SHS Medical Ethics & Patient Rights 2 — Questions and Answers
Question 1: A patient refuses a blood transfusion on religious grounds despite a life-threatening condition. What is the healthcare provider's ethical obligation?
- Administer the transfusion to save the patient's life
- Override the refusal if family members consent
- Respect the refusal if the patient is competent and informed (Correct answer)
- Seek a court order to proceed with treatment
Correct answer: Respect the refusal if the patient is competent and informed
A competent, informed adult has the right to refuse any treatment, including life-saving ones, based on personal or religious beliefs.
Question 2: Which principle of biomedical ethics requires healthcare workers to 'do no harm'?
- Autonomy
- Beneficence
- Nonmaleficence (Correct answer)
- Justice
Correct answer: Nonmaleficence
Nonmaleficence is the principle that obligates providers to avoid causing unnecessary harm or injury to patients.
Question 3: Under HIPAA, which of the following is considered a permissible disclosure of protected health information without patient authorization?
- Sharing records with the patient's employer
- Reporting a communicable disease to the public health department (Correct answer)
- Providing records to a marketing firm
- Disclosing details to curious family members
Correct answer: Reporting a communicable disease to the public health department
Public health reporting for communicable diseases is a legally recognized permissible disclosure under HIPAA's public interest exceptions.
Question 4: A patient's surrogate decision-maker should base decisions on which standard?
- What the surrogate believes is best for the patient
- The patient's previously expressed wishes or best interests (Correct answer)
- Recommendations of the majority of the care team
- The least expensive treatment option
Correct answer: The patient's previously expressed wishes or best interests
Surrogates must apply the substituted judgment standard — honoring what the patient would have wanted — or the best interest standard when preferences are unknown.
Question 5: Which document allows a patient to designate another person to make healthcare decisions on their behalf if incapacitated?
- Living will
- Do Not Resuscitate order
- Durable power of attorney for healthcare (Correct answer)
- Advance beneficiary notice
Correct answer: Durable power of attorney for healthcare
A durable power of attorney for healthcare (healthcare proxy) legally designates a specific individual to make medical decisions when the patient cannot.
Question 6: What is the primary purpose of an Institutional Review Board (IRB) in the context of medical research?
- To fund clinical trials
- To protect the rights and welfare of human research subjects (Correct answer)
- To approve the publication of research findings
- To license healthcare researchers
Correct answer: To protect the rights and welfare of human research subjects
IRBs review research protocols to ensure participant safety, informed consent, and ethical conduct of studies involving human subjects.
Question 7: A patient asks a nurse not to share their HIV-positive status with their spouse. The nurse believes the spouse is at risk. What should the nurse do first?
- Immediately disclose the status to the spouse
- Respect confidentiality absolutely and take no action
- Consult ethics committee and follow facility protocol on duty to warn (Correct answer)
- Document the request and do nothing further
Correct answer: Consult ethics committee and follow facility protocol on duty to warn
The nurse must balance confidentiality with potential duty-to-warn obligations, which requires consultation with ethics resources and adherence to institutional and state law.
SHS Medical Ethics & Patient Rights 2
A patient refuses a blood transfusion on religious grounds despite a life-threatening condition.
What is the healthcare provider's ethical obligation?