BHS Medical Ethics and Law 5 — Questions and Answers
Question 1: Which federal law governs the privacy and security of individually identifiable health information held by covered entities?
- EMTALA
- HIPAA Privacy and Security Rules (Correct answer)
- The Affordable Care Act
- The Health Information Technology for Economic and Clinical Health (HITECH) Act
Correct answer: HIPAA Privacy and Security Rules
HIPAA's Privacy Rule protects individually identifiable health information, and the Security Rule sets standards for electronic protected health information (ePHI) safeguards.
Question 2: Veracity as an ethical principle in healthcare requires that providers:
- Always reveal all details of a diagnosis regardless of context
- Be truthful with patients in a compassionate and clinically appropriate manner (Correct answer)
- Withhold bad news to protect patient emotional well-being
- Allow families to determine how much information patients receive
Correct answer: Be truthful with patients in a compassionate and clinically appropriate manner
Veracity obligates providers to be honest with patients while exercising sensitivity about timing, context, and emotional readiness in communicating difficult information.
Question 3: In the Tarasoff v. Regents of the University of California ruling, the court established that therapists have:
- Absolute confidentiality that cannot be broken for any reason
- A duty to warn identifiable third parties of serious threats from patients (Correct answer)
- Immunity from liability for patient violence against third parties
- The right to hospitalize any patient who expresses violent ideation
Correct answer: A duty to warn identifiable third parties of serious threats from patients
Tarasoff (1976) established that mental health professionals must take reasonable steps to protect identifiable potential victims when a patient poses a credible threat of serious harm.
Question 4: The principle of double effect is invoked ethically when:
- A treatment has both diagnostic and therapeutic purposes
- A good action has a foreseeable but unintended harmful side effect (Correct answer)
- Two providers share responsibility for a medical error
- A drug is used for both approved and off-label indications
Correct answer: A good action has a foreseeable but unintended harmful side effect
The doctrine of double effect permits an action with harmful side effects (e.g., high-dose opioids that may hasten death) if the intent is a good outcome (relief of suffering) and the harm is not the means to the good.
Question 5: A provider's duty of fidelity in healthcare ethics primarily means:
- Reporting all adverse events to risk management
- Keeping promises and honoring commitments made to patients (Correct answer)
- Maintaining accurate and complete medical records
- Referring patients to specialists when outside one's expertise
Correct answer: Keeping promises and honoring commitments made to patients
Fidelity (faithfulness) obligates healthcare providers to honor the trust patients place in them by keeping promises, maintaining confidentiality, and fulfilling professional commitments.
Question 6: A physician who charges Medicare for services not rendered has committed:
- Negligence
- Breach of contract
- Healthcare fraud under the False Claims Act (Correct answer)
- A HIPAA violation
Correct answer: Healthcare fraud under the False Claims Act
Billing federal healthcare programs for services not provided constitutes healthcare fraud, prosecutable under the False Claims Act with civil penalties and potential criminal charges.
Question 7: The concept of 'assent' in pediatric medical ethics differs from 'consent' because assent:
- Replaces parental consent once a child reaches age 12
- Is a developmentally appropriate agreement sought from the child in addition to parental consent (Correct answer)
- Is legally binding in all US states for children over 10
- Only applies to research settings, not clinical care
Correct answer: Is a developmentally appropriate agreement sought from the child in addition to parental consent
Assent respects the emerging autonomy of children by seeking their agreement to treatment while recognizing that legal consent authority rests with parents or guardians.
BHS Medical Ethics and Law 5
Which federal law governs the privacy and security of individually identifiable health information held by covered entities?