Relationship between culture and health-care ethics

 1  of 50

Which of the following is the most correct statement regarding the relationship between culture and health-care ethics?

 

  Health-care ethics have remained largely unchanged since the penning of the Hippocratic Oath.

  Health-care ethics are determined by interactions between professionals and society and frequently change.

  Health professionals determine the ethical values of their profession without input from society.

  Society dictates health-care ethics to health-care professionals, which is why ethics vary from country to country.

Question

 

2  of 50

 

 

 

What are the indirect costs of the uninsured? Choose all that apply.

 

  There are fewer losses due to absenteeism, since employees are not busy going to doctors’ visits.

  Unhealthy workers are less productive.

  Employers who do provide insurance pay higher insurance rates, in part because of cost shifting.

Question

 

3  of 50

 

 

 

Despite its challenges to the concept of autonomy, which portion of the ACA was upheld by the Supreme Court?

 

  Individual mandate

  Medicaid expansion

  Appropriations to reduce deductibles

Question

 

4  of 50

 

 

 

Despite providing care for many people who do not have insurance, Hospital A can balance its books because it receives sufficient money from its insured patients to offset its losses. This is best described as

 

  fraudulent billing.

  cost shifting.

  macroallocation.

Question

 

5  of 50

 

 

 

It is never acceptable to withhold information from patients for fear they will refuse treatment.

 

  True

  False

Question

 

6  of 50

 

 

 

Which of the following is most true regarding the government’s direct costs for the uninsured?

 

  State and local governments contribute very little to offset these costs since this is a federal responsibility.

  Ultimately, none of this money comes from taxpayers, so one need not worry about this cost.

  All of the uninsured qualified for Medicaid, so these monies were paid in the form of Medicaid reimbursements.

  In the early 2000s, the federal government paid nearly $19.9 billion to offset these costs.

  Medical facilities are rarely forced to shut down or convert to for-profit facilities due to losses incurred by serving the uninsured.

Question

 

7  of 50

 

 

 

Which of the following statements is most true of the models of medicine?

 

  In light of technological advances, the engineering model is now considered optimal for both quality of care and ethical standards.

  The priestly model is an ethically ideal relationship since the physician is the one who is responsible.

  Society still perceives health-care workers in the covenantal model, which implies an obligation beyond mere contract.

  It is predicted that the concierge model will emerge as the most popular model in light of the Affordable Care Act.

Question

 

8  of 50

 

 

 

What is a frequent result of receiving inadequate treatment for chronic conditions?

 

  Patients end up qualifying for research studies and receiving the latest treatments.

  Chronic conditions often escalate to crises requiring very expensive medical care.

  Typically, the conditions resolve on their own.

Question

 

9  of 50

 

 

 

What are the direct costs to the uninsured themselves? Choose all that apply.

 

  Each uninsured person loses an estimated $1,600-$3,300 per year for every year of being uninsured.

  It is estimated that lack of insurance causes fewer than 3,000 preventable deaths of individuals between 25 and 64 years of age each year.

  More than half of those with no insurance struggled to pay for rent and food due to medical bills.

  They are charged less for services than those with insurance.

Question

 

10  of 50

 

 

 

Moral rights are best described as

 

  rights that are universally recognized from one culture to the next.

  rights that exist because they have been written into legal code by a legislative body or decided upon in a court of law.

  rights that exist within a particular moral framework but have not necessarily been made into law.

  rights guaranteed by the United Nation’s Universal Declaration of Human Rights.

Question

 

11  of 50

 

 

 

A 12-year-old who is unable to breathe due to an asthma attack requires an inhaler. This is best described as a(n)

 

  inherent need.

  socially induced need.

  legally protected human right.

Question

 

12  of 50

 

 

 

The situation that arises when a patient freely and competently chooses a treatment option after being given complete information by a health-care professional is best referred to as

 

  autonomy.

  informed consent.

  therapeutic privilege.

  paternalism.

Question

 

13  of 50

 

 

 

Which of the following statements is most true of Institutional Ethics Committees (IECs)?

 

  They are to act primarily as advocates for health-care providers in conflicts with health-care surrogates.

  IECs function as health-care surrogates when no appropriate surrogate has been court appointed.

  The IEC is not a health-care surrogate and is not authorized to make decisions for a patient.

  The functions of an IEC should remain private so as to protect anonymity.

Question

 

14  of 50

 

 

 

Which of the following is the best example of competence?

 

  Despite her advanced age, the patient is capable of understanding the nature of her illness, the risks and benefits of the treatments described, and making a decision to undergo medical treatment.

  Although before the surgery the patient stated that she did not want to receive blood products for religious reasons, the physician ordered blood products because “it’s what she needs right now.”

  A patient who is overwhelmed by his diagnosis tells the doctor to “do what you think is best” and does not want to hear about risks or benefits.

  After the physician explains the diagnosis and the need for surgery, Ms. A. denies that the medical problem exists and refuses surgery.

Question

 

15  of 50

 

 

 

The belief that medical practice is based exclusively on scientific evidence is an example of

 

  ambiguity.

  opacity.

  an assumption.

  deontologism.

Question

 

16  of 50

 

 

 

A situation in which one party overpays for a service as a consequence of another party underpaying for a service is best referred to as

 

  fraudulent billing.

  cost shifting.

  macroallocation.

Question

 

17  of 50

 

 

 

In which situations is an adolescent’s confidentiality protected, even from parental knowledge?

 

  When the teen is able to provide his or her own funding source

  In circumstances in which the teen is legally permitted to consent for treatment

  Parents always have a right to medical information regarding their minor children.

  Only in a state that follows the Tarasoff rule

Question

 

18  of 50

 

 

 

What does the Patient Self-Determination Act (Omnibus Budget Reconciliation Act) require of health-care facilities?

 

  Adherence to patient preference in all instances

  Establishment of a payment schedule determined by the patient’s budget

  Identification of appropriate health-care surrogates for each patient

  Provision of information about advance directives

Question

 

19  of 50

 

 

 

The term direct costs refers to

 

  health-care costs resulting from services provided.

  cost shifting and higher insurance premiums.

  costs resulting from diminished work productivity and reduced GDP.

Question

 

20  of 50

 

 

 

Which of the following statements is true regarding placebos and the placebo effect? Choose all that apply.

 

  The placebo effect is also known as the Hawthorne effect.

  Placebos have been demonstrated to affect the immune system and cause addiction.

  Placebos are not supposed to have biological powers.

  Unconditional use of placebos is ethically justified in cases of psychosomatic illness.

Question

 

21  of 50

 

 

 

Which of the following is the best example of beneficence?

 

  Dr. N. chooses treatments that are in her patients’ best interests.

  Dr. L. decides not to let Mr. P. know about an experimental medication available because Dr. L. believes the excessive risks of taking the experimental medication outweigh the potential benefits.

  Although before the surgery the patient stated that she did not want to receive blood products for religious reasons, the physician ordered blood products because “it’s what she needs right now.”

  A surrogate refuses surgery for Mr. T. because the surrogate believes Mr. T. will have a difficult time recovering from the surgery due to his age.

Question

 

22  of 50

 

 

 

The “patient advocate” model of nursing calls for nurses to be

 

  focused on details of institutional coordination.

  helpful extensions of the physician.

  ethically independent agents.

  utilizing opacity in order to support patients when they disagree with the physician.

Question

 

23  of 50

 

 

 

A nurse practitioner recommends surgery for a patient without informing the patient of the alternative treatments available. Which of the following ethical principles did the nurse practitioner most clearly and directly violate?

 

  Beneficence

  Informed consent

  Therapeutic privilege

  Paternalism

Question

 

24  of 50

 

 

 

Ethically, health-care providers should

 

  refuse all patients that do not have the ability to pay.

  refuse patients when the practice is already oversubscribed.

  only refuse patients when the provider has announced his or her retirement.

  refer all low-income patients to a charitable organization instead of providing any health care to these patients.

Question

 

25  of 50

 

 

 

Which of the following statements best describes the opinion of Baillie et al. (2013) regarding health-care rationing?

 

  Rationing should be done at the federal level so that all Americans can participate.

  Until an emergency demands we consider resource limitations, rationing is unnecessary.

  Basic needs must take precedence over socially acquired needs or mere desires.

  All measures must be taken to prolong life since the United States is the wealthiest nation.

Question

 

26  of 50

 

 

 

Which of the following statements is most accurate regarding the health-care provider’s obligation to the patient?

 

  Providers must undertake only medically necessary actions that do not harm to the patient.

  All things considered, providers should ideally go to extraordinary lengths to prolong life.

  Providers should take medically necessary actions that promise more good than harm.

  These obligations vary so significantly from situation to situation that no generalizations apply.

Question

 

27  of 50

 

 

 

Which of the following is the best description of the term ambiguity as used in the readings for Lesson 1?

 

  Situation in which the clarity of the facts does not dictate the decision to be made

  Class of ethical theories that views the rightness or wrongness of an action in terms of the consequences of that action

  Situation in which knowledge is so limited that one cannot arrive at an answer, such that serious moral questions remain unresolved

  Class of ethical theory that asserts ethics ought to be as clearly and firmly based as mathematics and thus attempts to identify the universal moral laws that justify a particular action

Question

 

28  of 50

 

 

 

Virtue ethics is best described as a

 

  class of ethical theory that attempts to identify the universal moral laws that justify a particular action.

  class of ethical theory advocating character development and formation of appropriate moral disposition within the individual.

  class of ethical theory arguing that rational reflection on human nature will yield principles of good and bad that can guide human action in order to bring about human flourishing.

  class of ethical theory that views the rightness or wrongness of an action in terms of the consequences of that action.

Question

 

29  of 50

 

 

 

What is the most significant difficulty with substituted judgment?

 

  Many people do not discuss their end-of-life needs while there is time.

  There is little agreement about which ethical principles apply to surrogate decision-making.

  Surrogates are usually motivated by matters of personal gain or convenience.

  Malpractice claims typically arise when surrogate decision-makers are involved.

Question

 

30  of 50

 

 

 

Because the employees at Industrial Associates do not have insurance, they miss work frequently and are less productive. This is an example of

 

  tax deductions available under ACA.

  indirect costs of the uninsured.

  direct costs of the uninsured.

Question

 

31  of 50

 

 

 

Knowledge that, if revealed, would harm not only the client but also the profession and the society that depends upon the profession is called

 

  a natural secret.

  a professional secret.

  a promised secret.

  professional information.

Question

 

32  of 50

 

 

 

Utilitarianism is best described as a

 

  branch of philosophy that seeks to determine how human actions may be judged right or wrong.

  type of consequentialism that assesses the rightness or wrongness of an action based upon the aggregate consequences of that action for a social group.

  class of ethical theory that attempts to identify the universal moral laws that justify a particular action.

  class of ethical theory advocating character development and formation of appropriate moral disposition within the individual.

Question

 

33  of 50

 

 

 

A secret whose contents by nature are harmful if revealed is known as

 

  a natural secret.

  a professional secret.

  a promised secret.

  privileged information.

Question

 

34  of 50

 

 

 

You vow to a friend that you will keep her salary confidential. What type of secret is that?

 

  Natural secret

  Promised secret

  Professional secret

  Fidelity secret

Question

 

35  of 50

 

 

 

Practical wisdom is

 

  the ability to choose patterns of action through consideration of virtues along with the widest range of experience for the human person situated in society.

  information based on scientific fact that has never been disproven.

  information that all professionals learn during their courses of study.

  when the knowledge available causes opacity because the information is based upon the health-care professional’s personal experiences.

Question

 

36  of 50

 

 

 

A man tries to subpoena his soon-to-be ex-wife’s medical records to prove she has confessed her infidelity to her internist. He will fail because her records contain

 

  a natural secret.

  privileged information.

  no mention of personal issues.

  coded information that cannot be decoded by him.

Question

 

37  of 50

 

 

 

When a patient has been determined to be medically incompetent,

 

  informed consent must be sought from a surrogate decision-maker.

  the doctor must file appropriate paperwork with the courts.

  the physician may make medical decisions based on the principle of beneficence.

  the physician must institutionalize the patient so he or she can receive proper care.

Question

 

38  of 50

 

 

 

The Baby Doe rule applies primarily in instances in which the

 

  infant is chronically and irreversibly comatose.

  underlying medical condition is likely to resolve as a result of the treatment proposed.

  provision of the treatment proposed would be futile and inhumane.

  treatment proposed can be rendered comfortable for the patient.

Question

 

39  of 50

 

 

 

Approximately how many inpatients were found to be medically incompetent in one study, according to Applebaum (2007)?

 

  5%

  23%

  48%

  72%

Question

 

40  of 50

 

 

 

Which of the following best describes the concept of distributive justice outlined by Baillie et al. (2013)?

 

  The needs of the individual are the only legitimate concern in formulating an ethics of distribution.

  The contribution of the individual to society is the only legitimate concern in formulating an ethics of distribution.

  Including “contribution of the individual to society” is an affront to the individual’s dignity.

  Both need and contribution will enter into the formulation of any ethics of distribution, and these must be weighed against the scarcity of resources.

Question

 

41  of 50

 

 

 

A young woman has been in a coma for 3 weeks as the result of severe head trauma. It is unclear at this point whether she will recover. As a result, the medical team cannot all agree on how to best proceed with her medical treatment. Which of the following terms best describes this situation?

 

  Consequentialism

  Veracity

  Opacity

  Deontologism

Question

 

42  of 50

 

 

 

The role of a health-care worker, according to Baillie et al. (2013), is to

 

  advise patients on ways to obtain the best care.

  guarantee that patients do not suffer.

  assure they do not damage the hospital’s reputation.

  meet the patient’s most important goals.

Question

 

43  of 50

 

 

 

Ethics is best described as a

 

  situation in which the clarity of the facts does not dictate the decision to be made.

  class of ethical theories that views the rightness or wrongness of an action in terms of the consequences of that action.

  situation in which knowledge is so limited that one cannot arrive at an answer, such that serious moral questions remain unresolved.

  branch of philosophy that seeks to determine how human actions may be judged right or wrong.

Question

 

44  of 50

 

 

 

The patient has the right to information needed to make nonmedical decisions or to avoid great evils.

 

  True

  False

Question

 

45  of 50

 

 

 

What are the public-health hazards of a large uninsured population?

 

  Physicians may miss the early signs of an epidemic since infected people may not seek prompt medical care.

  There are no public-health hazards, so this is not an issue that requires a public-health response.

  As uninsured individuals age, they die before entering the Medicare system, thus saving taxpayers money.

Question

 

46  of 50

 

 

 

Which of the following rules is the most commonly upheld standard for informed consent?

 

  The patient preference rule

  The substantial harm rule

  The professional custom rule

  The transparency rule

Question

 

47  of 50

 

 

 

The best example of a person using deontologism as a source of ethics is a person who

 

  is certain that lying is human nature and therefore is not morally wrong.

  believes lying is wrong even if lying would accomplish a good result.

  perceives lying to be acceptable so long as it benefits a large number of people.

  cultivates particular habits based on his belief in their moral superiority.

Question

 

48  of 50

 

 

 

One problem with classical natural law is that

 

  what was once thought to be natural has been found to be social.

  it discourages loyalty to friends and family.

  national identity has been found to be unnatural.

  animal studies do not reveal morality to be natural.

Question

 

49  of 50

 

 

 

Which of the following situations is an appropriate instance in which to violate patient confidentiality? Choose all that apply.

 

  Reporting that a patient has expressed intent to kill someone specific later today, in a state with duty-to-warn laws

  Telling the spouse of a person who has been diagnosed with syphilis, a sexually transmitted disease

  In a state with minor consent laws, telling parents that their teen is sexually active

  Telling a husband that his wife is intending to get an abortion when the wife wants to keep it a secret

Question

 

50  of 50

 

 

 

People who violate the individual mandate must pay their penalty in what way?

 

  Fines

  Taxes

  Deductibles

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