CCP Ethics & Professional Standards in Chronic Care 2 — Questions and Answers
Question 1: A patient with poorly controlled diabetes refuses to follow the dietary plan recommended by the care team. What is the most ethically appropriate response?
- Discharge the patient from the chronic care program
- Document the refusal and continue to support the patient's autonomy while offering alternatives (Correct answer)
- Contact the patient's family to override the decision
- Withhold further services until the patient complies
Correct answer: Document the refusal and continue to support the patient's autonomy while offering alternatives
Respecting patient autonomy means supporting informed refusal while continuing to offer care and alternatives.
Question 2: Which principle underlies the obligation of a chronic care professional to report a colleague who is impaired while providing patient care?
- Justice
- Veracity
- Non-maleficence (Correct answer)
- Fidelity
Correct answer: Non-maleficence
Non-maleficence (do no harm) obligates professionals to act when a colleague's impairment puts patients at risk.
Question 3: A care manager discovers that a patient's advance directive conflicts with the family's wishes. What should the care manager do first?
- Follow the family's wishes to preserve relationships
- Follow the advance directive as it reflects the patient's autonomous choice (Correct answer)
- Convene a multidisciplinary team meeting without consulting the advance directive
- Ask the physician to make the final decision without review
Correct answer: Follow the advance directive as it reflects the patient's autonomous choice
A legally executed advance directive represents the patient's autonomous decision and takes precedence over family preferences.
Question 4: When a chronic care professional suspects elder abuse in a homebound patient, which action reflects the standard of mandatory reporting?
- Discuss suspicions only with the supervising physician
- Report concerns to the appropriate state Adult Protective Services agency (Correct answer)
- Wait for definitive proof before taking any action
- Confront the suspected abuser directly during a home visit
Correct answer: Report concerns to the appropriate state Adult Protective Services agency
Most US states mandate that healthcare professionals report suspected elder abuse to Adult Protective Services regardless of certainty.
Question 5: A pharmaceutical company offers a chronic care manager gift cards in exchange for recommending their medication management app to patients. This situation represents a:
- Legitimate marketing partnership
- Conflict of interest that violates professional ethics (Correct answer)
- Standard industry practice that requires only verbal disclosure
- Benefit that can be accepted if under $50 in value
Correct answer: Conflict of interest that violates professional ethics
Accepting gifts from vendors in exchange for patient referrals or recommendations constitutes a conflict of interest and violates professional ethics standards.
Question 6: The ethical concept of 'therapeutic privilege' — withholding information from a patient because it might cause harm — is generally regarded in modern chronic care ethics as:
- Widely accepted and frequently applied
- Increasingly rejected in favor of full disclosure and patient autonomy (Correct answer)
- Required by law in most US states
- Recommended for patients with cognitive impairment
Correct answer: Increasingly rejected in favor of full disclosure and patient autonomy
Modern bioethics strongly favors patient autonomy and full disclosure; therapeutic privilege is largely rejected except in narrow, carefully defined circumstances.
Question 7: A chronic care professional learns that a patient's insurance company is requesting detailed psychosocial records beyond what is medically necessary. The most appropriate response is to:
- Provide all records immediately to maintain insurer relations
- Release only the minimum necessary information required for the specific purpose (Correct answer)
- Refuse all communication with the insurer
- Ask the patient to handle the request directly without professional guidance
Correct answer: Release only the minimum necessary information required for the specific purpose
HIPAA's minimum necessary standard requires sharing only the information needed for the specific requested purpose.
CCP Ethics & Professional Standards in Chronic Care 2
A patient with poorly controlled diabetes refuses to follow the dietary plan recommended by the care team.
What is the most ethically appropriate response?