CDS Medical Ethics & Patient Rights 2 — Questions and Answers
Question 1: A patient with a cognitive disability refuses a recommended medical procedure. The care team believes the procedure is in the patient's best interest. What ethical principle is MOST at stake?
- Beneficence
- Autonomy (Correct answer)
- Non-maleficence
- Justice
Correct answer: Autonomy
Autonomy is the ethical principle that upholds an individual's right to make their own medical decisions, even if others disagree with those choices.
Question 2: Under the Americans with Disabilities Act (ADA), a hospital must provide effective communication for a deaf patient. Which of the following best fulfills this obligation?
- Written notes only
- A qualified sign language interpreter (Correct answer)
- Lip reading without assistance
- Speaking loudly and slowly
Correct answer: A qualified sign language interpreter
The ADA requires healthcare providers to furnish qualified interpreters to ensure effective communication with deaf patients.
Question 3: A surrogate decision-maker for a patient with a disability should base decisions on which standard?
- What the surrogate personally believes is best
- What the patient would have chosen (substituted judgment) (Correct answer)
- What is least expensive for the family
- What the physician recommends without exception
Correct answer: What the patient would have chosen (substituted judgment)
Substituted judgment requires the surrogate to make decisions based on the known wishes or values of the patient, not the surrogate's own preferences.
Question 4: Which federal law specifically protects people with disabilities from discrimination in programs receiving federal financial assistance, including most hospitals?
- HIPAA
- Section 504 of the Rehabilitation Act (Correct answer)
- EMTALA
- The Mental Health Parity Act
Correct answer: Section 504 of the Rehabilitation Act
Section 504 of the Rehabilitation Act of 1973 prohibits discrimination against individuals with disabilities in any program receiving federal financial assistance.
Question 5: A patient with an intellectual disability is admitted to the ER. Staff should prioritize which of the following actions first?
- Contact the patient's insurer
- Assess the patient's decision-making capacity (Correct answer)
- Ask family to make all decisions immediately
- Defer all treatment until a guardian is located
Correct answer: Assess the patient's decision-making capacity
Assessing decision-making capacity is the first step before involving surrogates or overriding patient preferences in any medical situation.
Question 6: A CDS professional notices that a client with a disability is being denied medically necessary services based on their disability status. This is an example of:
- Clinical triage
- Disability-based discrimination (Correct answer)
- Standard resource allocation
- Appropriate gatekeeping
Correct answer: Disability-based discrimination
Denying medically necessary services solely on the basis of disability status constitutes unlawful disability-based discrimination under federal law.
Question 7: Which concept best describes the obligation of healthcare providers to avoid causing harm to patients with disabilities through stereotyping or lowered expectations?
- Veracity
- Non-maleficence (Correct answer)
- Fidelity
- Paternalism
Correct answer: Non-maleficence
Non-maleficence obligates providers to do no harm, which includes avoiding biased assumptions that lead to substandard care for patients with disabilities.
CDS Medical Ethics & Patient Rights 2
A patient with a cognitive disability refuses a recommended medical procedure.
The care team believes the procedure is in the patient's best interest.
What ethical principle is MOST at stake?