NHI Medical Law and Ethics Questions and Answers — Questions and Answers
Question 1: A patient presents a valid Durable Power of Attorney for Health Care, naming their spouse as their health care agent. The patient is now incapacitated and unable to make decisions. A conflict arises between the instructions in the patient's living will and the spouse's current decision. Which of the following should legally be followed?
- The living will, because it was written by the patient.
- The spouse's decision, as the designated agent. (Correct answer)
- The physician's best medical judgment.
- The hospital's ethics committee's recommendation.
Correct answer: The spouse's decision, as the designated agent.
A Durable Power of Attorney for Health Care appoints a specific person (agent or proxy) to make decisions on the patient's behalf when they are incapacitated. This agent has the legal authority to interpret the patient's wishes, including those in a living will, and make decisions in the current medical context.
Question 2: A medical assistant is asked by a patient's friend for an update on the patient's condition. According to the HIPAA Privacy Rule, which of the following is the most appropriate response?
- "I can't share any information, but I can confirm they are a patient here."
- "Let me check the chart and see what I can tell you."
- "The patient is doing well and should be discharged soon."
- "I am not permitted to share patient information for privacy reasons." (Correct answer)
Correct answer: "I am not permitted to share patient information for privacy reasons."
The HIPAA Privacy Rule strictly protects individually identifiable health information (PHI). Disclosing any information about a patient's status or presence in a facility without their explicit consent is a violation. The only correct response is to refuse to provide information, citing patient privacy.
Question 3: The legal doctrine of 'res ipsa loquitur' means 'the thing speaks for itself.' In which of the following medical malpractice scenarios would this doctrine most likely apply?
- A patient's cancer diagnosis is missed, leading to a delay in treatment.
- A surgical sponge is discovered inside a patient's abdomen months after surgery. (Correct answer)
- A patient has an allergic reaction to a prescribed medication.
- A prescribed physical therapy regimen does not improve a patient's condition.
Correct answer: A surgical sponge is discovered inside a patient's abdomen months after surgery.
Res ipsa loquitur applies when an injury is of a kind that ordinarily would not occur without negligence, and the instrumentality causing the injury was under the defendant's exclusive control. A surgical sponge being left inside a patient is a clear example of this, as it implies negligence on the part of the surgical team.
Question 4: Which federal law requires healthcare facilities that receive Medicare and Medicaid funds to inform patients of their rights to make decisions concerning their medical care, including the right to accept or refuse treatment and the right to formulate advance directives?
- Health Insurance Portability and Accountability Act (HIPAA)
- Emergency Medical Treatment and Active Labor Act (EMTALA)
- Patient Self-Determination Act (PSDA) (Correct answer)
- Affordable Care Act (ACA)
Correct answer: Patient Self-Determination Act (PSDA)
The Patient Self-Determination Act (PSDA) of 1990 mandates that healthcare institutions must provide adult patients with written information about their rights under state law to make decisions about their healthcare. This includes the right to create advance directives like living wills and durable powers of attorney for health care.
Question 5: Which of the following elements is NOT a required component of informed consent?
- The nature of the proposed procedure or treatment.
- The risks and benefits of the procedure.
- The credentials and experience of the provider. (Correct answer)
- Reasonable alternatives to the proposed treatment.
Correct answer: The credentials and experience of the provider.
The core components of informed consent include a discussion of the nature of the treatment, its potential risks and benefits, and any reasonable alternatives, including the option of no treatment. While a patient can ask about a provider's credentials, it is not a legally required element that the provider must proactively disclose for consent to be considered 'informed.'
Question 6: A healthcare professional is found to have committed a tort of negligence. To establish this, the plaintiff must have proven four key elements. Which of the following is NOT one of the 'Four D's of Negligence'?
- Duty
- Dereliction
- Damages
- Defamation (Correct answer)
Correct answer: Defamation
The 'Four D's of Negligence' in a medical context are: Duty (the provider had a duty of care to the patient), Dereliction (or Breach of Duty - the provider failed to meet the standard of care), Direct Cause (the breach of duty directly caused the injury), and Damages (the patient suffered a legally recognizable injury). Defamation is a separate tort involving harm to a person's reputation.
NHI Medical Law and Ethics Questions and Answers
A patient presents a valid Durable Power of Attorney for Health Care, naming their spouse as their health care agent.
The patient is now incapacitated and unable to make decisions.
A conflict arises between the instructions in the patient's living will and the spouse's current decision.
Which of the following should legally be followed?