AAC Ethical & Legal Issues 2 — Questions and Answers
Question 1: A person with moderate Alzheimer's disease repeatedly asks to go home during a care facility visit. What ethical principle guides the care team to honor their emotional need without deception?
- Beneficence through therapeutic fibbing
- Autonomy through validation therapy (Correct answer)
- Non-maleficence by restraining the person
- Justice by applying facility policy uniformly
Correct answer: Autonomy through validation therapy
Validation therapy respects the person's emotional reality and supports autonomy without harmful deception.
Question 2: Which legal instrument allows a person to designate someone to make healthcare decisions if they lose decision-making capacity?
- Living will
- Durable power of attorney for healthcare (Correct answer)
- Advance directive registry
- Do-not-resuscitate order
Correct answer: Durable power of attorney for healthcare
A durable power of attorney for healthcare designates a healthcare proxy to make medical decisions when the person cannot.
Question 3: Under HIPAA, which situation permits disclosure of a person with Alzheimer's PHI without their explicit consent?
- A neighbor requests information for safety checking
- Marketing purposes by the care facility
- Treatment coordination with another provider (Correct answer)
- Insurance company request for billing records of a third party
Correct answer: Treatment coordination with another provider
HIPAA permits PHI disclosure for treatment, payment, and healthcare operations, including coordination with other treating providers.
Question 4: An Alzheimer's caregiver notices bruising on a resident that staff cannot explain. What is the immediate ethical and legal obligation?
- Document findings and report to the supervisor and adult protective services (Correct answer)
- Ask the resident's family before taking any action
- Assume the bruising is from a fall and monitor
- Consult the facility attorney before reporting
Correct answer: Document findings and report to the supervisor and adult protective services
Unexplained injuries must be documented and reported to supervisors and adult protective services per mandatory reporting laws.
Question 5: A family member with financial power of attorney wants to use the person's funds to pay their own personal debts. This action constitutes:
- Acceptable use within POA authority
- Financial exploitation and breach of fiduciary duty (Correct answer)
- Legal if the family member has no income
- Permissible under surrogate decision-making laws
Correct answer: Financial exploitation and breach of fiduciary duty
Using a vulnerable person's funds for personal benefit is financial exploitation and a breach of the agent's fiduciary duty.
Question 6: Which ethical framework prioritizes outcomes that produce the greatest good for the greatest number when making care decisions for people with Alzheimer's?
- Deontological ethics
- Virtue ethics
- Utilitarian ethics (Correct answer)
- Casuistry
Correct answer: Utilitarian ethics
Utilitarian ethics evaluates decisions based on the outcomes that maximize overall well-being for the most people.
Question 7: A person with early-stage Alzheimer's expresses a wish to stop taking a medication their physician recommends. What should the care team do first?
- Override the preference since they have Alzheimer's
- Assess whether the person currently has decision-making capacity (Correct answer)
- Immediately contact the healthcare proxy to decide
- Document the refusal and continue administering the medication
Correct answer: Assess whether the person currently has decision-making capacity
An Alzheimer's diagnosis alone does not eliminate capacity; the team must assess whether the person can understand and reason about the decision.
AAC Ethical & Legal Issues 2
A person with moderate Alzheimer's disease repeatedly asks to go home during a care facility visit.
What ethical principle guides the care team to honor their emotional need without deception?