TBI TBI Legal & Ethical Considerations 1 — Questions and Answers
Question 1: Informed consent for treatment is complex in TBI because of which primary challenge?
- Language barriers only
- Fluctuating or impaired decision-making capacity due to cognitive and consciousness deficits (Correct answer)
- Financial consent issues
- Insurance authorization delays
Correct answer: Fluctuating or impaired decision-making capacity due to cognitive and consciousness deficits
Cognitive impairment and altered consciousness in TBI can render a patient temporarily or permanently incapable of providing informed consent.
Question 2: When a TBI patient lacks decision-making capacity, which legal instrument designates someone to make healthcare decisions on their behalf?
- Last will and testament
- Durable power of attorney for healthcare (healthcare proxy) (Correct answer)
- Living will alone
- Court-appointed receivership
Correct answer: Durable power of attorney for healthcare (healthcare proxy)
A durable power of attorney for healthcare designates a surrogate decision-maker who can act on behalf of an incapacitated TBI patient.
Question 3: In TBI personal injury litigation, neuropsychological testing is used primarily for which purpose?
- Criminal guilt determination
- Objective documentation of cognitive deficits for disability or damages claims (Correct answer)
- Medication prescription guidance only
- Return-to-work clearance for employers
Correct answer: Objective documentation of cognitive deficits for disability or damages claims
Neuropsychological evaluations provide objective, standardized documentation of cognitive impairment supporting legal claims for damages in TBI cases.
Question 4: Which ethical principle is most challenged when a TBI patient in a minimally conscious state is unable to communicate end-of-life preferences?
- Beneficence
- Autonomy — the patient's right to self-determination cannot be directly exercised (Correct answer)
- Non-maleficence
- Justice
Correct answer: Autonomy — the patient's right to self-determination cannot be directly exercised
Autonomy requires that patients direct their own care, which becomes impossible when disorders of consciousness prevent communication of preferences.
Question 5: The Glasgow Outcome Scale (GOS) is used in TBI legal and clinical contexts primarily to measure what?
- Acute injury severity at scene
- Functional outcome and disability level following TBI for prognosis and legal damages (Correct answer)
- Pain intensity
- Medication response
Correct answer: Functional outcome and disability level following TBI for prognosis and legal damages
The GOS classifies TBI outcomes from death to good recovery, providing a standardized functional outcome measure used in research, clinical care, and legal proceedings.
Question 6: Mandatory reporting requirements relevant to TBI most commonly apply to which situation in the US?
- All concussions in adults
- Suspected child abuse causing TBI — clinicians are mandatory reporters (Correct answer)
- Sports-related concussion in high school athletes only
- TBI in workers' compensation cases
Correct answer: Suspected child abuse causing TBI — clinicians are mandatory reporters
Healthcare providers are mandatory reporters of suspected child abuse, and abusive head trauma (shaken baby syndrome) is a leading TBI cause in young children.
TBI TBI Legal & Ethical Considerations 1
Informed consent for treatment is complex in TBI because of which primary challenge?