Ethic and Legal Issues EXAM II Review

Expressed Consent

"An affirmative action or statement to signify one's intention) defines what type of consent?

Accreditation

"The process whereby a nongovernmental agency or organization evaluates and recognizes an institution or specialized program of study that meets certain established qualifications and educational standards for periodic evaluation" defines what term?

*****Please review the sample case found onpage 51with respect to the rights of pregnant workers.*****

****Please review the sample case found onpage 51with respect to the rights of pregnant workers****.

***Please review "vignette 12 -- improper communication situation.***

***Please review "vignette 12 -- improper communication situation.***

****Please review the last paragraph on page 65 that represents a kind of case study that continues on to the next page (?).***

***Please review the last paragraph on page 65 that represents a kind of case study that continues on to the next page (?).**

ARRT (American Registry of Radiologic Technologists)

/What is the most widely accepted certification organization for videographers and radiation therapists?

Patients Parents

14-year-old girl presents to the emergency department, accompanied by her 10 month old daughter and boyfriend. The boyfriend is the child's father. Patient complains of severe lower abdominal pain, although she is afebrile, with normal laboratory values and normal vital signs. No cause of the pain is able to be delineated, and the plan is to take the girl to the operating room to perform a diagnostic laparoscopy. In this case, from whom should informed consent be obtained?

Respect the patient's wishes

28 year old woman presents to the emergency department with malaise and fever. She is accompanied by her 4 year old son and her 30 year old sister. In the ER, patient is found to be febrile and initial diagnosis is sepsis of uncertain etiology. Plan is to begin intravenous antibiotics. Prior to beginning treatment the patient refuses, stating that she does not want antibiotics because god will heal her. She is known to be deeply spiritual. The physician fully explains to the patient the risk of death if not treated, yet the patient still refuses. During further discussion, it is discovered that the patient's sister has agreed to care for the son given death or incapacitation of the patient. In this situation, the appropriate next step is: -Provide treatment to the patient because she has a child who requires her care - Respect the patient's wishes

E. B and C

30 year old male presents to the emergency department with RLQ pain and fever. Labs reveal an elevated white blood count. The surgical intern tells the patient that appendicitis is suspected and that the plan is to proceed with surgery to remove the appendix. He explains that the surgery is to be performed to prevent complications of appendicitis, including abscess formation, sepsis or even death. He goes on to explain the risks of surgery, including bleeding, infection and damage to adjacent organs. What additional information needs to be included in this consent? A. Whether or not the intern would undergo the procedure in a similar circumstance. B. Alternative to the surgery, including receiving antibiotics and monitoring the patient. C. Name of the surgeon who will actually be performing the procedure. D. A, B and C E. B and C only

True

33 year old woman is in the operating room to undergo colectomy for ulcerative colitis. Patient was given appropriate information, and consented for the procedure. During the operation, a mass is identified involving the liver. Given the previous consent, it is acceptable for the surgeon to proceed further to either biopsy or excise the lesion. -True or False

True

47 year old drug abusing male presents to the Emergency department complaining of diffuse abdominal pain. Patient is found to be febrile, although the vital signs are stable. CT scan of the abdomen/pelvis reveals multifocal abscesses. Plan is for surgical evacuation of these multiple collections. In further evaluating this patient, it is found that the patient was in the emergency department a few weeks ago, and at that time had fewer, smaller abscesses. He refused treatment at that time, claiming that his body would heal itself. Based on these findings, the physician should conclude that this patient is competent from the standpoint of informed consent.

his/her parents or legal guardians

A minor is considered to be under the jurisdiction of whom?

Minor with a child

A minor may be considered an adult for the purpose of their own consent in each of the following cases except

Inability to adequately receive or evaluate information

A patient is considered incompetent when which of the following criteria are met?

Murder

A radiographer who takes the life of a terminally ill patient would be charged with _____?

placed in storage vaults that are available for reference

After one year, where should those films be stored?

sufficient information, by either the physician or their representative, to allow the patient to make an informed decision regarding whether or not to consent to a treatment or procedure.

Article: Informed consent is a patient's right to be presented with:

1. Diagnosis 2. Purpose of proposed treatment / procedure 3. Possible risks and benefits of proposed treatment / procedure 4. Possible alternatives to proposed treatment / procedure 5. Possible risks of not receiving treatment / procedure

Be familiar with the five essential elements of informed consent.

Active participation of the imaging professional doing good preventing harm

Beneficence involves which of the following

exact rules feelings and beliefs of the imaging professional legal issues and judicial decisions guidelines from the american medical assoc.

Biomedical ethics includes which of the following?

Certification

Blue Book Chapter 10 "The process by which a nongovernmental agency or organization grants recognition of competence to an individual who has met certain predetermined qualifications specified by that agency or organization" defines what term?

assault and battery

Blue Book Chapter 6: A surgeon who performs an operation (or a radiation therapist who gives a treatment) without the patient's consent may be liable for _______________________ and __________________________.

Joint Commission on the Accreditation of Healthcare Organizations

Blue Book Chapter 9: What do the initials JCAHO stand for?

U.S Department of Labor

Blue Book Chp 4: What US federal department is concerned with the issue of wages and hours?

No

Can a husband consent to his wife's radiation therapy treatment in a non-emergency situation?

to encourage citizens to assist their fellow man by rendering emergency medical aid to injured persons

Chapter 5 Blue Book: What is the "main purpose" of the Samaritan Laws?

Teleology

Consequentialism is another name for which of the following?

patients name, x-ray number, date, and place

Correctly marking films is critical for legal purposes. In addition to right and left markers, what four items must be imprinted on the radiographic film?

is when immediate treatment is required in order to prevent death or serious health impairment

Define "emergency" in the context of informed consent where such consent may not be required.

Significance of the motives

Deontology emphasizes which of the following?

personal study and investigations, system of professional conduct

Describe two major functions of a code of ethics:

Family's wishes

Discussion of each of the following must be included when giving Informed Consent except:

Removal of ovary for incidentally encountered ovarian mass

During performance of a procedure, when an unexpected finding is encountered, in which of the following cases would it not be OK to address that finding?

Theological

Ethical considerations are subject to philosophical, _____, and individual interpretations of what is right or wrong in a particular situation

A system or code of conduct and morals advocated by a particular individual or group

Ethics is defined as

17 and below

Generally speaking, what age for someone be in order to not be considered a minor?

the patient only , unless they fall under the category of not mentally competant

Generally speaking, who may give consent for treatment?

1. married 2.emancipated 3. pregnant 4. suffering from a venereal disease 5. in need of psychological or psychiatric care

Give five circumstances wherein a minor may be able to consent for their own care.

unwanted sexual advances, or visual, verbal, or physical conduct of a sexual nature

Give the EEOC definition for sexual harassment:

1.5 times

Hospitals and medical centers are required to compensate employees at what rate compared to the regular rate of pay for all overtime hours?

when the harasser is a rank and file employee and there was a program to prevent harassment

How might the employer avoid liability with respect to sexual harassment apart of an employee?

Implied Consent

If a patient rolls up their sleeve to receive an injection, this is an example of what type of consent?

the patient has the right to sue for medical malpractice

If informed consent is not obtained, what right does the patient have?

Sterilization procedure

In Virginia, a minor may consent for themselves in all of the following cases except:

When the temporary caretaker conveys that the parent wished care to be performed

In a case when a minor has been left in the temporary care of another, when would it not be acceptable to provide treatment?

30 days

In general, informed consent is valid for what length of time if the treatment is not planned well in advance?

24

In order to renew registration each year, the radiation therapist must pay an annual fee plus must document what number of "continuing education credits" over a two-year period?

Single parent at risk of death without family to care for child

In which of the following cases may it not be OK for the patient to refuse treatment?

When immediate treatment is necessary to prevent death or permanent impairment

In which of the following cases would informed consent NOT be necessary:

Complex??

Informed consent is required for (circle one) procedures: complex, simple, common

Good Samaritan Laws

Laws passed to protect its citizens from civil or criminal liability for any acts or omissions resulting from attempts to give emergency medical aid are called

Evil is avoided

Nonmaleficence occurs when which of the following takes place?

all hours worked in excess to 8 hours a day or 40 hours a week OR bi-weekly pay- 8 hours a day / 80 hours a week

Overtime pay is required if the hourly worker works in excess of how many hours per day and/or how many hours per week (and a one-week, 40 hour pay period AND in an 80 hour pay period)?

7 years or until minor reaches age of adult plus one to three years

Radiographic film should be kept for a minimum of how long?

Surgery to amputate limb

Regarding guardian decision-making for an incompetent patient, in which case may a court order be needed to provide treatment?

priestly

The ____ model treats the provider as an omniscient or fatherlike figure

convenantal

The _____ model is biased on traditional values and goals

contractual

The ethical model that treats the relationship between the health care provider and patient as a business agreement is the _____ model

value conflicts patients awareness of lack of awareness rights differing hierarchies of values

The imaging professional may encounter biomedical ethical problems because of which of the following?

nonmaleficence, beneficence

The strongest action is _________, or the avoidance of harm; ______ is weaker and concerns the doing of good.

OSHA

This legislative act protects employees from abuses of employers and helps to provide for a safer working environment.

True

True or False: Ethics was born of necessity

False, it is NOT a lawful excuse

True/false religious believe is a lawful excuse for breach of duty to provide medical care for a child under all circumstances. (Though, in spite of the answer to this question, most states allow religious and/or philosophical exemptions for parents not immunizing children).

True

True/false: Consent Forms need to clearly states that the patient should ask any questions they may have about the proposed procedure

False, they vary from state to state

True/false: Good Samaritan Laws are the same with respect to their particular coverage for each state

True

True/false: Hospital employees are to report any injury to a patient to appropriate hospital administration.

True

True/false: If there is no relationship between the parties involved, with respect to the possibility of rendering aid in an emergency situation, and no "duty" arises.

False

True/false: Informed consent is required for all medical procedures.

False, under control of STATE government

True/false: Licensure is under the control of the federal government.

False, they CAN be introduced in court of law as evidence

True/false: Radiographic films cannot be introduced in a court of law as evidence.

False

True/false: Under English and American law, everyone is forced to render aid in an emergency situation under all circumstances.

False

True/false: a parent's religious beliefs are always (legally) respected with respect to the parent denying treatment for their child.

False, can be rescinded verbally

True/false: a written consent must be rescinded only through another writing, and cannot be rescinded verbally.

True

True/false: according to the textbook the law may interfere with religious practice.

True

True/false: according to the textbook, the law does not interfere with religious convictions.

True

True/false: an oral or verbal consent is binding.

True

True/false: if a person is declared mentally incompetent, then it is possible for someone else, such as a legally authorized person or someone give them power of attorney, to give consent for treatment.

True

True/false: over time is not mandatory.

True

True/false: the Equal Pay Act demands that employees receive equal number of hours each pay period as compared with the other employees.

True

True/false: the employee or (facility) may be held liable for sexual harassment even if the employer was not aware of a harassment.

False

True/false: the employer need not get the approval of the employee in order to require extra work hours.

False

True/false: the fair labor standards act with respect to overtime pay applies to salaried or contracted workers as well as hourly workers.

True

True/false: the patient may rescind or decline the consent given either verbally or in writing at any time.

a process by which a government agency authorizes and individual to engage in a given occupation and use a specific title

Use the first sentence under the heading LICENSURE to define the term licensure.

1. to establish standards 2. to conduct surveys 3. To award accreditation

What are the three purposes listed for the JCAHO?

Occupational Safe and Health Act

What do the initials OSHA stand for?

Parens Patriae Doctrine

What doctrine allows the state to intervene to protect the health of the child?

A. Action must be good or morally indifferent in itself B. Agent must intend only the good effect and not the evil effect C. Evil effect cannot be a means to the good effect D. Proportionality must exist between good and evil effects

What four conditions are used in the principle of double effect to assess the proportionality of good and evil in an action?

to try to decrease the harmful effects of excessive and unnecessary amounts of radiation to which the public is being exposed by untrained and incompetent operators of x-ray equipment.

What is the "basic purpose" of licensure?

it might be difficult to prove the patients oral consent

What is the legal difficulty with respect to oral or verbal consent?

FLSA (Fair Labor Standards Act)

What legislation requires hospitals and medical centers to pay their employees at least minimum wage?

filed in the department

Where should "x-rays" ( what we will always be referring to as "radiographic films" or simply "films") be stored initially?

B. Fidelity to conscience

Which of the following defines morality?

ARRT (American Registry of Radiological Technologists)

Which of the following has the regulative powers to enforce the ethical codes?

Informed consent processes

Which of the following is a contractual agreement?

Patient standing in line to receive an Influenza vaccine.

Which of the following is an example of Implied Consent?

the individual is no longer under the control of another - generally this occurs when a minor is working and is responsible for their own support and necessities

With respect to a minor giving consent, defined the term "emancipated".

the act of the patient standing in line to receive a vaccination.

an example of implied consent.

what is normally thought of by consent, or when the patient consents by direct words, written or oral

express consent.