ABA Professional Standards & Ethics 3 — Questions and Answers
Question 1: An anesthesiologist moonlighting at a surgery center fails to disclose a financial ownership interest in that center to referred patients. This is primarily a violation of:
- The duty of confidentiality
- Informed consent and conflict of interest disclosure obligations (Correct answer)
- Scope of practice regulations
- Peer review protections
Correct answer: Informed consent and conflict of interest disclosure obligations
Financial conflicts of interest must be disclosed to patients as they can influence clinical recommendations and undermine informed decision-making.
Question 2: Which of the following scenarios MOST clearly represents a breach of patient confidentiality under HIPAA and professional ethics?
- Sharing de-identified case data at a medical conference
- Discussing a patient's airway difficulty with the ICU team managing the patient
- Mentioning a celebrity patient's surgery to a non-treating colleague (Correct answer)
- Accessing a patient's chart while providing direct care
Correct answer: Mentioning a celebrity patient's surgery to a non-treating colleague
Disclosing a patient's protected health information to someone not involved in their care—regardless of celebrity status—is an unauthorized disclosure violating confidentiality.
Question 3: The concept of 'therapeutic privilege'—withholding information from a patient to prevent harm from the disclosure—is:
- Broadly endorsed in the ASA ethics guidelines
- A valid exception when the information would cause immediate psychological harm
- Rarely justified and ethically controversial in contemporary practice (Correct answer)
- Required when family members request information be withheld
Correct answer: Rarely justified and ethically controversial in contemporary practice
Modern medical ethics heavily disfavors therapeutic privilege because it undermines patient autonomy; only exceedingly rare circumstances could justify withholding material information.
Question 4: An attending anesthesiologist signs off on a case personally performed entirely by a CRNA without meaningful supervision. Which ethical principle is PRIMARILY compromised?
- Veracity (Correct answer)
- Nonmaleficence
- Beneficence
- Justice
Correct answer: Veracity
Signing attestations for supervision that did not occur is a form of fraud and false documentation, directly violating the principle of veracity (truthfulness).
Question 5: When an anesthesiologist has a sincere conscientious objection to performing an abortion procedure's anesthesia, the ethically required action is:
- Refuse and provide no further assistance
- Override the objection when the procedure is legal
- Disclose the objection in advance and arrange for a willing colleague to cover (Correct answer)
- Perform the anesthesia regardless of personal beliefs
Correct answer: Disclose the objection in advance and arrange for a willing colleague to cover
Conscientious objection is recognized but requires timely disclosure and patient referral to ensure uninterrupted access to care.
Question 6: A patient's family demands that a DNR order be suspended for the duration of surgery. The anesthesiologist's ethical obligation is to:
- Automatically suspend the DNR for the entire perioperative period
- Discuss the implications with the patient and re-establish goals of care before surgery (Correct answer)
- Defer entirely to the surgeon's preference
- Honor the family's request without patient consultation
Correct answer: Discuss the implications with the patient and re-establish goals of care before surgery
The ASA recommends required reconsideration of DNR orders before surgery through patient-centered discussion, not automatic suspension.
Question 7: Which of the following BEST describes the ethical concept of 'professional integrity' as it applies to anesthesiologists?
- Adhering to billing codes accurately to maximize reimbursement
- Consistently aligning one's clinical actions with ethical values and professional standards (Correct answer)
- Maintaining a positive reputation among peers and administrators
- Following hospital policies even when they conflict with patient interests
Correct answer: Consistently aligning one's clinical actions with ethical values and professional standards
Professional integrity means that one's conduct reliably reflects ethical values and standards across all clinical, academic, and administrative roles.
ABA Professional Standards & Ethics 3
An anesthesiologist moonlighting at a surgery center fails to disclose a financial ownership interest in that center to referred patients.
This is primarily a violation of: