CTP Legal and Ethical Standards 5 — Questions and Answers
Question 1: A telehealth provider is asked by law enforcement for a patient's records without a subpoena. Under HIPAA, the provider should:
- Provide records immediately to cooperate with law enforcement
- Refuse all law enforcement requests under any circumstances
- Evaluate whether the specific conditions for law enforcement disclosure under HIPAA are met before disclosing (Correct answer)
- Notify the patient before disclosing any information to law enforcement
Correct answer: Evaluate whether the specific conditions for law enforcement disclosure under HIPAA are met before disclosing
HIPAA permits limited disclosures to law enforcement under specific conditions such as valid court orders or for certain public safety purposes, but providers must evaluate compliance carefully before disclosing.
Question 2: A telehealth patient who is a minor seeks confidential mental health treatment. The provider should first:
- Automatically include parents in all treatment decisions since the patient is a minor
- Consult state law on minor consent for mental health treatment before proceeding (Correct answer)
- Refuse treatment until the minor turns 18
- Require parental consent in all cases as federal law mandates it
Correct answer: Consult state law on minor consent for mental health treatment before proceeding
Minor consent laws for mental health treatment vary by state; providers must consult their state's specific statutes before determining whether parental consent is required.
Question 3: What is the primary ethical obligation when a telehealth provider realizes they lack the competence to treat a patient's presenting condition via telehealth?
- Continue treatment while seeking additional training
- Refer the patient to an appropriate provider and, if needed, provide temporary support during the transition (Correct answer)
- Terminate the therapeutic relationship immediately without referral
- Expand practice scope and seek retroactive training after the course of treatment
Correct answer: Refer the patient to an appropriate provider and, if needed, provide temporary support during the transition
Ethical practice requires providers to practice within their competency and to facilitate safe transitions to appropriate care when they cannot adequately serve a patient's needs.
Question 4: A telehealth provider's patient describes symptoms that suggest a medical emergency. The provider cannot confirm the patient's exact address. What should the provider do?
- Advise the patient to call 911 and terminate the session
- Attempt to identify the patient's location through all available means while keeping them on the line and coordinating emergency services (Correct answer)
- Document the situation and schedule a follow-up appointment
- Transfer care to the next available telehealth provider
Correct answer: Attempt to identify the patient's location through all available means while keeping them on the line and coordinating emergency services
Providers should establish and follow emergency protocols that include obtaining patient location information at the start of every session to enable emergency response when needed.
Question 5: Which of the following actions would violate the ethical principle of non-maleficence in a telehealth context?
- Recommending a lower-cost treatment option
- Providing telehealth services to a patient who clearly requires immediate in-person emergency care (Correct answer)
- Documenting session notes after the visit
- Using a HIPAA-compliant video platform
Correct answer: Providing telehealth services to a patient who clearly requires immediate in-person emergency care
Non-maleficence means avoiding harm; continuing telehealth with a patient who needs immediate in-person emergency care could cause harm by delaying necessary treatment.
Question 6: A telehealth provider receives a subpoena for patient records related to a legal case. What is the appropriate first step?
- Immediately produce all requested records to comply with the legal order
- Consult with legal counsel and notify the patient before disclosing, unless prohibited (Correct answer)
- Ignore the subpoena as HIPAA overrides all state court orders
- Destroy the records to protect patient confidentiality
Correct answer: Consult with legal counsel and notify the patient before disclosing, unless prohibited
Upon receiving a subpoena, providers should consult legal counsel, assess whether it meets legal requirements, and typically notify the patient so they can object before disclosure occurs.
Question 7: Under the APA Ethics Code and telehealth best practices, which statement about terminating telehealth services is most accurate?
- Providers may terminate immediately if the patient misses one appointment
- Termination should be clinically justified, with appropriate notice, referrals provided, and documentation of the reason (Correct answer)
- Termination via email is the standard method to create a written record
- Providers are not required to offer referrals upon termination if the patient has insurance
Correct answer: Termination should be clinically justified, with appropriate notice, referrals provided, and documentation of the reason
Ethical termination requires clinical justification, adequate notice to the patient, referrals to alternative care providers, and thorough documentation of the decision.
CTP Legal and Ethical Standards 5
A telehealth provider is asked by law enforcement for a patient's records without a subpoena.
Under HIPAA, the provider should: