BHS Medical Ethics and Law 2 — Questions and Answers
Question 1: A patient refuses a blood transfusion on religious grounds despite a life-threatening hemorrhage. The legally and ethically correct action is to:
- Override the refusal and transfuse immediately
- Document the refusal and respect the patient's decision (Correct answer)
- Seek a court order to override the refusal
- Transfer the patient to another facility
Correct answer: Document the refusal and respect the patient's decision
Competent adults have the legal and ethical right to refuse any medical treatment, including life-saving interventions, based on religious or personal beliefs.
Question 2: Under HIPAA, which of the following does NOT require patient authorization before disclosure?
- Release of records to the patient's employer
- Disclosure to the patient's attorney
- Reporting a gunshot wound to law enforcement (Correct answer)
- Sharing records with a life insurance company
Correct answer: Reporting a gunshot wound to law enforcement
HIPAA's 'required by law' exception permits disclosure to law enforcement for mandatory reporting obligations such as gunshot wounds without patient authorization.
Question 3: The ethical principle of nonmaleficence is best illustrated by which action?
- Obtaining informed consent before surgery
- Prescribing only evidence-based treatments to minimize harm (Correct answer)
- Distributing resources fairly among patients
- Respecting a patient's advance directive
Correct answer: Prescribing only evidence-based treatments to minimize harm
Nonmaleficence—'do no harm'—is exemplified by choosing treatments proven to minimize risk and avoid unnecessary injury.
Question 4: Which legal document allows a designated person to make healthcare decisions on behalf of an incapacitated patient?
- Living will
- Do Not Resuscitate order
- Durable power of attorney for healthcare (Correct answer)
- Physician Orders for Life-Sustaining Treatment (POLST)
Correct answer: Durable power of attorney for healthcare
A durable power of attorney for healthcare designates a healthcare proxy or agent to make medical decisions when the patient lacks decision-making capacity.
Question 5: A nurse discovers a colleague is diverting narcotics for personal use. The nurse's primary ethical obligation is to:
- Confront the colleague privately and give them a chance to self-report
- Report the behavior to the appropriate supervisor or authority (Correct answer)
- Document observations but take no further action
- Ignore it if patient care has not been visibly affected
Correct answer: Report the behavior to the appropriate supervisor or authority
Patient safety and professional accountability require reporting suspected diversion to supervisors or regulatory bodies, regardless of collegial relationships.
Question 6: A research participant wishes to withdraw from a clinical trial midway through. Ethically and legally, researchers must:
- Allow withdrawal only if a replacement participant is found
- Honor the withdrawal request immediately without penalty (Correct answer)
- Require completion to protect data integrity
- Notify the IRB before allowing withdrawal
Correct answer: Honor the withdrawal request immediately without penalty
The Belmont Report's principle of respect for persons guarantees the right to withdraw from research at any time without penalty or loss of benefits.
Question 7: Which standard is used to determine whether a healthcare provider's conduct constitutes negligence?
- The 'reasonable patient' standard
- The 'best interest' standard
- The 'reasonable practitioner' standard (Correct answer)
- The 'strict liability' standard
Correct answer: The 'reasonable practitioner' standard
Negligence is evaluated against what a reasonably competent practitioner in the same specialty would have done under similar circumstances.
BHS Medical Ethics and Law 2
A patient refuses a blood transfusion on religious grounds despite a life-threatening hemorrhage.
The legally and ethically correct action is to: