would be Utilitarianism. I would use Utilitarianism in this situation because based on the moral judgements made, or that will be made, of the case for Scott the best option that would be chosen based off of how many people would benefit from the decision made in this situation. Those people would include those who have a close connection with Scott; his family members, physicians and friends.

Confidentiality is essential for providing a caring response and maintaining trust in the provider-patient relationship.

True

Communications in healthcare involves which of the following means?

all of these may be involved

Match the following terms with the appropriate definition.

goal of research - to answer a question goal of healthcare - improve a patient's condition undue influence - excessive and inappropriate reward offered to obtain compliance coercion - an overt or implicit threat of harm is presented to obtain compliance

A caring response is the ethical goal of every health professional and patient relationship. Which of the following is not a characteristic of a caring response?

identifying whether you like someone's religious background

Jane believes that studies using animals are ethical only if the results of the study have a vastly greater benefit to humans than the burdens placed on the animals. Her views represent what stance?

middle ground

The virtue that motivates you to act according to what you are convinced is ethical is called:

moral courage

A case in which a health professional is uneasy about the level of understanding exhibited by a patient providing consent is an example of which type of ethical problem?

moral distress

Taryn is a student in her final year of college and is about to graduate and her honors thesis is due in two weeks. Throughout the introduction section, she pasted several sentences, changing only a few words, from several articles she planned to review as placeholders in her document. Taryn lost track of time and did not return to make these changes prior to submitting her thesis. Her advisor recognizes some of these phrases and now questions the originality of the work. Which type of plagiarism did Taryn commit?

mosaic plagiarism

In the story of Mitch, the student, and the home health visit, which ethical principles did Mitch violate? Check all that apply.

nonmaleficence justice veracity

The comments from the guardian ad litem in the second paragraph of Part 2 can be described in ethics terminology as a discussion of:

ordinary and extraordinary means

When is it appropriate to immediately report unethical behavior in a co-worker?

patient safety is of concern

Paying close attention to details and seeking appropriate communication tools are two components of ___________?

patient-centered care

Which of the following challenges may arise when the primary care provider is also the principal investigator of a research study? (Select all that apply.)

patients may feel pressured to participate so they do not disappoint their clinicians imbalance of power between the patient/subject and provider/researcher patients may confuse clinical care with research

Why should the informed consent process be an ongoing process?

patients may forget what they "signed up" for

A patient complains of low back pain to his physician. The physician tells the patient that he should take some pain relievers but gives him a "sugar pill" instead. The patient immediately reports a decrease in pain. What is this an example of?

placebo effect

What is most often the root cause of sentinel events in healthcare?

poor communication

Two patients (who have the same physician) need a liver transplant for survival. Patient Z is 45 years old and also suffers from diabetes, high cholesterol, and high blood pressure. Patient X is 60 years old without any other co-morbidities. The physician decided to add the 60-year old patient to the transplant registry, and not to add the 45-year old. Which factor most likely contributed to this decision?

prospect of success

An ethical problem requires attention to both __________ and __________ during the decision making process.

reasoning; emotions

Match the terms to their correct definitions.

refinement - modification of a experiment reduction - using a power analysis replacement - use of something other

Jim Hopper, a 40 year old sheriff, volunteers to participate in a research study about a new test for a genetic disease. Which of the following concepts are important to discuss before Hopper consents to participate? (Select all that apply.)

risks and benefits that Hopper can expect from his participation in the study the side effects that might arise during the study Hopper's right not to know the test's results

What must Kerry do to keep the key protected? (Select all that apply.)

store the key separate from the research store the key separate from the subjects' identifiers

Which theory is more often employed with organizational decision-making?

teleology

A fiduciary relationship means that healthcare professionals have a more powerful position in relation to patients which means they should act according to:

the best interests of patients

An ethical _________ includes an assumption about the very nature of right and wrong.

theory

A patient decides to enroll in a research study because he believes the experimental treatment must be the newest and the best, and so it will yield the most benefits for him. This is an example of which concept?

therapeutic misestimation

Under which circumstances might an individual be treated without providing consent? (Select all that apply.)

they are unconscious and unable to provide consent the parent of a minor gave consent to treat

A student in a healthcare program always has an ethical responsibility for which one of the following:

to speak up about ethical concerns they perceive

When considering what information should be entered into an electronic medical record, which of the following is (or are) good guidelines to follow? (Select all that apply.)

true information should only be recorded if it is relevant all information should be handled with regard for patient privacy and dignity questionable information should be clearly labeled as questionable

Dr. Hopkins is the principal investigator of a research study. Which ethical principle(s) would be violated if Dr. Hopkins did not inform his potential subjects of the risks they may be exposed to as a result of participation in the study? (check all that apply)

veracity nonmaleficence

A new drug for the treatment of breast cancer is available. Mary is a breast cancer patient who has received chemotherapy previously, and her cancer has returned in a very aggressive manner. After discussions with her medical team, she decides not to try this new drug. This is an example of:

withholding treatment