CASPer Exam CASPer: Medical Ethics 2 — Questions and Answers
Question 1: A patient with terminal cancer refuses further treatment and wants to go home to die. Their adult children insist doctors 'do everything possible.' What is the physician's primary obligation?
- Honor the patient's autonomous decision to refuse treatment (Correct answer)
- Follow the family's wishes to continue aggressive treatment
- Convene an ethics committee to override the patient's decision
- Transfer care to a physician willing to continue treatment
Correct answer: Honor the patient's autonomous decision to refuse treatment
A competent adult patient's right to refuse treatment takes precedence over family preferences, as autonomy is a foundational principle of medical ethics.
Question 2: A surgeon realizes mid-operation that the consent form was signed for the wrong procedure. The correct surgery is urgently needed. What should the surgeon do?
- Complete the needed procedure since the patient's life is at risk
- Stop, close the incision safely, and obtain proper informed consent before proceeding (Correct answer)
- Proceed and document the discrepancy in the chart afterward
- Call the patient's family for telephone consent and continue
Correct answer: Stop, close the incision safely, and obtain proper informed consent before proceeding
Unless immediate life-threatening emergency exists, surgery should stop and proper informed consent must be obtained before proceeding with a different procedure.
Question 3: A physician discovers that a colleague is practicing while impaired by alcohol. The physician has directly witnessed this. What is the most appropriate first action?
- Report the colleague directly to state medical board immediately
- Confront the colleague privately and give them a chance to self-report
- Document observations and report to the hospital's physician health program or chief of staff (Correct answer)
- Notify patients who may have been treated by the impaired colleague
Correct answer: Document observations and report to the hospital's physician health program or chief of staff
Most hospital systems require reporting impaired physicians through institutional channels (physician health program or administration) as the appropriate first step to protect patients.
Question 4: A 16-year-old requests contraception and asks that her parents not be told. She is otherwise healthy and the request is for preventive care. What should the provider do?
- Refuse care until parental consent is obtained
- Provide contraception and respect her confidentiality per minor consent laws (Correct answer)
- Notify her parents because she is a minor
- Provide the contraception but document that parents were notified
Correct answer: Provide contraception and respect her confidentiality per minor consent laws
In most US states, minors have the legal right to consent to contraceptive services without parental notification, and confidentiality should be maintained.
Question 5: A patient of limited English proficiency needs to discuss a serious diagnosis. The patient's bilingual adult child offers to interpret. What is the best approach?
- Accept the child's offer to save time and resources
- Use a professional medical interpreter to ensure accuracy and confidentiality (Correct answer)
- Use a translation app on a smartphone
- Delay the conversation until a bilingual staff member is available
Correct answer: Use a professional medical interpreter to ensure accuracy and confidentiality
Professional medical interpreters ensure accurate translation of complex medical information and protect patient confidentiality, which family members may compromise.
Question 6: A physician is asked by a pharmaceutical company to give a paid lecture promoting their new drug. The physician believes the drug is effective. What ethical concern is most relevant?
- The physician may not be qualified to give lectures
- Financial relationships with industry can create conflicts of interest that bias clinical judgment (Correct answer)
- Pharmaceutical companies should not engage physicians for education
- The lecture may violate HIPAA regulations
Correct answer: Financial relationships with industry can create conflicts of interest that bias clinical judgment
Paid relationships with pharmaceutical companies represent conflicts of interest that can unconsciously bias a physician's clinical recommendations and public statements.
Question 7: A dying patient tells you in confidence that they want to donate their organs but their family is opposed. The patient has not completed an advance directive. What should guide the decision?
- The family's wishes, since they are the legal decision-makers after death
- The patient's expressed wish, and encourage completion of an advance directive or donor registration (Correct answer)
- Hospital policy, which defaults to family consent for organ donation
- A court order to resolve the conflict
Correct answer: The patient's expressed wish, and encourage completion of an advance directive or donor registration
A competent patient's expressed wish to donate organs should be honored; the physician should help the patient formalize this through registration or advance directive.
CASPer Exam CASPer: Medical Ethics 2
A patient with terminal cancer refuses further treatment and wants to go home to die.
Their adult children insist doctors 'do everything possible.' What is the physician's primary obligation?