CMT Medical Law and Ethics 2 — Questions and Answers
Question 1: The Health Insurance Portability and Accountability Act (HIPAA) primarily protects:
- Healthcare worker employment rights
- Patient health information privacy (Correct answer)
- Hospital accreditation standards
- Insurance company profits
Correct answer: Patient health information privacy
HIPAA establishes national standards for protecting the privacy and security of patients' protected health information (PHI).
HIPAA, enacted in 1996, includes the Privacy Rule (governing use and disclosure of PHI), the Security Rule (protecting electronic PHI), and the Breach Notification Rule (requiring notification of unauthorized disclosures). PHI includes any individually identifiable health information in any form. Covered entities include healthcare providers, health plans, and healthcare clearinghouses. Violations can result in civil penalties ($100-$50,000 per violation) and criminal penalties (up to $250,000 and 10 years imprisonment for intentional misuse).
Question 2: Informed consent requires all of the following EXCEPT:
- Explanation of the procedure
- Description of risks and benefits
- Guarantee of a successful outcome (Correct answer)
- Discussion of alternatives
Correct answer: Guarantee of a successful outcome
Informed consent requires explanation, risks, benefits, and alternatives, but never a guarantee of outcome.
Informed consent is both an ethical principle and legal requirement. Essential elements include: (1) description of the proposed procedure or treatment, (2) expected benefits, (3) material risks and potential complications, (4) alternatives including no treatment, (5) opportunity to ask questions, and (6) voluntary agreement without coercion. The patient must be competent and of legal age. Consent must be obtained before the procedure begins. Medical technicians may witness consent but typically cannot obtain it—that responsibility falls to the physician performing the procedure.
Question 3: A patient's right to make decisions about their own medical care is known as:
- Beneficence
- Autonomy (Correct answer)
- Justice
- Fidelity
Correct answer: Autonomy
Autonomy is the ethical principle that recognizes a patient's right to self-determination in healthcare decisions.
Autonomy is one of the four fundamental principles of medical ethics (Beauchamp and Childress). It respects the patient's right to make informed decisions about their own care, including the right to refuse treatment. This principle underlies informed consent, advance directives, and the right to a second opinion. Beneficence means acting in the patient's best interest, nonmaleficence means 'do no harm,' and justice means fair distribution of resources. When autonomy conflicts with beneficence (e.g., patient refuses life-saving treatment), the patient's autonomous decision generally takes precedence.
Question 4: An advance directive is a legal document that:
- Assigns a patient's financial assets
- Specifies healthcare wishes if the patient becomes incapacitated (Correct answer)
- Grants medical staff immunity from lawsuits
- Transfers patient records between facilities
Correct answer: Specifies healthcare wishes if the patient becomes incapacitated
An advance directive documents a patient's healthcare preferences for situations when they cannot communicate their wishes.
Advance directives include living wills (specifying desired or unwanted treatments) and durable power of attorney for healthcare (designating a healthcare proxy to make decisions). The Patient Self-Determination Act (1990) requires Medicare/Medicaid-participating facilities to inform patients of their right to create advance directives. These documents must be completed while the patient is competent. Common provisions address resuscitation (DNR), mechanical ventilation, artificial nutrition, and organ donation. Medical technicians must document advance directive status and ensure the care team is aware.
Question 5: The ethical principle of 'nonmaleficence' means:
- Doing good for the patient
- Do no harm (Correct answer)
- Treating all patients equally
- Telling the truth
Correct answer: Do no harm
Nonmaleficence is the principle of 'primum non nocere'—first, do no harm.
Nonmaleficence obligates healthcare workers to avoid causing unnecessary harm to patients. This includes both intentional harm and negligent harm (failing to meet the standard of care). Examples include: not performing procedures beyond one's competence, reporting medication errors, maintaining equipment properly, and following safety protocols. Nonmaleficence sometimes conflicts with beneficence—for example, chemotherapy causes harm (side effects) while attempting to do good (cure cancer). Healthcare workers must weigh potential benefits against potential harms for each intervention.
Question 6: What constitutes a breach of patient confidentiality?
- Discussing a patient's condition with the treating physician
- Sharing patient information with unauthorized individuals (Correct answer)
- Documenting patient care in the medical record
- Reporting suspected child abuse to authorities
Correct answer: Sharing patient information with unauthorized individuals
Sharing patient information with anyone not authorized or directly involved in the patient's care is a confidentiality breach.
Patient confidentiality is both an ethical obligation and legal requirement. Breaches include: discussing patients in public areas (elevators, cafeterias), leaving medical records visible, sharing login credentials for electronic health records, posting patient information on social media, and disclosing information to family members without patient consent. Exceptions where disclosure is permitted include: mandated reporting (abuse, communicable diseases), court orders, worker's compensation claims, and public health emergencies. Medical technicians must be vigilant about protecting patient information in all forms—verbal, written, and electronic.
CMT Medical Law and Ethics 2
The Health Insurance Portability and Accountability Act (HIPAA) primarily protects: