ABA Professional Standards & Ethics 2 — Questions and Answers
Question 1: An anesthesiologist discovers that a colleague is consistently performing nerve blocks outside their documented competency. What is the most ethically appropriate first action?
- Report immediately to the state medical board
- Discuss the concern directly with the colleague
- Document the incidents and report to the department chief (Correct answer)
- Ignore the situation if no adverse outcomes have occurred
Correct answer: Document the incidents and report to the department chief
Documenting incidents and reporting to the department chief initiates a formal peer review process that protects patient safety while following appropriate institutional channels.
Question 2: Which ASA ethical principle is MOST directly violated when an anesthesiologist accepts a gift from a pharmaceutical representative in exchange for preferential drug selection?
- Autonomy
- Nonmaleficence
- Justice
- Fidelity (Correct answer)
Correct answer: Fidelity
Fidelity requires loyalty to the patient's best interests; accepting gifts that influence drug selection creates a conflict of interest that breaches this duty.
Question 3: A patient scheduled for elective surgery is found to have an advance directive refusing blood transfusions. Intraoperatively, the patient develops life-threatening hemorrhage. What should the anesthesiologist do?
- Transfuse immediately given the emergency
- Honor the advance directive and use only blood-sparing techniques (Correct answer)
- Obtain surrogate consent before acting
- Transfer care to another anesthesiologist
Correct answer: Honor the advance directive and use only blood-sparing techniques
A valid advance directive reflecting a competent patient's prior decision must be honored; the emergency does not override a documented refusal from a previously competent patient.
Question 4: Under the ASA Guidelines for the Ethical Practice of Anesthesiology, which of the following best describes the anesthesiologist's obligation regarding informed consent?
- Consent may be delegated entirely to the surgeon
- The anesthesiologist must personally obtain consent for anesthetic care (Correct answer)
- Written consent for anesthesia is optional if surgical consent is obtained
- Consent is implied when a patient agrees to surgery
Correct answer: The anesthesiologist must personally obtain consent for anesthetic care
The anesthesiologist bears personal responsibility for obtaining informed consent specific to the anesthetic plan, risks, and alternatives.
Question 5: An anesthesiologist is asked to participate in a lethal injection execution. According to ASA guidelines, this is:
- Permissible if state law authorizes it
- A personal choice left to the individual physician
- Ethically prohibited as it violates the physician's healing role (Correct answer)
- Acceptable only in states with the death penalty
Correct answer: Ethically prohibited as it violates the physician's healing role
The ASA and AMA prohibit physician participation in executions because it fundamentally conflicts with the physician's role as a healer.
Question 6: Which action BEST exemplifies the ethical principle of justice in anesthesia practice?
- Providing the same anesthetic technique to every patient
- Allocating anesthesia resources based on clinical need and equitable criteria (Correct answer)
- Prioritizing patients who can afford premium services
- Giving priority to patients of referring physicians
Correct answer: Allocating anesthesia resources based on clinical need and equitable criteria
Justice requires fair distribution of resources and care based on clinical need rather than ability to pay or social status.
Question 7: A patient with decision-making capacity refuses preoperative anxiolytic medication after discussing risks. The surgeon urges the anesthesiologist to administer it anyway. The anesthesiologist should:
- Defer to the surgeon's clinical judgment
- Administer a lower dose as a compromise
- Respect the patient's refusal and document accordingly (Correct answer)
- Consult the ethics committee before proceeding
Correct answer: Respect the patient's refusal and document accordingly
Patient autonomy requires that a competent patient's refusal be respected, regardless of the surgeon's or anesthesiologist's clinical preference.
ABA Professional Standards & Ethics 2
An anesthesiologist discovers that a colleague is consistently performing nerve blocks outside their documented competency.
What is the most ethically appropriate first action?