CCMA Medical Law and Ethics 2 — Questions and Answers

Question 1: Which of the following best defines 'informed consent'?

Any verbal agreement between a patient and physician
A patient's permission to proceed with treatment after being fully educated about the procedure, risks, benefits, and alternatives (Correct answer)
A form signed by the patient before entering the medical office
Consent given by a patient's family member on their behalf

Correct answer: A patient's permission to proceed with treatment after being fully educated about the procedure, risks, benefits, and alternatives

Informed consent requires the physician to disclose the procedure, its risks and benefits, alternatives, and consequences of refusal, and then obtain voluntary patient agreement.

Valid informed consent requires: (1) Disclosure — the physician explains the procedure, purpose, risks, benefits, alternatives (including doing nothing), and expected outcomes; (2) Comprehension — the patient understands the information in language they can comprehend; (3) Voluntariness — consent is given freely, without coercion; (4) Capacity — the patient has the legal and mental capacity to consent. The medical assistant's role is to witness the signature, not to obtain informed consent (which is the physician's responsibility). Informed consent is not required in emergencies when the patient cannot consent.

Question 2: Under HIPAA, a patient's protected health information (PHI) may be disclosed without authorization for:

Marketing purposes by the healthcare provider
Treatment, payment, and healthcare operations (TPO) (Correct answer)
Informing the patient's employer of their diagnosis
Reporting test results to a patient's family member

Correct answer: Treatment, payment, and healthcare operations (TPO)

HIPAA's Privacy Rule permits disclosure of PHI without patient authorization specifically for Treatment, Payment, and Healthcare Operations (TPO).

HIPAA permits PHI disclosure without patient authorization for: (1) Treatment — sharing PHI with other providers involved in the patient's care; (2) Payment — submitting claims and coordinating benefits; (3) Healthcare Operations — quality assessment, training, auditing, compliance activities. PHI may also be disclosed without authorization for: public health activities, law enforcement (with conditions), judicial proceedings (subpoena), workers' compensation, and national security. Marketing, employer disclosures, and family notifications (unless specifically authorized) require written patient authorization.

Question 3: A patient who signs a release of information form is exercising which legal right?

Right to refuse treatment
Right to access their medical records
Right to authorize disclosure of their PHI (Correct answer)
Right to amend their medical record

Correct answer: Right to authorize disclosure of their PHI

A release of information form is the mechanism by which a patient authorizes the disclosure of their protected health information to a specified third party.

A valid HIPAA authorization (release of information) must include: (1) Specific description of PHI to be released; (2) Name of person/entity authorized to disclose; (3) Name of person/entity to receive the PHI; (4) Purpose of the disclosure; (5) Expiration date or event; (6) Patient's dated signature. Patients also have rights to access their own records (right to access), request amendments to incorrect records (right to amend), receive a list of disclosures (accounting of disclosures), and request restrictions on use of their PHI.

Question 4: Which of the following is an example of medical malpractice?

A physician charging above average fees for services
A physician failing to diagnose appendicitis in a patient who later dies due to that failure (Correct answer)
A patient leaving the office without scheduling a follow-up
A medical assistant being rude to a patient

Correct answer: A physician failing to diagnose appendicitis in a patient who later dies due to that failure

Medical malpractice occurs when a healthcare provider's failure to meet the standard of care causes patient harm. Failing to diagnose a serious condition that results in patient harm meets all four elements of malpractice.

The four elements (4 D's) of medical malpractice must all be proven: (1) Duty — a provider-patient relationship existed; (2) Dereliction — the provider failed to meet the accepted standard of care; (3) Direct cause — the dereliction directly caused harm; (4) Damages — actual harm (injury, death, financial loss) resulted. Failing to diagnose appendicitis when a reasonable physician would have, resulting in perforation and death, satisfies all four elements. Rudeness may constitute professional misconduct but does not meet malpractice criteria unless physical harm resulted.

Question 5: The concept of 'respondeat superior' in healthcare means:

Patients have the right to refuse treatment
A physician must report communicable diseases to public health authorities
Employers may be held legally responsible for the negligent acts of their employees performed within the scope of employment (Correct answer)
A healthcare provider must obtain second opinions before surgery

Correct answer: Employers may be held legally responsible for the negligent acts of their employees performed within the scope of employment

Respondeat superior ('let the master answer') is the legal doctrine that employers are vicariously liable for the negligent acts of their employees when those acts occur within the scope of their employment.

Respondeat superior is a doctrine of vicarious liability: if an employee commits a negligent act while performing duties within the scope of their employment, the employer may be held legally liable. For example, if a medical assistant negligently gives a wrong medication and the patient is harmed, the physician-employer may be sued along with the medical assistant. This emphasizes the importance of proper staff training, supervision, and scope of practice adherence. Employees are always personally responsible for their own actions; respondeat superior adds employer liability.

Question 6: A physician who abandons a patient without proper notice is guilty of:

Assault
Breach of confidentiality
Medical abandonment (Correct answer)
Defamation

Correct answer: Medical abandonment

Medical abandonment occurs when a physician terminates the physician-patient relationship without proper notice or adequate time for the patient to obtain alternative care.

Medical abandonment occurs when a physician: (1) Unilaterally discontinues the patient relationship; (2) Without sufficient notice (typically 30 days); (3) Without providing time for the patient to find alternative care; (4) While the patient still needs medical care. Proper patient dismissal requires: written certified letter, 30-day notice period, offer to provide emergency care during the transition, and assistance with referrals/records transfer. Abandonment can result in civil liability for resulting harm, disciplinary action, and license revocation. Medical assistants should follow practice protocols when dismissing patients.

CCMA Medical Law and Ethics 2

Which of the following best defines 'informed consent'?

Select your answer