CMD CMD Ethics & Medical Decision-Making 2 — Questions and Answers
Question 1: Which ethical framework evaluates the morality of an action solely based on its outcomes or consequences?
- Deontology
- Virtue ethics
- Utilitarianism (Correct answer)
- Principlism
Correct answer: Utilitarianism
Utilitarianism judges actions by whether they produce the greatest good for the greatest number.
Question 2: The concept of 'double effect' in medical ethics is most relevant when:
- A treatment benefits two patients simultaneously
- Pain management may hasten death as an unintended side effect (Correct answer)
- Two physicians disagree on a treatment plan
- A facility operates two separate care units
Correct answer: Pain management may hasten death as an unintended side effect
The doctrine of double effect justifies an action with both good and unintended harmful effects, such as high-dose opioids for comfort care.
Question 3: When obtaining informed consent for a clinical procedure on a nursing facility resident, which element is MOST critical?
- Obtaining the signature of the next of kin
- Ensuring the resident understands risks, benefits, and alternatives (Correct answer)
- Getting written consent from the attending physician
- Documenting that the administrator approved the procedure
Correct answer: Ensuring the resident understands risks, benefits, and alternatives
Valid informed consent requires that the resident comprehends material information including risks, benefits, and alternatives.
Question 4: A Medical Director is asked to certify a resident as unable to make decisions solely to allow a family-preferred treatment. This action would violate which principle?
- Justice
- Fidelity and honesty (Correct answer)
- Non-maleficence
- Beneficence
Correct answer: Fidelity and honesty
Falsely certifying incapacity violates the duty of fidelity and professional honesty owed to the resident.
Question 5: In long-term care, the principle of justice as it applies to resource allocation MOST closely means:
- All residents receive identical treatments regardless of need
- Resources are distributed fairly based on clinical need and established criteria (Correct answer)
- The wealthiest residents receive priority for scarce services
- Justice only applies to legal disputes, not clinical decisions
Correct answer: Resources are distributed fairly based on clinical need and established criteria
Justice in healthcare requires equitable distribution of resources according to need and transparent criteria.
Question 6: A resident with early-stage dementia expresses a wish to return home, but the care team believes this is unsafe. The Medical Director should:
- Dismiss the request because the resident has dementia
- Perform a formal capacity assessment and involve the ethics committee if needed (Correct answer)
- Transfer care immediately to a geriatric psychiatrist
- Simply document the request without further action
Correct answer: Perform a formal capacity assessment and involve the ethics committee if needed
A formal capacity assessment is required before overriding a resident's expressed preference, even with cognitive impairment.
CMD CMD Ethics & Medical Decision-Making 2
Which ethical framework evaluates the morality of an action solely based on its outcomes or consequences?