RH Ethics, Safety & Clinical Practice 3 — Questions and Answers
Question 1: Which scenario represents a BREACH of client confidentiality?
- Sharing de-identified case notes in a supervised clinical training
- Discussing a client's case by name at a public lecture without consent (Correct answer)
- Providing records to another provider with signed client authorization
- Maintaining encrypted digital records with password protection
Correct answer: Discussing a client's case by name at a public lecture without consent
Disclosing identifiable client information publicly without consent violates confidentiality regardless of the educational intent.
Question 2: Comfrey (Symphytum officinale) leaf is restricted for internal use primarily due to the presence of:
- Volatile oils causing kidney irritation
- Pyrrolizidine alkaloids with hepatotoxic potential (Correct answer)
- High tannin content causing GI ulceration
- Oxalate crystals causing systemic toxicity
Correct answer: Pyrrolizidine alkaloids with hepatotoxic potential
Pyrrolizidine alkaloids (PAs) in comfrey are cumulative hepatotoxins linked to veno-occlusive liver disease with chronic internal use.
Question 3: A new client has a history of hormone-sensitive breast cancer. Which herb requires the most caution when formulating a protocol?
- Ashwagandha (Withania somnifera)
- Red clover (Trifolium pratense) (Correct answer)
- Eleuthero (Eleutherococcus senticosus)
- Hawthorn (Crataegus monogyna)
Correct answer: Red clover (Trifolium pratense)
Red clover contains isoflavones with estrogenic activity that may stimulate hormone-receptor-positive tumors, requiring particular caution in this population.
Question 4: The term 'informed consent' in herbal practice means:
- The client signs a form absolving the herbalist of all liability
- The client receives complete information about the proposed protocol, risks, alternatives, and right to refuse (Correct answer)
- The client agrees to follow all recommendations without question
- The herbalist obtains verbal agreement before beginning any session
Correct answer: The client receives complete information about the proposed protocol, risks, alternatives, and right to refuse
True informed consent requires full disclosure of relevant information so the client can make a voluntary, educated decision about their care.
Question 5: An herbalist practicing in a US state where herbalism is not licensed should be MOST careful to avoid:
- Recommending dietary supplements
- Diagnosing medical conditions or prescribing treatments (Correct answer)
- Teaching herbal classes to the public
- Growing and selling herbs
Correct answer: Diagnosing medical conditions or prescribing treatments
Diagnosing and prescribing are reserved for licensed medical practitioners; doing so constitutes unlicensed medical practice regardless of the tools used.
Question 6: Which practice best demonstrates 'first, do no harm' (primum non nocere) in herbalism?
- Using the highest dose possible to ensure efficacy
- Selecting the gentlest effective herb and monitoring for adverse reactions (Correct answer)
- Avoiding all herbs with any known side effects
- Relying solely on traditional use without considering current safety data
Correct answer: Selecting the gentlest effective herb and monitoring for adverse reactions
Non-maleficence is best served by choosing the least harmful effective option and monitoring client response throughout treatment.
Question 7: When a client experiences an unexpected adverse reaction to an herbal formula, the practitioner should FIRST:
- Immediately discontinue the formula and assess the client's condition (Correct answer)
- Add more herbs to counteract the reaction
- Advise the client to wait and see if it resolves on its own without changes
- Increase the dose to push through the reaction
Correct answer: Immediately discontinue the formula and assess the client's condition
Stopping the suspected causative formula and evaluating the client's current condition is the immediate priority to prevent escalation of harm.
RH Ethics, Safety & Clinical Practice 3
Which scenario represents a BREACH of client confidentiality?