BHS Medical Ethics and Law 4 — Questions and Answers
Question 1: The Emergency Medical Treatment and Labor Act (EMTALA) requires that hospitals with emergency departments must:
- Provide free care to all uninsured patients indefinitely
- Screen and stabilize all patients regardless of ability to pay (Correct answer)
- Accept all transfers from other hospitals without limitation
- Treat patients only if they sign financial responsibility forms first
Correct answer: Screen and stabilize all patients regardless of ability to pay
EMTALA mandates that Medicare-participating hospitals provide a medical screening exam and stabilizing treatment to anyone presenting to the ED regardless of insurance status or ability to pay.
Question 2: In distributive justice, the egalitarian approach to resource allocation prioritizes:
- Giving resources to those who can afford to pay
- Distributing resources equally regardless of need or merit (Correct answer)
- Allocating resources to maximize overall social benefit
- Rewarding those who contribute most to society
Correct answer: Distributing resources equally regardless of need or merit
Egalitarianism holds that all persons deserve equal shares of resources based on equal worth, without regard to social status, wealth, or contribution.
Question 3: A provider learns that a patient has tested positive for HIV but refuses to notify their sexual partner. The ethical tension is between:
- Beneficence and nonmaleficence
- Confidentiality and duty to protect third parties (Correct answer)
- Autonomy and justice
- Veracity and fidelity
Correct answer: Confidentiality and duty to protect third parties
This scenario creates conflict between the duty to maintain patient confidentiality and the duty to protect an identifiable third party from serious, preventable harm.
Question 4: Which of the following best describes 'futile treatment' in clinical ethics?
- Treatment that is too expensive for the healthcare system to afford
- Treatment that cannot achieve the intended physiological effect or patient goals (Correct answer)
- Treatment the patient refuses but the family requests
- Any treatment in the ICU lasting more than 30 days
Correct answer: Treatment that cannot achieve the intended physiological effect or patient goals
Medical futility refers to interventions that are physiologically ineffective or cannot meet the patient's stated goals of care, justifying withdrawal or withholding.
Question 5: The 'four-box' clinical ethics consultation method evaluates cases through which four domains?
- Beneficence, nonmaleficence, autonomy, justice
- Medical indications, patient preferences, quality of life, contextual features (Correct answer)
- Diagnosis, prognosis, treatment, outcomes
- Legal standards, professional norms, institutional policy, patient values
Correct answer: Medical indications, patient preferences, quality of life, contextual features
Jonsen, Siegler, and Winslade's four-box method organizes ethical analysis around medical indications, patient preferences, quality of life, and contextual/social features.
Question 6: Under the Americans with Disabilities Act (ADA), healthcare facilities must provide reasonable accommodations, which include:
- Waiving all fees for patients with disabilities
- Providing sign language interpreters for deaf patients when medically necessary (Correct answer)
- Hiring a fixed percentage of disabled staff members
- Exempting disabled patients from standard triage protocols
Correct answer: Providing sign language interpreters for deaf patients when medically necessary
The ADA requires healthcare entities to provide auxiliary aids and services, such as qualified interpreters, to ensure effective communication with patients who are deaf or hard of hearing.
Question 7: A patient with capacity makes a decision that her physician believes is medically unwise. Ethically, the physician should:
- Invoke therapeutic privilege and override the decision
- Respect the decision after ensuring it is truly informed (Correct answer)
- Request a psychiatric consultation to assess capacity
- Discharge the patient for non-compliance
Correct answer: Respect the decision after ensuring it is truly informed
Respect for autonomy requires honoring an informed, capacitated patient's choices even when the clinician disagrees with the medical wisdom of those choices.
BHS Medical Ethics and Law 4
The Emergency Medical Treatment and Labor Act (EMTALA) requires that hospitals with emergency departments must: