Healthcare Ethics Pre/Post Tests

Which of the following groups of people, according to Cantor and Baum, are made disproportionately vulnerable by a pharmacist's refusal to fill a prescription?

(All of these) -The impoverished -Those living in rural areas -Those whose access to alternative pharmaceutical providers is limited

Which of the following are typical motivations for a physician's nondisclosure to their patient, according to Francoise Baylis?

(all of the above) Concerns about professional relationships with other physicians, Diminished professional reputation owing to a perception of incompetence, Fear of disciplinary proceedings or litigation

According to Ken Baum, when does the criminally condemned patient most need the care of a physician?

At the end of the criminal process

A mode of moral reasoning that is case-based, stressing the pivotal role of the particularity of cases while deemphasizing the role of theory and routinized appeals to the principles of bioethics.

Casuistry

The aim of the physician-patient interaction is to help the patient determine and choose the best health-related values that can be realized in the clinical situation. The physician is thus required to delineate information on the patient's clinical situation and then elucidate the types of values embodied in the available options.

Deliberative model

The conception of patient autonomy is moral self-development; the patient is empowered not simply to follow unexamined preferences or examined values, but to consider, through dialogue, alternative health-related values, their worthiness, and their implications for treatment.

Deliberative model

A moral theory premised on feminist values, seeking to unmask and challenge the oppression, discrimination, and exclusion that women, the impoverished, the disabled, people of color and other disenfranchised peoples have faced.

Feminist Ethics

Beneficence

Foster the interests and happiness of other persons and of society at large.

A consequentialist theory based on the principle of utility wherein you should do the action that will cause the greatest good for the greatest number of people, or which will cause the least harm to the fewest people

Utilitarianism

What is the term that best fits the following definition: a metaphorical way of keeping all parties from knowing their special characteristics (i.e. if he or she is rich or poor, black or white, male or femal, or politically liberal or conservative) and is designed to prevent people from tailoring social principles to their own advantage?

Veil of Ignorance

A family of moral theories that are specially concerned with or that give special priority to the role of the virtues in moral life.

Virtue Ethics

True or False: One of the characteristics of adequacy of health care is its ability to reflect a reasoned judgment not only about the impact of the condition on the welfare and opportunity of the individual but also about the efficacy and the cost of the care itself in relation to other conditions and the efficacy and cost of the care that is available for them?

true

True or False: The case of Vitaly Tarasoff et al. V. The Regents of the University of California et al. is a case that debates whether or not the University of California et al. owed a duty of care to Tatiana Tarasoff and her family despite the fact that the Tarasoff's were not the patient in the case in question.

true

True or False: The court in the Tarasoff case asserted that the risk that unnecessary warnings may be given to potential victims of patients in treatment is a reasonable price to pay for the lives of possible victims that may be saved.

true

True or False: To protect physicians who participate in state mandated executions from license challenges for violating ethics codes, states commonly provide legal immunity and promise anonymity?

true

True or False: While some states require that a physician personally supervise the execution of criminals convicted of capital crimes, the American Medical Association and other licensing organizations prohibit physician participation in executions.

true

Which of the following are steps that Baylis suggests should be taken by the medical profession to encourage honest disclosure of medical errors?

(A, B, C, E) Provide a collegial and supportive environment, Remind physicians that patients will experience emotions other than (or in addition to) anxiety if/when they discover that they have been lied to or misled, explore ways the determination of negligence could be dealt with separately from the issue of compensation, & Redirect attention toward the profession's obligation to create an environment in which truthfulness with patients regarding medical errors is an expected, common, everyday occurrence.

Physician participation in executions commonly refers to only those actions taken as part of the actual execution process. However, Ken Baum argues that which of the following are also actions that physicians take which participate in capital punishment? Select all that apply.

-Preparatory actions scheduled prior to the conviction of the alleged criminal. -Examination of the condemned to determine whether any medical condition might interfere with the execution process and treatment of those conditions so that the condemned will be healthy enough for execution. -Supervising the arrangement of medical supplies needed for the execution. -Preparing syringes with lethal solution -Monitoring the flow of lethal solution during the execution itself. -Supervising attachment of a heart monitor to the condemned -Pronouncing death after the execution. -Physician facilitation of the gathering of evidence or testify in criminal trials and capital sentencing hearings.

Rights are, at least partially, meant to permit individuals control over their own futures. Which of the following are reasons that Goldman offers as to why these decisions should normally be left to the individuals themselves?

-The presumption that the individual is the best judge of their own interest, which may depend on personal value orderings known only to them. -Self determination, at least in regard to important decisions (which might include, in medical contexts, decisions that may involve life and death alternatives, affect the completion of major life projects, or affect bodily integrity) has an independent value. -Individuals may come to resent even the well-meaning decision of another more-so than they would should the harm come as a result of their own decision.

Which of the following are reasons cited by the dissenting judge in the Tarasoff case for maintaining doctor-patient confidentiality in the face of threats of violence to third parties? Select as many as apply.

-The ruling will cripple the use and effectiveness of psychiatry. -The ruling will prevent patients from seeking treatment. -The ruling will prevent patients from fully disclosing their actual mental and behavioral health needs -The ruling will increase the number of persons who become civilly committed (a total deprivation of liberty).

Which of the following are true about Emergency Contraception? Select all that apply.

-There is a narrow window of efficacy. -They may inhibit ovulation or create an unfavorable environment for the implantation of a blastocyst. -They have no effect on an established pregnancy

Justice

Act fairly, distributes benefits and burdens in an equitable fashion, and resolve disputes by means of fair procedures.

Principle of Equality's Difference Principle

All goods should be equally distributed, except where an unequal distribution makes everyone, especially the worst off, better.

According to Baylis, medical errors are which of the following?

Avoidable

Why does Kant believe rational beings have a special moral standing?

Because rational beings have the ability to act on the basis of reason and to conform their behavior to the moral law.

According to Finkelstein and colleagues, patients of a right to _________ and physicians have a corresponding obligation to _________. Fill in the blanks.

Blank One: The Truth; Blank Two: Be Truthful

Ackerman identifies four major constraints on autonomous behavior. Identify them below.

Cognitive constraints, Social constraints, Physical constraints, & Psychological constraints

Which of the following is a categorical imperative?

Commands that are valid for rational agents as such, independent of the feelings and desires they happen to have. For instance, "One must not lie."

A moral theory that rejects liberal individualism, instead holding that moral decisions ought to serve the purpose of creating the kind of community that we want to live in rather than protecting or creating the kind of individual who lives in that community.

Communitarianism

Which of the following is NOT an argument against a pharmacist's right to object explored by Cantor and Baum?

Conscientious objection is integral to democracy

Principle of Liberty

Everyone is to have as much liberty as possible, consonant with every one else's having the same amount of liberty.

Principle of Equality - Equality of Opportunity

Everyone is to have equal opportunity in achieving the various offices and roles in society; they are all to be open to everyone.

True or False: According to a 1999 study, 97% of doctors are aware of the guidelines governing their participation in executions?

False

True or False: According to our text, all religious beliefs inherently imply one specific ethical orientation-- Utilitarianism.

False

True or False: Ackerman argues that the discussion of how physicians can best respect persons who are patients can ignore the psychological and social dimensions of illness?

False

True or False: Blackhall et. all claim that advanced care directives and the concern about too much care at the end of life are the most important concerns for all segments of the population?

False

True or False: Blackhall et. all found that the most important factor contributing to physician attitudes toward truth-telling was religion.

False

True or False: Consequentialist moral theories believe the consequences of an action are insignificant to moral judgment?

False

True or False: Goldman asserts that we may always override a person's autonomy when in our opinion the potential harm to him from allowing autonomous decision outweighs the value of his freedom.

False

True or False: Ken Baum argues that the preservation of life is the paramount maxim for medical practitioners and is always in the best interest of the patient.

False

True or False: The "Hippocratic Oath" does not require physicians to guard the privacy of their patients.

False

True or False: The Principles of Medical Ethics of the American Medical Association requires physicians to inform the patient of his own condition in order to serve the protection of patient autonomy and well being.

False

True or False: The Tarasoff case upheld that proof, aided by hindsight, that a healthcare professional judged wrongly regarding their patient's intention to do violence to another is sufficient to establish negligence.

False

True or False: The physician who discloses an error perpetuates the myth of the infallible physician?

False

True or False: The word "superogatory" is best defined as being a legal, moral or professional requirement or duty; compulsory?

False

True or false: The right to an education is a negative right according to Libertarians?

False

Sometimes called the scientific, engineering or consumer model, this model's objective for physician-patient interaction is for the physician to provide the patient with all relevant information, for the patient to select the medical interventions he or she wants, and for the physician to execute the selected interventions.

Informative model

The conception of patient autonomy is patient control over medical decision making.

Informative model

The aim of the physician-patient interaction in this model is to elucidate the patient's values and what he or she actually wants, and to help the patient select the available medical interventions to realize these values. Toward this end, the physician assists the patient in elucidating and articulating their values and in determining what medical interventions best realize the specified values, thus helping to interpret the patient's values for the patient.

Interpretive model

The conception of patient autonomy is self-understanding; the patient comes to know more clearly who he or she is and how the various medical options bear on his or her identity.

Interpretive model

Which of the following is not one of the advantages our textbook suggests are associated with Utilitarianism?

It's non-consequentialist approach ensures that locus of moral goodness is external to human thought or action.

A non-consequentialist moral theory that holds you have a duty to do acts that conform to categorical imperatives which are universal and treat people as ends in themselves and never merely as means.

Kantianism

Which of the following groups were most likely, according to Blackhall et. all, to hold that it is cruel to tell a patient the truth about a fatal prognosis?

Korean- and Mexican-Americans

Which of the following subject groups studied by Blackhall et. all was more likely to see truth-telling as cruel and potentially harmful?

Korean- and Mexican-Americans

A rights-based approach that holds individual liberty as the highest value, so moral conduct should permit individuals to act freely so long as their actions do not impede others to act freely in turn.

Libertarianism

"When, due to a physician's lack of knowledge, failure to execute a requisite skill, or failure to exercise good judgment, a planned act or omission fails to achieve its intended outcome and this failure has nothing to do with chance or inherent risk ."

Medical Error

When a certain set of circumstances, a sequence or cluster of actions and decisions by different people combine in unfortunate ways that result in unintentional harm, a medical mishap is considered which of the following?

Multifactorial

Which of the following is the best definition of the right to self determination?

One's right to control over decisions vital to the course of one's life.

Sometimes called the parental or priestly model, this model ensures that patients receive the interventions that best promote their health and well-being; it assumes that there are shared objective criteria for determining what is best for the patient and that the physician is in the best position to make this decision.

Paternalistic model

The conception of patient autonomy is patient assent, either at the time or later, to the physician's determinations of what is best.

Paternalistic model

Universalization is only one aspect of Kantian ethics. Equally important is Kant's insistence on which of the following tenets?

Persons must always be treated as "ends in themselves" and never merely as means.

Principle of Utility

Persons must do that which creates the greatest good for the greatest number, or which causes the least harm to the fewest.

Which of the following are arguments in favor of a pharmacist's right to object that Cantor and Baum discuss?

Pharmacists can and should exercise independent judgement as a matter of commitment to their obligation to a duty of care.

According to Baylis, which of the following are NOT aspects of the element of subjectivity in naming misadventures as errors and in determining levels of culpability?

Physical contexts

Which of the following premises in the argument for medical paternalism does Goldman reject?

Premise Three: Health and prolonged life can be assumed to have priority among preferences for patients who place themselves under physicians' care.

A mode of moral reasoning that begins with our common moral experience and the manifest importance of keeping a short list of moral duties like autonomy, beneficence, nonmaleficience, and justice.

Principlism

Non-malefiecence

Refrain from harming other persons.

Autonomy

Respect the capacity of individuals to choose their own vision of the good life and act accordingly.

A moral theory that holds our obligations are determined by the agreements we have made and that we ought to fulfill our obligations because we agreed to.

Social Contract Theory

Which of the following is an example of what Goldman refers to as "justified paternalism"?

State control over physician licensing and the requirement that prescriptions be obtained for many kinds of drugs.

Recognizing that pain medication may have the positive effect of reducing a cancer patient's pain, but also the negative effect of depressing the same patient's respiration is an example of which of the following?

The Doctrine of Double Effect

While liability is defined as "a duty to use ordinary care and skill to avoid danger" with regard to another such "that if [the defendant] did not use ordinary care and skill in his own conduct he would cause danger or injury to the person or property of the [plaintiff]" (102), which of the following is the consideration the assenting judges found to be most important consideration in their finding against UC Berkeley et al.?

The foreseeability of harm to the plaintiff

Deliberative model

The physician acts as a teacher or friend, engaging the patient in dialogue on what course of action would be best.

Paternalistic model

The physician acts as the patient's guardian, articulating and implementing what is best for the patient.

Interpretive model

The physician is a counselor, and advisor, supplying relevant information, helping to elucidate values, and suggesting what medical interventions realize these values.

Informative model

The physician is a purveyor of technical expertise, providing the patient with the means to exercise control.

Which of the following is true about the therapist's obligation to reveal threats of violence as established by the Tarasoff ruling?

The therapist ought to reveal such information discreetly, and in a fashion that would preserve the privacy of the patient to the fullest extent compatible with the prevention of threatened danger.

Which of the following are accurate statements about categorical imperatives?

They are commands that are valid for all rational beings independent of the feelings or desires they happen to have.

True or False: According to Baylis, one of the reasons for silence on the part of physicians, as regards not only their own 'errors' but those of their colleagues, is genuine uncertainty about whether a particular adverse outcome is the result of an error?

True

True or False: According to one study seven to eight times as many patients suffered negligent injuries as filed malpractice claims?

True

True or False: Ackerman argues that doctors' higher social status and educational attainment can prevent patients from acting upon their considered choices (impeding patient autonomy).

True

True or False: Blackhall et. all link the desire to complete a will prior to death and the desire 'to settle one's affairs' to the attempts to reach one's control into situations in which we otherwise have no ability to exert to control.

True

True or False: Goldman further asserts that choice unhindered by others is nevertheless not truly free when determined by internal factors, among them fear, ignorance, or other irrational motivation, which result in choice at variance with the individual's deeper preferences.

True

True or False: In a high-context culture, such as that of Korea, Japan, or Mexico, one is expected to infer from the social context many things without being told explicitly?

True

True or False: In the Tarasoff case, the court found that the health care provider (the defendant) did in fact predict that Poddar would kill, but were negligent in failing to warn.

True

True or False: Ken Baum argues that the condemned death row inmate is, for all practical purposes, terminally ill and deserves to be treated as such.

True

True or False: Ken Baum argues that the condemned should be free to request or refuse physician oversight, and the individual physician should be free to choose to participate in executions or not to do so.

True

True or False: Not all harms that result from medical interventions(for example, sepsis, prolonged pain, prolonged hospitalization, additional therapy, permanent disability, death) are due to medical errors.

True

True or False: Rationality is represented by our ability to think, to plan our lives, and to be motivated by abstract considerations?

True

True or False: The "Hippocratic Oath" forbids doctors from operating on patients?

True

True or False: The "Hippocratic Oath" requires that medical education should be free.

True

True or False: The Ordinary-Extraordinary treatment distinction is context dependent.

True

True or False: The Tarasoff case hinges on the question of whether there is a duty to warn and whether that duty outweighs the patient's right to doctor-patient confidentiality in treatment.

True

True or False: The word "obligatory" is best defined as being a legal, moral or professional requirement or duty; compulsory?

True

True or False: Universalization requires us to abstract from the actual circumstances and to refrain from making exceptions of ourselves.

True

True or False: Well-meaning physicians may be loathe to disclose medical errors to patients because they believe that full disclosure serves no useful purpose.

True

Which of the following is NOT an objection our textbook lists as being associated with Utilitarianism?

Utilitarian morality does not relate to the satisfaction of some abstract or arbitrary code; rather, it relates to the improvement of the human condition, which means alleviating suffering and increasing happiness.

Please select the situations in which, traditionally speaking, a doctor's duty not to harm his patient's health or shorten his life might appear to override otherwise obtaining rights of the patients to full truth according to Goldman.

Where the truth will cause direct harm such as depression or loss of continued will to live. & Where informing may be instrumentally harmful in leading to the choice of the wrong treatment or none at all.

True or False: Norman Daniels argues that fair equality of opportunity requires opportunity to be equal for all persons and a leveling of individual differences?

false

Which of the following is the best definition of paternalism?

the overriding or restricting of rights or freedoms of individuals for their own good, including in instances where competent adults can be assumed to act otherwise against their own interests, values, or true preferences.