PAM Medical Ethics & Patient Rights 3 — Questions and Answers
Question 1: A patient with cognitive impairment cannot provide informed consent for a PAM procedure. Who is the most appropriate decision-maker?
- The physical therapist
- The patient's legally authorized representative or healthcare proxy (Correct answer)
- The hospital billing department
- Any available family member, regardless of legal designation
Correct answer: The patient's legally authorized representative or healthcare proxy
When a patient lacks decision-making capacity, a legally authorized representative or designated healthcare proxy assumes the role of surrogate decision-maker.
Question 2: A therapist continues applying cryotherapy after a patient verbally withdraws consent mid-treatment. This constitutes:
- Acceptable practice if the therapy is nearly complete
- Battery, since treatment continued without consent (Correct answer)
- Abandonment of the therapeutic relationship
- A minor documentation error
Correct answer: Battery, since treatment continued without consent
Continuing a physical intervention after a patient withdraws consent constitutes battery, which is an intentional and unconsented touching.
Question 3: Which documentation practice best protects both the patient's rights and the therapist's legal standing when using PAM?
- Recording only the final outcome of each session
- Documenting consent, parameters, patient response, and any adverse effects each session (Correct answer)
- Keeping mental notes to reduce paperwork
- Filing consent forms only for high-risk modalities
Correct answer: Documenting consent, parameters, patient response, and any adverse effects each session
Comprehensive session documentation including consent, parameters, and patient responses creates a legal and clinical record that protects all parties.
Question 4: A therapist believes a prescribed PAM treatment is inappropriate for the patient's condition. The most ethical course of action is to:
- Administer the treatment as prescribed without question
- Refuse treatment and discharge the patient
- Consult with the prescribing physician to discuss concerns (Correct answer)
- Substitute a different modality without informing the physician
Correct answer: Consult with the prescribing physician to discuss concerns
Consulting with the prescribing physician respects the collaborative nature of healthcare while fulfilling the therapist's duty to advocate for patient safety.
Question 5: The Patient Self-Determination Act (PSDA) requires healthcare facilities to:
- Mandate all patients complete advance directives
- Inform patients of their right to create advance directives upon admission (Correct answer)
- Override patient wishes when clinically necessary
- Restrict PAM treatments based on patient age
Correct answer: Inform patients of their right to create advance directives upon admission
The PSDA requires that healthcare facilities inform patients of their right to make advance directives and to participate in decisions about their care.
Question 6: Veracity as an ethical principle obligates a physical therapist to:
- Avoid sharing negative prognoses to protect patient morale
- Provide truthful information about treatment options and expected outcomes (Correct answer)
- Withhold information if it may cause patient anxiety
- Share only information the patient specifically requests
Correct answer: Provide truthful information about treatment options and expected outcomes
Veracity requires honesty and truthfulness with patients, including accurate information about prognosis, risks, and realistic expectations.
Question 7: Which situation represents an appropriate use of the ethical concept of therapeutic privilege?
- Withholding information because the therapist finds it inconvenient to explain
- Limiting disclosure when full information would severely harm a patient's mental health (Correct answer)
- Keeping treatment details secret to maintain professional authority
- Sharing patient data with insurance companies without consent
Correct answer: Limiting disclosure when full information would severely harm a patient's mental health
Therapeutic privilege is a narrow exception allowing clinicians to limit information disclosure only when it would cause severe psychological harm, but it must be used cautiously.
PAM Medical Ethics & Patient Rights 3
A patient with cognitive impairment cannot provide informed consent for a PAM procedure.
Who is the most appropriate decision-maker?