CCM Ethics, Advocacy, & Legal Issues 3 — Questions and Answers
Question 1: When a case manager encounters a conflict between a client's stated preferences and the family's wishes, the ethical priority is to:
- Follow the family's wishes to avoid conflict
- Honor the client's autonomous decision if the client has capacity (Correct answer)
- Defer to the physician's recommendation
- Convene a team meeting and let the majority decide
Correct answer: Honor the client's autonomous decision if the client has capacity
Autonomy dictates that competent clients have the right to make their own healthcare decisions regardless of family disagreement.
Question 2: Which ethical framework evaluates the morality of an action based solely on its outcomes and overall benefit?
- Deontological ethics
- Virtue ethics
- Utilitarian ethics (Correct answer)
- Rights-based ethics
Correct answer: Utilitarian ethics
Utilitarianism judges actions by their consequences, seeking the greatest good for the greatest number of people.
Question 3: A case manager learns a client is being discharged to an unsafe home environment. The BEST ethical action is to:
- Discharge the client as planned to respect autonomy
- Advocate for a safety assessment and explore alternatives before discharge (Correct answer)
- Report the physician to the hospital ethics committee immediately
- Contact Adult Protective Services without first discussing with the client
Correct answer: Advocate for a safety assessment and explore alternatives before discharge
Advocacy requires the case manager to ensure a safety assessment and explore alternatives, balancing autonomy with non-maleficence.
Question 4: In the context of CCM practice, 'fidelity' as an ethical principle means:
- Ensuring confidentiality of all client records
- Keeping promises and honoring commitments to clients (Correct answer)
- Treating all clients equally regardless of diagnosis
- Avoiding dual relationships with clients
Correct answer: Keeping promises and honoring commitments to clients
Fidelity refers to the obligation to keep promises, be truthful, and honor commitments made to clients and colleagues.
Question 5: A client signs a consent form but later states they did not understand what they agreed to. This raises concerns about:
- Implied consent
- The validity of informed consent (Correct answer)
- Therapeutic privilege
- Competency by default
Correct answer: The validity of informed consent
Valid informed consent requires comprehension; a signature without understanding does not constitute legally or ethically valid consent.
Question 6: Which federal law prohibits discrimination against individuals with disabilities by programs receiving federal financial assistance?
- Americans with Disabilities Act (ADA)
- Section 504 of the Rehabilitation Act (Correct answer)
- Family and Medical Leave Act (FMLA)
- Mental Health Parity and Addiction Equity Act
Correct answer: Section 504 of the Rehabilitation Act
Section 504 of the Rehabilitation Act of 1973 prohibits disability discrimination specifically in federally funded programs and activities.
Question 7: When a case manager suspects a colleague is providing substandard care that harms clients, the FIRST step should be:
- Immediately report to state licensing authorities
- Document observations and report through the organization's internal process (Correct answer)
- Confront the colleague publicly
- Ignore the situation to avoid workplace conflict
Correct answer: Document observations and report through the organization's internal process
Ethical practice requires documenting concerns and using established internal reporting channels before escalating externally.
When a case manager encounters a conflict between a client's stated preferences and the family's wishes, the ethical priority is to: