CAA Professional Ethics & Standards 2 — Questions and Answers
Question 1: A patient refuses a blood transfusion on religious grounds even though the anesthesiologist believes it is necessary. What is the CAA's ethical obligation?
- Override the refusal to save the patient's life
- Document the refusal and respect the competent patient's autonomy (Correct answer)
- Consult only the surgeon before proceeding
- Administer the transfusion without documentation
Correct answer: Document the refusal and respect the competent patient's autonomy
Competent adult patients have the right to refuse any treatment, including life-saving transfusions, and this decision must be respected and documented.
Question 2: Which organization publishes the primary scope of practice standards for Certified Anesthesiologist Assistants?
- American Society of Anesthesiologists (ASA)
- American Academy of Anesthesiologist Assistants (AAAA) (Correct answer)
- National Board for Certification and Recertification of Nurse Anesthetists
- Joint Commission on Accreditation of Healthcare Organizations
Correct answer: American Academy of Anesthesiologist Assistants (AAAA)
The AAAA (now part of the American Academy of Anesthesiologist Assistants) establishes and publishes the professional scope of practice for CAAs.
Question 3: A CAA discovers that a colleague is consistently falsifying anesthesia records. The most appropriate first step is to:
- Ignore it to avoid workplace conflict
- Report the behavior through appropriate institutional channels (Correct answer)
- Confront the colleague publicly in front of patients
- Contact the state medical board without any internal reporting
Correct answer: Report the behavior through appropriate institutional channels
Falsifying medical records is a serious ethical and legal violation that must be reported through proper institutional channels, such as risk management or administration.
Question 4: Informed consent for anesthesia is considered legally and ethically valid only when the patient:
- Signs the form regardless of comprehension
- Has decision-making capacity, receives adequate information, and consents voluntarily (Correct answer)
- Is informed only of the general anesthetic plan
- Consents after surgery when more information is available
Correct answer: Has decision-making capacity, receives adequate information, and consents voluntarily
Valid informed consent requires the patient to have capacity, receive material information about risks/benefits/alternatives, and agree without coercion.
Question 5: Under the ethical principle of justice in healthcare, a CAA should:
- Prioritize patients who can pay higher fees
- Provide equitable care regardless of socioeconomic status or background (Correct answer)
- Allocate more resources to patients with better prognoses
- Defer to insurance company guidelines for all treatment decisions
Correct answer: Provide equitable care regardless of socioeconomic status or background
Justice requires fair distribution of healthcare resources and equitable treatment of all patients without discrimination based on socioeconomic or personal factors.
Question 6: A CAA who accepts gifts from pharmaceutical representatives in exchange for preferential use of their products has violated which ethical principle?
- Veracity
- Non-maleficence
- Fidelity (Correct answer)
- Confidentiality
Correct answer: Fidelity
Fidelity requires loyalty to patients' best interests, and accepting gifts that influence prescribing or product selection places the provider's interests above the patient's.
Question 7: When a patient lacks decision-making capacity and has no advance directive, who typically serves as the surrogate decision-maker?
- The attending anesthesiologist makes all decisions unilaterally
- The next of kin or legally authorized representative using substituted judgment (Correct answer)
- The hospital ethics committee makes all clinical decisions
- Any available nurse familiar with the patient
Correct answer: The next of kin or legally authorized representative using substituted judgment
When a patient lacks capacity and has no advance directive, the surrogate (usually next of kin) applies substituted judgment to decide as the patient would have wished.
CAA Professional Ethics & Standards 2
A patient refuses a blood transfusion on religious grounds even though the anesthesiologist believes it is necessary.
What is the CAA's ethical obligation?