CCM Ethical Principles and Conduct 3 — Questions and Answers
Question 1: Under HIPAA, a case manager may share protected health information (PHI) without client authorization for which of the following purposes?
- Marketing a new health plan product
- Treatment, payment, and healthcare operations (Correct answer)
- Sharing with the client's employer upon request
- Conducting pharmaceutical research without oversight
Correct answer: Treatment, payment, and healthcare operations
HIPAA permits disclosure of PHI without authorization for treatment, payment, and healthcare operations activities.
Question 2: A case manager is caring for a client from a culture where family elders traditionally make all healthcare decisions. The client appears to defer to family. What is the BEST ethical approach?
- Exclusively communicate with the elder to respect cultural norms
- Determine whether the client voluntarily accepts this arrangement and document it (Correct answer)
- Override the family's role to ensure individual autonomy
- Refer the client to a culturally matched case manager
Correct answer: Determine whether the client voluntarily accepts this arrangement and document it
Culturally competent care requires assessing whether the client freely accepts family decision-making rather than assuming or overriding it.
Question 3: The ethical principle of justice in case management PRIMARILY refers to:
- Advocating exclusively for the highest-cost clients
- Fair and equitable distribution of resources and services (Correct answer)
- Maintaining strict confidentiality for all clients equally
- Providing the same treatment plan to every client regardless of need
Correct answer: Fair and equitable distribution of resources and services
Justice requires that resources and services be distributed fairly based on need, not preference or ability to pay.
Question 4: A case manager who discloses a client's HIV status to the client's employer without consent has violated which foundational ethical principle?
- Nonmaleficence
- Justice
- Confidentiality (Correct answer)
- Fidelity
Correct answer: Confidentiality
Unauthorized disclosure of sensitive health information is a direct violation of the ethical and legal duty of confidentiality.
Question 5: Which of the following scenarios BEST illustrates the principle of nonmaleficence in case management?
- A case manager advocates for additional therapy visits a client requests
- A case manager delays discharge until safer home conditions are confirmed (Correct answer)
- A case manager distributes limited resources to the most complex cases
- A case manager truthfully informs a client about a poor prognosis
Correct answer: A case manager delays discharge until safer home conditions are confirmed
Delaying discharge to prevent harm from an unsafe environment directly applies the principle of 'do no harm.'
Question 6: When a case manager faces a situation where two ethical principles conflict, the BEST approach is to:
- Always prioritize beneficence over all other principles
- Apply a systematic ethical decision-making framework (Correct answer)
- Defer all ethical decisions to the client's physician
- Avoid intervening until the conflict resolves itself
Correct answer: Apply a systematic ethical decision-making framework
Ethical conflicts require a structured framework that considers all principles, stakeholders, and consequences rather than automatic prioritization.
Question 7: A client refuses a recommended medication, citing personal beliefs. The case manager believes the refusal is harmful. What is the MOST ethically appropriate response?
- Override the refusal by contacting the pharmacy directly
- Ensure the client is informed of consequences, document the refusal, and respect the decision (Correct answer)
- Report the client to adult protective services for self-neglect
- Discontinue case management services due to non-compliance
Correct answer: Ensure the client is informed of consequences, document the refusal, and respect the decision
A competent client's informed refusal must be respected; the case manager's role is to ensure understanding, document it, and continue supportive care.
CCM Ethical Principles and Conduct 3
Under HIPAA, a case manager may share protected health information (PHI) without client authorization for which of the following purposes?