CCM Ethical Principles and Conduct 5 — Questions and Answers
Question 1: A case manager working in a correctional facility must balance the institution's security requirements with a client's healthcare needs. This tension BEST exemplifies:
- A scope of practice conflict
- A role conflict requiring ethical navigation between institutional and client loyalties (Correct answer)
- A standard administrative challenge with no ethical dimension
- A breach of the case manager's duty to report
Correct answer: A role conflict requiring ethical navigation between institutional and client loyalties
Correctional settings create role conflicts where institutional authority and client-centered advocacy must be carefully balanced.
Question 2: Which of the following actions VIOLATES a case manager's duty of fidelity?
- Documenting a client's progress accurately in the medical record
- Making a commitment to a client and then failing to follow through without justification (Correct answer)
- Referring a client to a specialist outside the original care plan
- Disclosing mandatory reporting information as required by law
Correct answer: Making a commitment to a client and then failing to follow through without justification
Fidelity requires keeping promises and honoring commitments made to clients; unexplained failure to follow through is a violation of this duty.
Question 3: A client with full decision-making capacity states they want to stop dialysis, knowing it will result in death. The case manager should PRIMARILY:
- Initiate an emergency psychiatric evaluation to assess competency
- Respect the client's decision and facilitate goals-of-care planning (Correct answer)
- Contact the family to override the client's wishes
- Report the client to the ethics committee without the client's knowledge
Correct answer: Respect the client's decision and facilitate goals-of-care planning
A competent client has the right to refuse life-sustaining treatment; the case manager's role is to support goals-of-care planning and ensure comfort.
Question 4: Ethical case management practice requires that case managers avoid acting outside their:
- Geographical jurisdiction
- Scope of practice and competence (Correct answer)
- Employer's preferred vendor list
- Insurance panel authorization
Correct answer: Scope of practice and competence
Practicing beyond one's scope of practice and competence is an ethical violation that can harm clients and expose the case manager to liability.
Question 5: When a case manager identifies an ethical dilemma, consulting an institutional ethics committee is MOST appropriate when:
- Any disagreement arises between the case manager and client
- The dilemma involves complex competing values that cannot be resolved through standard processes (Correct answer)
- The client requests a second clinical opinion
- A billing dispute occurs between a provider and insurer
Correct answer: The dilemma involves complex competing values that cannot be resolved through standard processes
Ethics committees are designed for complex moral conflicts involving competing values, not routine clinical or administrative disagreements.
Question 6: A case manager who works in a workers' compensation setting has access to an injured worker's full psychiatric history unrelated to the work injury. Sharing this information with the employer would be:
- Permissible since the employer is paying for the claim
- A violation of confidentiality and possibly HIPAA (Correct answer)
- Required to ensure the employer can provide appropriate accommodations
- Acceptable if the employee has signed a general workers' compensation release
Correct answer: A violation of confidentiality and possibly HIPAA
Workers' compensation authorizations typically cover only injury-related information; releasing unrelated psychiatric records violates confidentiality and HIPAA.
Question 7: Which behavior BEST reflects the ethical obligation of a case manager to practice with integrity?
- Documenting only positive outcomes to improve performance metrics
- Accurately reporting errors, limitations, and outcomes even when unfavorable (Correct answer)
- Withholding information from clients to reduce their anxiety
- Following employer instructions without questioning ethical implications
Correct answer: Accurately reporting errors, limitations, and outcomes even when unfavorable
Integrity demands honest, accurate reporting of all outcomes and errors, which builds trust and supports continuous quality improvement.
CCM Ethical Principles and Conduct 5
A case manager working in a correctional facility must balance the institution's security requirements with a client's healthcare needs.
This tension BEST exemplifies: