TB & SM Applied Law and Ethics in Health Care 1st Edition by Wendy Mia Pardew Complete

TEST BANK & SOLUTION MANUAL

2023

COMPLETE Elaborated Test Bank & Solution Manual for

Applied Law and Ethics in Health Care 1st Edition Wendy Mia Pardew 2023

Applied Law and Ethics in Health Care 1st Edition by Wendy Mia Pardew

ISBN-10 0357623878 ISBN-13 978-0357623879

Test Bank and Solution Manual for Applied Law and Ethics in Health Care 1st Edition by Wendy Mia Pardew

ISBN-10 0357623878 ISBN-13 978-0357623879 THIS IS NOT THE ACTUAL BOOK. YOU ARE BUYING it is the Official Test Bank in e-version INSTANT DOWNLOAD >The test bank is what most professors use as a template when making exams for their students, which means there’s a very high chance that you will see the exact questions in the tests! >The file is either in.pdf, excel, or zipped in the package and can easily be read on PCs and Macs. >Delivery is INSTANT. You can download the files IMMEDIATELY once payment is done.

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TABLE OF CONTENTS

Chapter:1. The Big Business of Health Care and You. Chapter:2. Laws and Regulations You Will Encounter.

Chapter:3. From the Constitution to the Courtroom.

Chapter:4. Criminal Acts and Intentional Torts.

Chapter:5. What Makes a Contract.

Chapter:6. Medical Malpractice and Other Lawsuits.

Chapter:7. The Health Record.

Chapter:8. Introduction to Ethics.

Chapter:9. Laws and Ethics of Patient Confidentiality.

Chapter:10. Professional Ethics and the Living.

Chapter:11. Reproductive Issues and Early Life.

Chapter:12. Death and Dying.

W.Docs Chapter:1. The Big Business of Health Care and You.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

True / False 1. In addition to protecting patients, laws also operate to protect the public. a. True b. False ANSWER: True 2. Physicians are not vicariously liable for the behavior of their employees. a. True b. False ANSWER: False 3. Most medical office employees are not licensed to practice medicine. a. True b. False ANSWER: True 4. Dividends are the net worth of a corporation. a. True b. False ANSWER: False 5. In managed care, the actual care a patient receives is influenced by the policies and procedures of the managed care plan. a. True b. False ANSWER: True Multiple Choice 6. If you are not certain that an assigned task is within your scope of practice, what should you do? a. Leave the position and seek a job that does not stretch professional boundaries. b. Contact regulatory authorities. c. Tell the provider that you are not prepared or skilled to do the task. d. Raise the concern with the employer and discuss until it is resolved.

ANSWER: d 7. The standard of care for a certified health care professional is ________________________. a. highly developed and dictated by the state b. not as well defined as it is for licensed professionals c. based on the employer’s definition d. dependent on the employee’s ethical preference ANSWER: b 8. Which is a legal business entity? a. Stockholder b. Partnership Copyright Cengage Learning. Powered by Cognero.

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c. Agent d. Conglomerate ANSWER: b 9. Identify the true statement about sole proprietorships. a. It is a two-person entity. b. The sole proprietor does not have to pay taxes. c. The sole proprietor benefits from profits. d. The sole proprietor cannot hire employees.

ANSWER: c 10. Which of the following statements is true? a. A medical assistant is held to a lower standard of care than is a layperson. b. A medical assistant is held to the reasonable person standard. c. A medical assistant, working as an agent under the physician’s direction, may be held to the same standard of care as a physician. d. A medical assistant is only held to the same standard of care as a physician when dispensing medical advice.

ANSWER: c 11. Personal protection means: a. protecting yourself from needless co-worker criticism b. protecting the facility from loss of revenue c. protecting yourself from loss of earning power d. protecting the provider from loss of reputation ANSWER: c 12. Licensure laws: a. protect physicians and medical office staff. b. protect the public and serve patients’ interests. c. are set by the federal government. d. signify exceptional qualifications for the occupation.

ANSWER: b 13. Why is it important for medical assistants to understand and work within the parameters of the laws that apply to a medical office? a. Doing so protects themselves and their employer. b. Doing so protects the patient. c. Doing so protects the physician. d. Doing so protects the pharmacist and the physician.

ANSWER: a 14. In today’s medical office, the certified health care professional is permitted to do which of the following? a. Act independently to care for patients b. Communicate directly with patients c. Give medical advice d. Diagnose and treat patients Copyright Cengage Learning. Powered by Cognero.

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ANSWER: b 15. Which of the following is a type of legal entity in which one person operates a business for profit and has unlimited personal liability for the business? a. solo practice b. sole proprietorship c. conglomerate d. limited liability company ANSWER: b 16. A Patient Bill of Rights offered by many hospitals and other health care facilities are: a. always required by law. b. standard among all health care facilities. c. may differ for each health care facility. d. required by law in all federal facilities.

ANSWER: c 17. Which is true about a Limited Liability Company (LLC)? a. An LLC’s ground rules are decided by the government. b. An LLC is owned by a single individual who wants full responsibility for profit and losses. c. An LLC can be owned by an individual or group. d. An LLC does not require tax reporting.

ANSWER: c 18. Most medical office professionals are not licensed to practice medicine and __________. a. must do anything required to assist the patient b. must carry out their responsibilities without making medical decisions or acting outside the areas of their expertise c. may sometimes dispense medical advice d. must carry out their responsibilities without making medical decisions or acting outside the areas of their expertise and may sometimes dispense medical advice ANSWER: b 19. Locum tenens means: a. a physician or other professional who is temporarily performing the duties of another. b. a certification. c. a legal action pursuant to federal law. d. scope of practice.

ANSWER: a 20. A Patient Bill of Rights: a. provides billing information related to current treatment. b. acknowledges a patient’s right to choose, consent to, and to refuse treatment. c. explains legal and ethical rights. d. explains legal and ethical rights, and acknowledges a patient’s right to choose, consent to, and to refuse treatment.

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ANSWER: d 21. Which is a feature of the Affordable Care Act (ACA)? a. Health plans must cover preventive care. b. The No Surprises Act is part of ACA c. Eliminates coverage for pre-existing conditions. d. Eliminates standards for health insurance plans.

ANSWER: a 22. Which indicates the holder has completed education, experience and has basic minimum qualifications required by state law to perform certain procedures for a specific occupation? a. Degree b. Being hired to work in a physician’s office c. A license d. Being hired to work in a physician’s office and a degree ANSWER: c 23. What will you receive once you have attained a minimum level of education and training and passed an examination required by an accredited certifying organization? a. Degree b. Certification c. Professionalism d. License ANSWER: b 24. What federal law requires every health plan and provider to maintain reasonable and appropriate safeguards to ensure the confidentiality of health information? a. HITECH b. FMLA c. ACA d. HIPAA ANSWER: d 25. What is the name of profits of a corporation that are distributed to stockholders? a. Shares b. Dividends c. Gifts d. Stocks ANSWER: b 26. Which is a feature of Managed Care? a. Delivering health care with lower costs and increased quality. b. Allowing health care services without restrictions. c. Eliminating premiums. d. Brand name prescription access.

ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:1. The Big Business of Health Care and You.

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27. As a member of society, one is expected to carry out interpersonal relationships in a responsible manner that will not cause harm. This is known legally as holding an individual to what kind of standard? a. Standard of care b. Reasonable person c. Guardian ad litem d. Respondeat superior ANSWER: b 28. What type of MCO does not use primary care physicians as gatekeepers and seeks to improve health care and reduce costs by using groups of physicians, hospitals, and other health care providers to coordinate cost-effective, quality health care and to reward positive patient outcomes by sharing cost-savings with providers? a. HMO b. POS c. ACO d. LCO ANSWER: c 29. What is the name of a legal entity that is an association of two or more individuals who act as co-owners of a business venture? a. Corporation b. Limited Liability Company c. Proprietor d. Partnership ANSWER: d 30. Legal entities include sole proprietorships, partnerships, professional associations, limited liability partnership, and limited liability companies. What is another type of legal entity? a. Corporation b. Stockholder c. Group d. Dividend ANSWER: a Subjective Short Answer 31. Why should health care professionals understand their legal professional responsibility?

ANSWER: Ignorance of the law does not protect the professional from being guilty of a violation or the consequences of a violation. Therefore, health care professionals have the responsibility to understand the laws and regulations about their chosen career.

32. Describe how the medical office personnel are the link between the patient and the doctor.

ANSWER: They arrange office visits, laboratory tests, therapeutic appointments, and hospital admissions.

33. Describe fee-for-service.

ANSWER: Fee-for-service is payment per service, sometimes that service is per hour sometimes per service item.

34. When is telemedicine used?

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ANSWER: Telemedicine is a health care delivery system used when the patient is in one location and the treating physician is in another, possibly thousands of miles away.

35. Describe the implications for “respondeat superior” as it applies to employee protection while working within their scope of employment.

ANSWER: Respondeat superior (“let the master answer”) means that physicians are vicariously liable for the behavior of their employees (such as medical assistants or nurses) while the employees are working within the scope of their employment.

36. Name two forms of Prepaid Group Practices (PGPs).

ANSWER: Staff model and group model 37. Define negligence.

ANSWER: Negligence is not using reasonable and prudent care within the circumstance.

38. Describe the differences among a sole proprietorship, partnership, and corporation.

ANSWER: Answers should include: Sole Proprietor is a single physician, therapist, or other licensed health care profession operating a business alone. A partnership is two or more people who combine their work, money, and talents to do what one could not do alone. A corporation is a group of people banding together and creating an artificial being, or entity, that can do something that the members of the group could not do individually.

39. Identify two types of Health Maintenance Organizations (HMOs) provider payment structures.

ANSWER: Answers should include: Prepaid Group Practice (PGP) are a group of physicians who agree to provide comprehensive health care services for a fixed prospective per capita payment to a definite population.

Individual Practice Associations (IPAs) are groups of physicians who join together into an agreement with other organizations to provide medical services to a defined population.

40. Define the term managed care.

ANSWER: Answers should include: Managed Care is a term used to describe a system of integration of the financing and delivery of health care to provide comprehensive services to an identified segment of the population.

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W.Docs Chapter:2. Laws and Regulations You Will Encounter.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

True / False 1. Permitting unlicensed personnel to perform medical procedures within the physician’s scope of practice is not grounds for the revocation or suspension of a medical license. a. True b. False ANSWER: False 2. Controlled substances acts restrict the distribution, classification, sale, and use of certain drugs. a. True b. False ANSWER: True 3. Employment policies that appear to treat all employees equally but have an adverse impact on a particular protected group can result in a disparate impact. a. True b. False ANSWER: True 4. The Federal Age Discrimination Act (FADA) protects the rights of workers under the age of 40. a. True b. False ANSWER: False 5. The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers from using genetic information when hiring, firing, training, or promoting employees. a. True b. False ANSWER: True Multiple Choice 6. Licensing boards can ______ licenses and ______ medical providers for working outside of their scope of practice. a. revoke; reprimand b. refuse; reinstate c. censure; relinquish d. provide; pursue ANSWER: a 7. In many states, failure to report specific injuries or deaths can result in ______________. a. lawsuits b. misdemeanor charges c. loss of license d. action against the hospital ANSWER: b 8. As a mandatory reporter, what should a nurse do if there is suspected abuse or neglect when caring for a patient?

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W.Docs Chapter:2. Laws and Regulations You Will Encounter.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

a. not get involved in the issue b. notify a physician, supervisor, and law enforcement c. wait for another nurse to report it d. confront the abuser ANSWER: b 9. What does the EEOC stand for? a. Employing Equally Out of College b. Equal Employment Opportunity Commission c. Employment Equals Outstanding Colleagues d. Elder Equal Opportunities Commission ANSWER: b 10. Which federal act establishes a federal minimum wage, mandates extra pay for overtime work, regulates the employment of children, and is administered by the Department of Labor. a. Family and Medical Leave Act (FMLA) b. Fair Labor Standards Act (FLSA) c. Equal Pay Act d. Employee Retirement Income Security Act ANSWER: b 11. State legislatures establish medical boards with the authority to a. protect physicians and medical office staff. b. control health care provider licensing. c. require drug testing of all health care professionals. d. set standards in patient care.

ANSWER: b 12. What does the procedures manual describe? a. job responsibilities b. required skills c. how to perform responsibilities d. personnel policies ANSWER: c 13. Physicians are required to submit reports on a regular basis to various governmental agencies. Which of these should be reported? a. non-communicable diseases b. accidents c. births, deaths, and communicable diseases d. patient load ANSWER: c 14. Elder abuse is governed at the _______________ level. a. state b. federal and state Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:2. Laws and Regulations You Will Encounter.

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c. federal d. state and local ANSWER: b 15. Under _____ law, employers are not allowed to ask interview questions concerning race, religion, age, or whether a woman is pregnant. a. Equal employment b. FLMA c. Discrimination d. Employment ANSWER: c 16. Social Security includes what related but different programs? a. retirement, disability, and dependent’s/survivor’s benefits b. OSHA and HIPAA c. Fair Labor Standards d. Family and Medical Leave ANSWER: a 17. Most people 65 years of age or older, rich or poor, are eligible for _____ coverage. _____ is provided for low-income individuals and is obtainable through local social services or welfare departments. a. Medicare; Medicaid b. Medicaid; Medicare c. retirement; Medicaid d. retirement; Medicare ANSWER: a 18. Which statement best describes the regulations for blood-borne pathogens? a. Regulations cover clinical aspects of practice. b. Regulations do not require universal precautions. c. Regulations cover both administrative and clinical aspects of practice. d. Regulations require employees to get vaccinations from employers only.

ANSWER: c 19. People join unions for many reasons, but primarily because they: a. like organizations. b. are dissatisfied with their job description. c. are dissatisfied with wages, benefits, or working conditions. d. are content with their job responsibilities.

ANSWER: c 20. A job description describes: a. how specific tasks of a job should be carried out. b. the responsibility required of each employee. c. guidelines for performing procedures. d. an action for product liability.

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W.Docs Chapter:2. Laws and Regulations You Will Encounter.

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ANSWER: b 21. What is a procedural attempt to achieve collective agreements between an employer and accredited representative of a group of employees to improve conditions of employment? a. risk management b. bargaining unit c. quality assurance d. collective bargaining ANSWER: d 22. _________ legislatures establish medical boards with the authority to control health care provider licensing. a. Federal b. International c. State d. Governmental ANSWER: c 23. The licensing board has the power to __________ a license for reasons such as performing procedures that are not within the provider’s scope of practice. a. renew b. revoke c. grant d. inform ANSWER: b 24. One ground for ___________ of a medical license is permitting unlicensed personnel to perform medical procedures within the scope of practice of physicians. a. issuance b. granting c. revocation d. renewal ANSWER: c 25. Controlled substances acts restrict the _______ , ________, and _________ of certain drugs. a. manufacturing, allocation, and licensing b. chemicals, foods, and sale c. licensing, classification, and chemicals d. distribution, classification, and sale ANSWER: d 26. Are employers allowed to test potential employees as part of the hiring process? a. No, never. b. Yes, if agreed by employee and signed in advance. c. Yes, when tests are carefully constructed to ensure it measures skills necessary to do the job. d. No, except for when discrimination is suspected.

ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:2. Laws and Regulations You Will Encounter.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

27. Illegal discrimination may be shown by either disparate treatment or ____________. a. the number of prior lawsuits b. the number of employee complaints c. disparate impact d. interstate commerce ANSWER: c 28. An EEOC Charge of Discrimination must be filed within ______ days following the incident, unless the facts warrant an exception that extends the period to ______ days. a. 300; 180 b. 60; 300 c. 180; 300 d. 90; 180 ANSWER: c 29. If a health care professional has knowledge of abuse to a child and fails to report the abuse, then this can result in a. federal assistance. b. the prosecution of the health care professional c. reporter protection d. no discipline of the health care professional.

ANSWER: b 30. The OSHA rules and regulations are intended to prevent ________ and promote _________. a. job safety; injuries b. discrimination; equality c. injuries; job safety d. blood borne pathogens; hand washing ANSWER: c Subjective Short Answer 31. Name the three federal acts that seek to protect various forms of elder abuse.

ANSWER: The Elder Justice Act of 2009, The Older Americans Act, and The Elder Abuse Victims Act of 2009.

32. Who administers workers’ compensation laws?

ANSWER: Workers’ compensation laws are administered by state governments.

33. What are medical practice laws?

ANSWER: Medical practice laws control the practice of medicine.

34. What does Title I of the Americans with Disabilities Act (ADA) do?

ANSWER: Title I of the ADA prohibits employment discrimination and places the burden on an employer to prove that the requirements of a specific job could not be changed to accommodate a disabled applicant.

35. What do Titles II and III of the ADA guarantee for the disabled?

ANSWER: Titles II and III of the ADA guarantee the disabled access to the workplace.

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36. Why does the government control the manufacture, storage, and distribution of drugs or chemicals through the controlled substances acts?

ANSWER: The government controls a drug or chemical because of its potential for misuse or abuse.

37. What is a procedures manual?

ANSWER: A procedures manual describes how a task in the job description should be carried out.

38. What is Medicare?

ANSWER: Medicare is a federal insurance program for people who are entitled to Medicare from their Social Security contributions and payment of premiums.

39. In what situations can discrimination occur during the hiring process?

ANSWER: The answer should include preemployment testing, drug testing, and interviewing.

40. What is Medicaid?

ANSWER: Medicaid provides for low-income individuals and is obtainable from local social services or welfare departments.

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W.Docs Chapter:3. From the Constitution to the Courtroom.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

True / False 1. The Preamble and the Amendments make up the Constitution. a. True b. False ANSWER: False 2. Congress has 535 voting members, including 100 Representatives and 435 Senators. a. True b. False ANSWER: False 3. The first thing an experienced medical malpractice lawyer will do is try to obtain a copy of the patient’s medical records. a. True b. False ANSWER: True 4. The three branches of government are the administrative, the legislative, and the judiciary. a. True b. False ANSWER: False 5. You should only release a copy of a patient’s medical records after verifying that a signed authorization form is in the patient’s chart. a. True b. False ANSWER: True Multiple Choice 6. Who passes legislation? a. The President b. Congress c. The President’s Cabinet d. The Judiciary ANSWER: b 7. What clause tells us that federal law will govern when there is a conflict between federal and state law? a. The Supremacy Clause b. The Interstate Commerce Clause c. The Commerce Clause d. The Necessary and Proper Clause ANSWER: a 8. Negligent acts fall under which category of law? a. Civil Law Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:3. From the Constitution to the Courtroom.

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b. Criminal Law c. Common Law d. Administrative Law ANSWER: a 9. What occurs at the end of the second phase when the discovery is complete, and the judge declares the case is ready for trial? a. Pretrial conference b. Depositions c. Negotiations d. Examination ANSWER: a 10. The ____________ determines whether federal or state law is applicable and enforceable. a. administration b. legislative branch c. president d. Constitution ANSWER: d 11. Which of the following falls under the responsibilities of administrative agencies? a. adjudication b. legislation c. arbitration d. mediation ANSWER: a 12. _____ means “let the decision stand.” a. Respondeat superior b. Stare decisis c. Writ of certiorari d. Cert. denied ANSWER: b 13. During Phase II, _____ consists of depositions, interrogatories, motions, and witness identification. a. arbitration b. discovery c. pretrial conference d. testimony ANSWER: b 14. Once a complaint has been filed, the patient officially becomes the _____ and the provider officially becomes the _____. a. defendant/plaintiff b. plaintiff/defendant c. prosecutor/respondent Copyright Cengage Learning. Powered by Cognero.

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d. respondent/prosecutor ANSWER: b 15. Testimony is: a. a motion. b. a writ of certiorari. c. evidence. d. confidential.

ANSWER: c 16. Ninety percent of cases settle out of court. Cases are settled out of court in several ways, including: a. arbitration and/or mediation. b. plea bargaining and/or testimony. c. incident reports and/or agreement. d. mediation and/or discovery.

ANSWER: a 17. The _________________ Clause states that Congress is authorized to “make all laws which shall be necessary and proper for carrying into execution the foregoing powers, and all other powers vested by this Constitution in the government of the United States, or in any department or officer thereof.” a. Necessary and Proper b. Supremacy c. Enumerated Powers d. Interstate Commerce ANSWER: a 18. In a bench trial, the: a. jury makes the decision. b. negotiation process is continued. c. judge serves as both judge and jury. d. jury declares a mistrial.

ANSWER: c 19. When preparing a testimony, a witness: a. should be subjective b. can provide false statements c. should offer additional information when possible d. must pay attention in all legal proceedings ANSWER: d 20. In a medical malpractice case, who is the plaintiff? a. The patient b. The physician c. The attorney d. The defendant ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:3. From the Constitution to the Courtroom.

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21. A deposition is: a. a constitutional right. b. the final settlement of a case. c. monetary compensation for loss or injury. d. sworn verbal statement in response to questions.

ANSWER: d 22. Perjury is: a. a false statement during a deposition. b. a false statement made to your attorney. c. a false statement made to the physician during a patient office visit. d. a false statement during negotiations.

ANSWER: a 23. The stages of the federal appellate process are: a. federal district court, U.S. Court of Appeals, U.S. Supreme Court b. federal district court, superior district court, U.S. Supreme Court c. superior district court, U.S. Court of Appeals, U.S. Supreme Court d. appellate court, federal district court, U.S. Supreme Court ANSWER: a 24. In a criminal case, “beyond a reasonable doubt” is: a. the standard of guilt b. the standard of proof. c. the burden of guilt. d. the burden of proof.

ANSWER: b 25. A person charged with a crime is the _________________. a. plaintiff b. defendant c. prosecution d. guilty party ANSWER: b 26. A misdemeanor is a crime punishable by imprisonment in jail for less than _____ or a fine. a. three months b. five years c. one year d. six months ANSWER: c 27. Which of the following can be used to settle a lawsuit? a. reformation b. mediation Copyright Cengage Learning. Powered by Cognero.

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c. deposition d. discovery ANSWER: b 28. Who makes up the executive branch of government? a. The president b. The president and the president’s cabinet c. senators d. Judges ANSWER: b 29. The objective of the federal judicial branch of government is, in part, to interpret whether laws are _______. a. rational b. fair c. legal d. constitutional ANSWER: d Multiple Response 30. Which of the following is court-made law that arises from judges’ interpretation of statutory or regulatory law? a. Administrative Law b. Common Law c. Criminal Law d. Civil Law ANSWER: b Subjective Short Answer 31. In which division of law will the defendant be found liable or not liable?

ANSWER: Civil law 32. What is filed in Phase II of a medical malpractice case that causes the patient to officially become the plaintiff?

ANSWER: A complaint 33. When is a copy of the patient’s medical records authorized for release?

ANSWER: A copy of the patient’s medical records should only be released after verifying that a signed release form is in the patient’s chart.

34. During a trial, who determines what laws are involved in the case?

ANSWER: The judge 35. Who can appeal a decision in Phase IV of a medical malpractice lawsuit?

ANSWER: Either party can appeal a decision, but usually, the losing party appeals.

36. What authority does Congress delegate to administrative agencies?

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ANSWER: Answer should include how administrative agencies make rules and regulations pertaining to their specialty, and how agencies are empowered to adjudicate disputes.

37. What happens in Phase III of a medical malpractice lawsuit?

ANSWER: In Phase III, the case goes to trial to settle the dispute between two parties.

38. What is common law?

ANSWER: Common law is court-made law that arises from judges’ interpretation of statutory or regulatory law.

39. Who will receive the plaintiff’s medical records when a medical malpractice lawsuit is filed?

ANSWER: The plaintiff’s medical records will be given to the defendant, their attorney, and experts.

40. The preparation of the attorney and the witnesses is crucial to winning a lawsuit. What should a witness consider when preparing for testimony?

ANSWER: Answer should include looking at both sides, seeing where the witness fits into the total picture, trying to anticipate what defense the other side will offer, trying to be objective about strong points and weak arguments, and following the instructions given to you by your attorney.

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W.Docs Chapter:4. Criminal Acts and Intentional Torts.

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True / False 1. A felony is defined as a crime of grave or more serious nature than those designated as misdemeanors. Under federal law and many state statutes, it is any offense punishable by imprisonment for a term exceeding 1 year or death. a. True b. False ANSWER: True 2. A misdemeanor is a crime punishable by imprisonment in jail for less than one year or a fine. a. True b. False ANSWER: True 3. Physicians are considered mandated reporters of child abuse according to most state statutes. a. True b. False ANSWER: True 4. A husband who threatens to harm his wife is committing domestic violence. a. True b. False ANSWER: True 5. “Renting patients” means that patients are recruited and paid for procedures they do not need and is considered fraud. a. True b. False ANSWER: True Multiple Choice 6. When reporting suspected child abuse to the child protective services agency (CPS) in your state, what is the most crucial next step taken by CPS before referring the report to the district attorney? a. Monitor the child in their environment b. Question the family, caretakers, or foster home c. Confirming and substantiating the reported abuse d. View any historical records related to the child ANSWER: c 7. After observing an illegal activity in the health care setting, which of the following is most important to do next? a. Follow office protocol and contact the appropriate person or department b. Call the state authorities c. Fill out the designated incident report form d. Gather health information for the affected patient in their medical records, as it will be needed for reporting ANSWER: a 8. What type of elder abuse is suspected in the following example? George, an 87-year-old man, is found unconscious in his home by his son following a phone call from his physician’s office after missing several of his scheduled Copyright Cengage Learning. Powered by Cognero.

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appointments. George shows signs of starvation, and his home is disheveled. George’s caretaker is arrested on suspicion of abuse. a. Financial abuse b. Unintentional abuse c. Psychological abuse d. Intentional abuse ANSWER: d 9. In what instance can the confidentiality of the patient-provider relationship be broken? a. An adult patient discusses their disease with their physician. b. A parent is charged with child abuse. c. A 17-year-old female discusses their sexual history with their physician. d. A family member expresses concern for the health of their elderly parent.

ANSWER: b 10. You are reporting an illegal activity you witnessed while working in your health clinic. Which of the following should be included in the reporting process? a. Your suspicions of how long the activity has occurred b. Detailed information about the activity with facts and the people involved c. Relevant information from the patient’s chart, regardless of patient privacy statutes or rules d. Your state’s district attorney information ANSWER: b 11. The most common civil claim in medical law is an action known as a tort. Tort liability is classified as: a. intentional, negligent, or liability without fault. b. intentional, negligent, or malpractice. c. intentional, malpractice, or strict liability. d. negligent, malpractice, or strict liability.

ANSWER: a 12. The standard of proof required to find a defendant guilty in a criminal case is: a. beyond a reasonable doubt. b. clear and convincing evidence. c. preponderance of evidence. d. reasonable suspicion.

ANSWER: a 13. Which of the following is considered a civil cause of action? a. Manslaughter b. Malpractice c. Murder d. Misdemeanor ANSWER: b 14. Manslaughter is defined as: a. the unlawful killing of another intentionally.

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b. the unlawful killing of another accidentally. c. the unlawful killing of another negligently. d. unlawful killing of another without malice.

ANSWER: d 15. Conspiracy occurs when two or more persons: a. are joined together for a common purpose. b. come reasonably close to committing a crime. c. commit an unlawful or criminal act. d. are negligent together.

ANSWER: c 16. Larceny would occur if you took a lawnmower from your neighbor: a. without permission, and you had no intent to return it. b. and you pretend you don’t know who owns it when questioned. c. with your neighbor’s permission, and then you returned it. d. and you forgot to return it.

ANSWER: a 17. These types of abuse have mandatory reporting statutes governed by state law. a. Child abuse b. Domestic abuse c. Verbal abuse of an adult d. Adult drug abuse ANSWER: a 18. Which of the following statements is true regarding reporting child abuse and penalties for failure to report abuse? a. All states have the same hotline for reporting abuse. b. All states require complaints to be directed to child protective agencies. c. All states have the same reporting and penalties. d. All states have reporting laws.

ANSWER: d 19. Clara, a 4-year-old child, was brought into the clinic by her parents after reporting that she fell down the stairs. What physical indicators could indicate possible child abuse? a. Hyperactivity when being asked to remain still for the examination b. Wincing when touched by the health care provider c. Wearing a diaper and wetting herself during the examination d. Evidence of a skull fracture on X-ray and bruises along her arms ANSWER: d 20. Elder abuse is divided into ______ classifications. a. three b. four c. five d. six Copyright Cengage Learning. Powered by Cognero.

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ANSWER: b 21. What crime is committed when a physician does not practice in good faith, uses a form of treatment not generally accepted in medical science, or practices under the influence of drugs or alcohol, causing death to a patient? a. Murder b. Conspiracy c. Manslaughter d. Negligence ANSWER: c 22. What is an intentional action or lack of action causing the merciful death of someone suffering from a terminal illness? a. Euthanasia b. Manslaughter c. Malpractice d. Suicide ANSWER: a 23. One of the classifications of elder abuse is ____________________ abuse. Examples of this type of abuse are elderly patients with lapsed and unfilled prescriptions, unbrushed and unwashed hair, general unkempt appearance, and not eating well. a. unintentional b. physical c. intentional d. financial ANSWER: a 24. Insurance abuse includes ____________________ services that have been provided. a. discussing b. discussing procedures for c. billing for d. charging excessively for ANSWER: d 25. If you suspect Medicaid fraud has occurred in the hospital where you work, where can you report the illegal activity? a. Local law enforcement office b. The CEO of the hospital c. To the patient(s) affected d. Medicaidfraudhotline.com ANSWER: d 26. A ___________ penalty will be imposed on someone who knowingly receives a bribe for referring a patient in order to be paid by Medicare or Medicaid. a. civil b. judiciary c. criminal d. monetary Copyright Cengage Learning. Powered by Cognero.

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ANSWER: c 27. Not all states require medical professionals to report ______________. a. rape of a minor b. births and deaths c. treating an adult rape victim d. physical abuse of a minor ANSWER: c 28. When an individual working in a medical office breaks a law, the individual’s ____________________ makes the difference as to whether the behavior is labeled criminal or civil. a. intent b. authority c. behavior d. state of mind ANSWER: a 29. The importance of intentional torts for patients and plaintiffs lies in the ability of the victims to receive _______ for their injuries. a. a refund b. damages c. a sentence d. an award ANSWER: b 30. A tort is a private wrong or injury, other than a breach of contract, for which the court will provide a remedy. Which of the following is classified as an intentional tort against a person? a. Battery b. Negligence c. Conspiracy d. Liability ANSWER: a Subjective Short Answer 31. What information is needed when reporting suspected child abuse?

ANSWER: The reporter will be asked to provide as much information about the child’s situation as they can, including the names and addresses of the child and the child’s parents or other persons responsible for the child’s care, the child’s age, conditions in the child’s home environment, the nature and extent of the child’s injuries, and information about other children in the same environment.

32. Briefly explain the purpose of the Violence Against Women Act (VAWA).

ANSWER: The purpose of the Violence Against Women Act (VAWA) is to address the right of women to be free from domestic violence.

33. Explain the Fourth Amendment of the U.S. Constitution.

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ANSWER: The Fourth Amendment protects an individual against unreasonable search of person, house, office, or vehicle and unreasonable seizure of person, papers, and effects. The police may not enter a person’s home without a search warrant.

34. Define assault and battery.

ANSWER: The answer should include this being any willful attempt or threat to injure another person or nonconsensual touching.

35. The Department of Justice civil fraud section follows provisions of this Act, to recover funds in the health care area.

What is the name of this Act? ANSWER: The False Claims Act (FCA), 31 U.S.C. § 3729.

36. What is a misdemeanor?

ANSWER: A misdemeanor is an offense classified lower than a felony and generally punishable by a fine or imprisonment other than in a penitentiary.

37. Describe the difference between robbery and theft.

ANSWER: Robbery is the forcible stealing of the personal property of another either from their person or in the immediate presence of the victim. Theft is the taking property without the property owner's consent. An individual is guilty of robbery if, while carrying out theft, the victim is physically injured or has been threatened and put in fear of bodily injury.

38. What three things are required to be proven beyond reasonable doubt to find a defendant guilty of conspiracy?

ANSWER: (1) The defendant joined in an agreement or plan, (2) with the purpose to do something unlawful, and (3) the defendant joined the conspiracy knowing of the unlawful plan and intending to help carry it out.

39. What are the behavioral indicators of child abuse?

ANSWER: The child is overly compliant or passive or extremely aggressive; the child is demanding; there is a rolereversal of “parental” behavior; or the child is lagging in development.

40. Identify five forms of fraud in the medical office.

ANSWER: (1) “Upcoding” procedures to something more expensive, (2) kickbacks for referrals, (3) filing false information, (4) billing for services not provided, and (5) “renting” patients.

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W.Docs Chapter:5. What Makes a Contract.

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1. The patient-provider relationship is the keystone of medical practice but is not necessarily contractual in nature. a. True b. False ANSWER: False 2. Parties enter into a contractual relationship by mutual assent. a. True b. False ANSWER: True 3. Third-party collection agencies that pursue past due health care debt are governed by the Fair Debt Collections Practice Act (FDCPA). a. True b. False ANSWER: True 4. A minor has the capacity to sue in court and is dependent on the parent to file lawsuits before the age of majority. a. True b. False ANSWER: False 5. A contract can be written or oral. a. True b. False ANSWER: True 6. Written instructions about a person’s future medical care is called _________. a. breach of contract b. advanced directive c. termination of contract d. duty ANSWER: b 7. The majority of states require that one or more parents be advised of, or consent to a minor’s ________ . a. emancipation b. abortion c. conservator d. undue influence ANSWER: b 8. A(n) _______ is any person under the federal age of majority in the United States. a. agent b. principal c. guardian d. minor ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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9. Health care providers and facilities each have protocols in place for ______ accounts that abide by the Fair Debt Collections Practice Act. a. past due b. bad check c. termination of contract d. injunctive relief ANSWER: a 10. When a person agrees to work for, and under the direction of another, a principal–agent relationship is created. In the medical office, the health care provider is the __________ and the medical assistant is the _________. a. principal; agent b. offer; acceptance c. agent; principal d. acceptance; offer ANSWER: a 11. A breach of contract occurs when: a. the patient fails to pay their account. b. one party does not prevent the other from performing. c. the promised cure does take place. d. the patient pays their account in full.

ANSWER: a 12. To form a contract, there must be a clear understanding between the parties, known as _________, assent, or meeting of the minds. a. warranty b. agency c. implied d. mutual agreement ANSWER: d 13. A patient and health care provider voluntarily agree on a surgical procedure the patient requires. This is an example of a(n) _______. a. abandonment b. undue influence c. contract d. mutual assent ANSWER: c 14. If a patient and health care provider cannot agree on a treatment plan. They can both mutually agree to ________. a. terminate the contract b. patient abandonment c. breach of contract d. statute of limitations ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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15. What is an actual agreement between the parties, the terms of which are openly stated in distinct and explicit language, either verbally or in writing? a. An implied contract b. A warranty c. An express contract d. A health care proxy ANSWER: c 16. Minors, incompetent persons, and individuals under the influence of a drug that alters their mental state are considered: a. emancipated. b. statutory adults. c. legally disabled. d. mentally competent.

ANSWER: c 17. Which statement best describes the statute of limitations? a. The length of time to mutually agree on a contract b. The length of time after injury a plaintiff has before they may no longer file a suit c. The length of time it takes a patient to reach the age of majority d. The length of time it takes to withdraw from treating a patient ANSWER: b 18. The physician tells a patient that she will be cured after a procedure. If after the procedure, the patient is not cured.

The physician could now be liable for ____________. a. breach of contract b. undue influence c. negligence d. durable power of attorney ANSWER: a 19. Generally, neither a minor nor a minor’s parents may consent to sterilization, transplants, experimental medical care, or refusal or withholding of treatment without what? a. A court order b. Agreement from the physician c. Agreement from the minor d. Agreement from the parents and the physician ANSWER: a 20. Examples of _______ are the living will and health care power of attorney. a. implied contract b. consideration c. express contract d. advance directives ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:5. What Makes a Contract.

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21. A person with _____ cannot enter into a contract, and must have a legally appointed guardian that does this on their behalf. a. mutual agreement b. full cognitive ability c. an emancipated minor d. mental incompetence ANSWER: d 22. What is the legal relationship between physician and patient? a. Consensual b. Contractual c. Fee for service d. Principal and agent ANSWER: b 23. A(n) ________ is a non-emancipated minor in mid- to late-teens who has the intelligence and emotional maturity to be able to grasp the information necessary to make an informed decision. a. mature minor b. agent c. guardian d. conservator ANSWER: a 24. The employee answering a health care provider’s phone is working under the ________. a. contract b. injunctive relief c. law of agency d. specific performance ANSWER: c 25. To __________ a patient means that the physician gives up completely—deserts the patient—and indicates that the physician intends to terminate the contractual relationship? a. proxy b. unduly influence c. abandon d. contract with ANSWER: c 26. What is a proposal to perform a certain action or pay a specified amount? a. Consideration b. Acceptance c. Offer d. Mutual assent ANSWER: c 27. Special rules called the _________ governs the relationship between the principal and agent.

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W.Docs Chapter:5. What Makes a Contract.

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a. warranty b. law of agency c. duress d. conservator ANSWER: b 28. What type of minor is someone under the age of majority who is deemed to be completely self-supporting and able to enter into contracts? a. Emancipated b. Guardian c. Mature d. Conservator ANSWER: a 29. What is the name for a court-appointed person given authority to manage only the financial affairs of an incompetent person? a. A mature minor b. A guardian c. A parent d. A conservator ANSWER: d 30. A medical assistant prepares an injection, and a patient rolls up his or her shirt sleeve to receive the injection. What type of contract is this? a. Express b. Implied c. Written d. Mutual ANSWER: b 31. Provide examples of what an advanced health care directive can include within it.

ANSWER: A health care advance directive can include choices regarding organ and tissue donation, as well as other instructions. The advanced health care directive involves the acceptance or refusal of medical or surgical treatment the patient wishes to receive. It also requires documentation of the patient’s receipt of this information in the medical record, as well as whether a patient has executed an advance directive.

32. Describe various ways in which a patient or provider can terminate a contract.

ANSWER: A contract between a health care provider and a patient can be terminated in several ways. The most satisfactory outcome is that the health care provider treats the patient, the patient pays the health care provider the required fee or copayment, both parties are satisfied, and the contract concludes. The parties can mutually agree to terminate the relationship. A health care provider’s termination of a patient should be provided by written notice sent by certified mail, return receipt requested, and filed in the patient’s chart.

33. What are examples of advance directives?

ANSWER: The living will, the durable power of attorney, and the health care proxy are all advance directives.

34. What are the differences between implied and express contracts?

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ANSWER: An express contract is an explicit agreement between two or more parties. Whereas, an implied contract is an agreement not indicated by direct words but evident from the conduct of the parties.

35. What does it mean to be an agent?

ANSWER: An agent is someone who has the authority to act for another under specific conditions.

36. What are the four elements that make up a contract?

ANSWER: Offer, acceptance, consideration, and mutual assent 37. What constitutes a contract for employment?

ANSWER: The contract states that the individual is employed, at what rate, what the job consists of, and any other terms are that are necessary to define the framework of employment. Health care providers and professionals may have employment contracts that state that they are employed, at what rate, what the job consists of, and whatever other terms are necessary to define the frame-work of employment. If there is no employment contract, the employee is deemed to be an employee-at-will, which means that the employer can dismiss the employee at any time, without warning, and for any nondiscriminatory reason.

38. Describe who cannot legally form a contract.

ANSWER: Minors, incompetent persons, and individuals under the undue influence of a drug that alters their mental state cannot legally form a contract. A person with a legal disability cannot form a contract because a contract cannot be made by or enforced against a person who does not have the legal capacity for mutual agreement. Minors, incompetent persons, and individuals under the undue influence of a drug that alters their mental state are among those who are considered legally disabled for the purpose of forming a contract.

39. Explain and give an example of common law rule in the treatment of minors.

ANSWER: A minor is incapable of giving effective consent for the administration of medical treatment. Therefore, without the consent of the parents or guardian, medical practitioners are liable for assault and battery.

Exceptions to the rule are made in medical emergencies and for mature and emancipated minors.

40. Describe the two main elements, consideration and mutual agreement, necessary to make a contract.

ANSWER: To form a contract, there must be a clear understanding between the parties, known as mutual agreement, assent, or meeting of the minds. A contract comes into being when one party makes an offer, the other party accepts, and some form of consideration passes between them. All contracts have some form of consideration. Without consideration, a contract is not enforceable.

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W.Docs Chapter:6. Medical Malpractice and Other Lawsuits.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

True / False 1. Malpractice is defined as not doing something that a reasonable person would do or doing something that a reasonable person would not do. a. True b. False ANSWER: False 2. Negligence is defined as failing to act with reasonable and prudent care given the circumstances. a. True b. False ANSWER: True 3. Premise liability is a theory used in product liability cases in which the seller is liable for any and all defective or hazardous products that unduly threaten a consumer's personal safety. a. True b. False ANSWER: False 4. Health care professionals often work under the direct supervision of the health care provider; therefore, they are often covered by the health care provider’s malpractice insurance. a. True b. False ANSWER: True 5. A health care professional stops at the scene of an accident to assist the injured person. The health care professional leaves the scene of the accident before any other adequate help responds. The health care professional could be charged with medical malpractice. a. True b. False ANSWER: True Multiple Choice 6. ____________ can be addressed in office staff meetings and training sessions to help employees support each other. a. Defensive medicine b. Burnout c. Negligence d. Peer reviews ANSWER: b 7. __________ results as a direct consequence and without which the injury result would not have happened. a. Breach of duty b. Proximate cause c. Expert witness d. Standard of care ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:6. Medical Malpractice and Other Lawsuits.

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8. The statute of limitation of medical malpractice lawsuits usually gives the patient ______ to sue for damages but can be as long as _______ depending on the state and the injury incurred. a. 5 years, 10 years b. 2 years, 10 years c. 1 year, 10 years d. 10 years, 15 years ANSWER: b 9. Sometimes the breach of duty is so obvious, it is not necessary to prove causation, demonstrating that the thing speaks for itself and is defined as ________ . a. standard of care b. causation c. injury d. res ipsa loquitur ANSWER: d 10. A patient may withdraw _________ at any time, even after the authorized treatment has begun. a. duty b. standard of care c. informed consent d. agency ANSWER: c 11. Which of the following can disprove a medical malpractice lawsuit? a. The health care provider’s breach was the proximate cause of the patient’s injury. b. The duty had not been upheld at the professional standard of care. c. There was no patient-provider relationship. d. The patient had a resulting injury.

ANSWER: c 12. Which of the below is a defense to a medical malpractice cause of action lawsuit? a. Peer-reviews b. Defensive medicine c. Non-verbal communication d. Assumption of risk ANSWER: d 13. __________________ is a term used to describe voluntary acceptance of a known danger. a. Contributory negligence b. Comparative negligence c. Assumption of risk d. Affirmative duty ANSWER: c 14. A ________ tort makes a manufacturer liable for compensation to anyone using its product if damages or injuries occur from defects in that product. a. premises liability Copyright Cengage Learning. Powered by Cognero.

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b. informed consent c. product liability d. strict liability ANSWER: c 15. Which statement best describes some of the ethical and moral implications regarding informed consent? a. Some patients want to hear bad news. b. Most patients always remember what the physician tells them. c. A patient may selectively remember comments by the health care provider. d. The sicker the patient is, the more accurate the patient’s memory for details becomes.

ANSWER: c 16. One of the negative consequences of so many medical malpractice lawsuits is that physicians: a. primarily treat obstetric and orthopedic cases. b. stay away from the treatment of difficult cases. c. apply for emergency room duty to regain their confidence. d. attempt new procedures or employ new drugs.

ANSWER: b 17. Burnout happens when health care professionals: a. are sued for medical malpractice. b. enjoy serving the public. c. are exhausted from overwork. d. specialize in a particular field of medicine.

ANSWER: c 18. Risk management measures a health care professional can take to avoid lawsuits include: a. maintaining an unfriendly relationship with patients. b. becoming burnout. c. ensuring the patient understands the information provided. d. practicing defensive medicine.

ANSWER: c 19. A licensee enters a property with _____________ a. illegal intent b. implied permission c. affirmative duty d. product liability ANSWER: b 20. Affirmative duty: a. does not require inspection of the property. b. does not require reasonable care. c. does not necessarily make the premises safe. d. is to protect the invitee.

ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:6. Medical Malpractice and Other Lawsuits.

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21. Nonverbal communication is best defined as: a. enunciation. b. using body language. c. voice projection. d. text messaging.

ANSWER: b 22. Indicate which of the following products could be part of a product liability case. a. Building b. Heart pacemaker c. Medical clinic d. Laboratory ANSWER: b 23. Who is legally responsible for obtaining informed consent from a patient? a. Medical assistant b. Janitor c. Receptionist d. Physician ANSWER: d 24. _______ is any professional misconduct and implies a greater duty of care to the injured person than the reasonable person standard. a. Negligence b. Malpractice c. Standard of care d. Intentional tort ANSWER: b 25. A(n) ____________________ is a person who is working against an individual or party, an opponent, not an ally. a. conservator b. attorney c. adversary d. guardian ad litem ANSWER: c 26. The healthcare provider’s ___________ must be the cause of the injury. a. res ipsa loquitur b. breach of duty c. relationship d. defensive medicine ANSWER: b 27. There are ____________________ (conforming to professionally proper behavior) and moral implications in informed consent, especially when a drug or procedure is in the research phase and physicians are experimenting on patients.

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a. professional b. medical c. malpractice d. ethical ANSWER: d 28. Select which of the following are defenses available to the defendant of a medical malpractice lawsuit. a. statute of limitations b. risk management c. defensive medicine d. peer-reviewed ANSWER: a 29. What is the first element of a malpractice case that must be proven? a. There was a patient-provider relationship. b. There was a duty owed. c. There was a breach of duty. d. There are damages.

ANSWER: a 30. A malpractice cause of action usually arises from two factors: the ____________________ factor, which is the injury suffered by the patient; and the ____________________ factor, which is the alienation, anxiety, frustration, and potential anger in the patient. a. subjective; objective b. objective; subjective c. damages; breach of duty d. damages; subjective ANSWER: b Subjective Short Answer 31. Define what an expert witness is and why they are important in a medical malpractice lawsuit.

ANSWER: A person whose education, profession, or specialized experience qualifies them to testify about their area of expertise as it relates to the lawsuit. An expert witness is someone who will testify about their professional opinion and whether they believe the standard of care was met.

32. Explain the statute of limitations.

ANSWER: In medical malpractice actions, the statute of limitations is specified in each state’s medical malpractice law. Statutes of limitations are necessary because as the years go by, evidence vanishes, witnesses’ memories dim, and witnesses die. By setting a time frame within which a lawsuit may be initiated, there is assurance that relevant evidence is available for the fact finders and the parties.

33. Define strict liability in tort.

ANSWER: Strict liability is a theory used in product liability cases in which the seller is liable for any and all defective or hazardous products that threaten the consumer’s safety.

34. List elements of a medical malpractice lawsuit.

ANSWER: To have a medical malpractice lawsuit, the patient must prove the following: Copyright Cengage Learning. Powered by Cognero.

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1. There was a patient–provider relationship.

2. This relationship established the duty owed by the health care provider to the patient.

3. The duty had not been upheld at a professional standard of care.

4. The health care provider breached the duty to the patient.

5. The patient had a resulting injury.

6. The health care provider’s breach was the proximate cause of the patient’s injury.

35. Describe reasonable care in a medical setting.

ANSWER: Reasonable care indicates that the patient is cared for in a safe manner that does not place the patient at any unforeseeable risk, and the pain levels are low.

36. Why is it important to get an informed consent form signed by the patient before a procedure?

ANSWER: Legally the patient must be adequately informed about the potential outcomes, risks, and any adverse effects associated with the procedure before performing a procedure. The signed consent form is a legal document that indicates the patient has been informed and has an adequate level of understanding of the procedure.

This form can help the defense in a medical malpractice lawsuit.

37. What is contributory negligence?

ANSWER: Contributory negligence is a term used to describe any unreasonable behavior on the part of the patient that contributed to the cause of injury.

38. Explain the Good Samaritan law and how it relates to a health care professional stopping to assist a person who has been injured.

ANSWER: If a helper stops and assists, he or she will be held to a standard of care appropriate to the individual’s training and experience.

39. What are some common patient choice litigation factors?

ANSWER: Patient injury, patient anxiety, patient alienation, patient frustration, patient anger, and poor provider communication. A malpractice lawsuit usually arises from two factors: the objective factor, which is the patient’s injury, and the subjective factor, which is the patient’s alienation, anxiety, frustration, and potential anger. Although medical malpractice as a legal concept requires both injury and negligence, the injury alone does not usually bring about the intense hostility that a lawsuit expresses. Many malpractice suits are brought because of the health care provider's poor communication.

40. Office emergencies usually do not fall under the protection of Good Samaritan laws. Explain why.

ANSWER: Office emergencies usually do not fall under the protection of Good Samaritan laws. In a medical office, a patient–physician relationship already exists: the doctor is offering services, and the patient is seeking services.

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W.Docs Chapter:7. The Health Record.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

True / False 1. While maintaining perfect records should always be the goal, incorrect entries may happen. When an error occurs with a paper chart, cross out the mistake, initial and date it, and then write the correct information. a. True b. False ANSWER: True 2. In certain states, legislators have given the patient, the patient’s physician, and/or the authorized agent the right to examine or copy health records. a. True b. False ANSWER: True 3. Credibility of a health record refers to whether the information recorded is believable. a. True b. False ANSWER: True 4. If changes are made to health records beyond a reasonable period of time following discharge, particularly after a physician or hospital is on notice of a potential lawsuit, changes in the health record are almost always serious and raise red flags. a. True b. False ANSWER: True 5. Most EHR systems track each entry by user, date, and time. So, if a mistake is made and the record needs to be changed, the original error will remain, but there will be an addendum with the correct information. a. True b. False ANSWER: True Multiple Choice 6. What determines who owns a patient’s health record? a. The Health Information Technology for Economic and Clinical Health Act (HITECH) b. The Health Insurance Portability and Accountability Act (HIPAA) c. The Health Maintenance Organization (HMO) d. State Law ANSWER: d 7. What requires that patients have the right to see their records, to obtain copies, and to make corrections in them? a. The Health Information Technology for Economic and Clinical Health Act (HITECH) b. Health Insurance Portability and Accountability Act (HIPAA) c. The Cures Act d. State laws ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:7. The Health Record.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

8. What includes both computer hardware and software systems to store patient information? a. Electronic Health Record (EHR) b. Application Programming Interfaces (API) c. Protected Health Information (PHI) d. Paper chart ANSWER: a 9. Which of the following is a written order to produce documents? a. Subpoena b. Subpoena Cum Laude c. Subpoena Duces Tecum d. Property Right ANSWER: c 10. Who is responsible for keeping health records accurate? a. The employer b. The record keeper c. The patient d. The insurance company ANSWER: b 11. Provisions within the _______ further the interoperability of health care information between insurance companies, providers, patients, and technology vendors. a. Cures Act b. Health Insurance Portability and Accountability Act (HIPAA) c. Electronic Health Record (EHR) d. Health Information Technology for Economic and Clinical Health Act (HITECH) ANSWER: a 12. Which statement best describes the ownership of health records? a. Ownership can be exclusively exercised. b. Ownership does not belong to the physician or medical facility. c. Ownership carries with it the right and power to exercise authority over the property. d. Ownership does prevent others from the right to see the record.

ANSWER: c 13. When may changes to a patient’s record be accepted as rewritten or amended? a. After the patient is discharged b. After notice of a potential lawsuit c. While patient is under treatment d. At any given time ANSWER: c 14. In what situation would a patient implicitly consent to sending a truthful health record to a third party? a. When the patient is submitting a third-party payment claim. b. When the patient submits to a physical examination for the purpose of life insurance benefits.

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W.Docs Chapter:7. The Health Record.

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c. When the record could be used in litigation against the third party. d. When the patient is mentally ill.

ANSWER: b 15. Which statement best describes HIPAA requirements regarding patients’ rights to their health records? a. Patients have the right to see their health records when participating in a research study. b. Patients have the right to make corrections in their health records. c. Inmates are authorized copies of their health records. d. Patients are only authorized copies of their health records when filing a complaint.

ANSWER: b 16. Hospitals and health care providers should have a written policy on file detailing the procedures for releasing patient information. The policy must reflect: a. local and state law. b. federal law and HIPAA regulations. c. state and federal law. d. state law.

ANSWER: c 17. When in doubt about releasing medical information, you should: a. get oral authorization from the patient. b. send the information via the physician’s cell phone or PDA and let the patient know after the transmission. c. err by not disclosing rather than disclosing. d. remember that the owner of the privilege to keep information confidential is the physician.

ANSWER: c 18. Who may release health records of a deceased patient? a. Immediate family members b. The health care provider c. The next of kin d. A personal representative ANSWER: d 19. ___________ allows patients to see their records and make corrections in them. a. Subpoena duces tecum b. HIPAA c. Privileged communication d. Federal rules of evidence ANSWER: b 20. To correct an entry in a hard copy health record, you should: a. cross out the mistake, initial and date it, then write in the correct information. b. write the correct information, change the date and the time, and sign it in the side margin. c. remove the erroneous entry and prepare a new entry indicating the erroneous entry has been removed. d. use correction fluid to hide the mistake, write the correct information, date and sign the entry.

ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:7. The Health Record.

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21. What is a recorded collection of data on a patient? a. Health record b. Family history c. Test results d. PHI ANSWER: a 22. Which of the following established incentives for the use of EHRs and penalties for not using them? a. The Health Information Technology for Economic and Clinical Health Act (HITECH) b. The Health Insurance Portability and Accountability Act (HIPAA) c. The Cures Act d. Federal Law ANSWER: a 23. With an integrated health record, the patient is represented by a __________ record that includes all outpatient and inpatient activity. a. single b. massive c. double d. multi-folder ANSWER: a 24. Who can consent to the release of health records? a. Patient at the age of majority b. Incompetent person c. Conservator d. Physician ANSWER: a 25. Which of the following is a sufficient method for a patient to authorize the release of health records? a. Oral request b. Over the phone c. In writing d. Patients are not authorized to release health records ANSWER: c 26. Minor patients are typically unable to consent to the release of their health records. Who of the following has authority to release the minor patient’s records? a. Immediate family members b. Parent c. Conservator d. Attorneys ANSWER: b 27. Under which of the following circumstances would minors be authorized to release their health records?

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W.Docs Chapter:7. The Health Record.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

a. When diagnosed with a sexually transmitted disease. b. When they are receiving a physical exam to participate in school athletics. c. When they receive a subpoena. d. Minors are never authorized to release their health records.

ANSWER: a 28. In time-sensitive circumstances, which of the following is an appropriate method to deliver medical information? a. By mail b. Over the phone c. Secure email d. Video conference ANSWER: c 29. When can health records be withheld if payment of the patient’s bill is pending? a. When the amount owed is less than $100 b. When the amount owed is more than $100 c. In all circumstances d. Never ANSWER: d 30. HITECH stands for: a. The Health Impact Technology for Ergonomic and Climacteric Health Act. b. The Health Insiders Technology for Economic and Customers’ Health Act. c. The Health Information Technology for Economic and Clinical Health Act. d. The Human Information Technology for Economic and Clinicians Health Act. ANSWER: c Subjective Short Answer 31. What ethical obligations does a physician have in the management of medical records?

ANSWER: Obligation encompasses managing the records of current patients, retaining old records against possible future need, and providing copies or transferring records to a third party as requested by the patient or the patient’s authorized representative.

32. Who should be notified when an error is found in a health record?

ANSWER: When authorized by the patient to examine them for use in possible litigation against the health care provider or a third party.

33. Under what circumstances is the credibility of record-keeping subject to questioning?

ANSWER: Delayed filing of laboratory tests, incomplete files, illegible records, altered or fabricated records, or the loss or concealment of information.

34. What is the difference between a subpoena and a subpoena duces tecum?

ANSWER: A subpoena is a command to appear at a specified time and place to testify. A subpoena duces tecum is when the court commands a witness to produce at trial a certain pertinent document the witness holds.

35. What issues may occur with integrated health records?

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W.Docs Chapter:7. The Health Record.

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ANSWER: Answer can include the following: (1) Cross-indexing of the hospital and outside office records is very limited and usually represented by a copy of the discharge summary from the hospital chart in the office record of the attending health care provider; (2) the hospital record seldom carries any direct report of medical office visits unless the medical office is part of the hospital; and (3) the technologies of a hospital and one of its practices may not be compatible.

36. When would a third party be required to review errors in record-keeping?

ANSWER: When the record keeper is in dispute with the health care provider, the facts should be reviewed by a neutral third party.

37. What should be included in requests to release health records?

ANSWER: The request should have time limits, identify the purposes for which the records will be used, and identify the particular information requested.

38. What must accompany the requested information when it is disclosed?

ANSWER: When information requested is disclosed, it must be accompanied by instructions that forbid its re-disclosure to others who are not authorized to receive it.

39. What is the difference between the ownership of jewelry and the ownership of medical records?

ANSWER: Ownership usually carries with it the exclusive right and power to exercise authority and control over the use of the property. In the case of the health record, the owner cannot control the record exclusively.

40. When are office records and hospital records subject to inspection by an attorney?

ANSWER: When authorized by the patient to examine them for use in possible litigation against the health care provider or a third party.

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W.Docs Chapter:8. Introduction to Ethics.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

True / False 1. Bioethics studies the ethical dilemmas and issues of biological research as it relates to medicine. a. True b. False ANSWER: True 2. Behavior that does not take moral principles into consideration is known as amoral. a. True b. False ANSWER: True 3. Philosophy is the viewpoint of a value system. A philosophy can be from an individual or community’s perspective. a. True b. False ANSWER: True 4. Deontological theories of ethics are concerned with the outcomes and consequences of ethical decisions. a. True b. False ANSWER: False 5. Since there is no single approach to make ethical decisions, a person may look to cultural values, moral upbringing, present circumstances, society’s expectations, and a multitude of other variables. a. True b. False ANSWER: True Multiple Choice 6. Working under a code of ethics can be a challenge for health care professionals because: a. the principles are unclear. b. they face difficult decisions while interacting with patients and families. c. codes of ethics are only for one specialty of professional. d. developing a code of ethics is a difficult task and therefore flawed.

ANSWER: b 7. Medical ethics includes: a. theories of how ethics generally develop. b. studies of technology and patient care. c. questions involving modern medical technology. d. legal enforcement of medicine.

ANSWER: c 8. Morals are developed throughout our lifetime by experiences with: a. medical technologies. b. definite paths of immoral conduct.

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W.Docs Chapter:8. Introduction to Ethics.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

c. careful studies of Kohlberg and Piaget. d. family, friends, and culture.

ANSWER: d 9. Ethical theories are: a. overwhelming academics. b. ethical dilemmas. c. decision-making frameworks. d. complete answers to dilemmas ANSWER: c 10. Two groups of western ethical theories are: a. virtue and duty. b. Kohlberg and Piaget. c. right and wrong. d. deontological and teleological.

ANSWER: d 11. The study of ethics is grounded theoretically in ______________, which helps create standards of right and wrong behavior. a. etiquette b. technology c. philosophy d. medicine ANSWER: c 12. When making an ethical decision, the first step should be: a. provide reasons for actions. b. implement the action. c. identify the parties that have an interest in the matter. d. identify the dilemma and the values.

ANSWER: d 13. When there is an ethical dilemma, what is a source that health care professionals usually turn to in order to solve the question? a. Law or organization’s policy b. Deontological theories c. Teleological theories d. Virtue based theories ANSWER: a 14. Values are developed by: a. growing up. b. professional societies. c. codes of ethics. d. requirements by law.

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W.Docs Chapter:8. Introduction to Ethics.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

ANSWER: a 15. Etiquette is: a. a demonstration of politeness, professionalism, and courtesy. b. outlined in policy and procedure manuals. c. defined as one physician giving courtesy or preference to another physician. d. the same as medical ethics.

ANSWER: a 16. Health care professionals need to understand their own ethics and how they may conflict with the ethics of the workplace because: a. an educated professional should study the various ethical theories. b. it is inappropriate to discuss personal morality and ethics during an ethical dilemma. c. an entire inventory of a person’s own beliefs is required to be a health care professional. d. arguing about ethics with a supervisor may cause dismissal.

ANSWER: b 17. What is the difference between personal and professional ethics? a. Personal ethics are defined by the employer, and professional ethics are defined by religious belief. b. Professional ethics are defined by personal needs, and personal ethics are based upon patient need. c. Personal ethics reflect values that the individual person lives by day to day. Professional ethics reflect values established in the workplace. d. Personal and professional ethics are not different; they are the same.

ANSWER: c 18. Breaking ________ codes results in the disapproval of at least a segment of society but breaking _______ codes results in penalties enforced by the law. a. legal; ethical b. legal; moral c. ethical; legal d. moral; legal ANSWER: c 19. Kohlberg developed a theory about how people develop values which includes: a. four stages based on age. b. three levels based on thought process. c. two levels based on self-evidence. d. two levels based on experience.

ANSWER: b 20. Personal ethics are: a. a person’s level of compliance at work. b. a person’s values and beliefs. c. the results of a person’s decisions. d. a person’s usual actions at work.

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W.Docs Chapter:8. Introduction to Ethics.

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21. Common principles within most people’s personal ethics would include: a. individuality and success. b. duty and professionalism. c. honesty and respect. d. faith and choice of religion.

ANSWER: c 22. The study of ____________________ is grounded theoretically in philosophy. a. biology b. medicine c. ethics d. law ANSWER: c 23. What are collections of principles about what is right? a. Morals b. Etiquette c. Ethics d. Bioethics ANSWER: a 24. A moral principle that guides choices and conduct is: a. a moral. b. a philosophy. c. an ethic. d. a virtue.

ANSWER: c 25. Which statement describes Utilitarianism? a. Decisions are based on virtue. b. Decisions are based on duty. c. Decisions are based on the greatest good. d. Decisions are based on business success.

ANSWER: c 26. A school nurse updating a student’s record indicating that a vaccine was administered when there was no vaccine administered is an example of: a. professional conduct. b. immoral conduct. c. amoral conduct. d. right moral conduct.

ANSWER: b 27. Which is a tenet of the AMA’s Code of Ethics for physicians? a. A physician shall support medical care for all people.

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W.Docs Chapter:8. Introduction to Ethics.

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b. A physician shall strive for accuracy above all. c. A physician shall not consult with colleagues. d. A physician shall never report another physician for misconduct.

ANSWER: a 28. What type of problem does each individual approach from their own perspective, which includes cultural values, moral upbringing, present circumstances, society’s expectations, and a multitude of other variables? a. Etiquette b. Professional c. Bioethics d. Ethics ANSWER: d 29. Professional ethics are formed by: a. religious belief. b. family upbringing. c. accrediting authorities. d. academics.

ANSWER: c 30. Values are: a. prescribed codes of courteous social behavior. b. ethical issues surrounding biological research. c. principles of thought and conduct that are considered desirable. d. situations where a challenging decision must be made between two or more options.

ANSWER: c Subjective Short Answer 31. Describe a situation where professional and personal ethics may conflict.

ANSWER: Possible answers: 1-The health professional does not ethically support the patient's chosen treatment. 2-The medication or treatment is tested on animals, and the health professional is ethically opposed to animal testing.

32. What are the differences between a violation of the law and a violation of ethics?

ANSWER: A violation of the law, negligent act, or a breach of contract, for example, may result in prison, fines, or monetary damages, among others. A code of ethics violation in health care may result in license suspension or revocation, or other negative repercussions from your employer, colleagues, patients, family, or friends.

33. What are some groups that may be the ultimate decision maker in ethical dilemmas?

ANSWER: Possible answers: ethics committee, a hospital’s risk department, or a panel composed of different disciplines, providers, other health care providers, a lawyer, the courts, the patient (or their family), medical ethicists, or medical office personnel.

34. What care should a health care professional take in regard to conflicts between personal and professional ethics?

ANSWER: Health care professionals should identify and evaluate their own personal ethics, identify any that may conflict with ethics in the workplace, and address strategies on how to manage potential ethical dilemma situations before they encounter intense, pressure-filled, decision-making moments.

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W.Docs Chapter:8. Introduction to Ethics.

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35. Describe the consequences of a health care provider not having a clear understanding of their own personal ethics and how they coincide or conflict with professional ethics.

ANSWER: Possible answers: 1- Providers could refuse to treat patients because of their personal ethics about the patient’s choice of care. 2- The provider's credibility or trustworthiness could be damaged.

36. Explain the difference between personal ethics and professional ethics.

ANSWER: Personal ethics pertains to a person’s values in all aspects of their personal lives, which is influenced by their experiences, family, faith, and community, while professional ethics pertains to a person’s values within the workplace and is influenced by the employer, the nature of the business, regulation, compliance and accreditation standards.

37. What would be an acceptable response to an ethical issue?

ANSWER: Considering the issue and then using the eight steps toward facing an ethical dilemma realizing the options of different theories.

38. What would be a strategy for separating personal and professional ethics in the workplace?

ANSWER: Determining the ultimate decision maker in the situation may help to identify what ethical position should be taken.

39. Why is it essential that a health care professional have an understanding of ethics and ethical decision-making?

ANSWER: In order to respond quickly to ethical dilemmas, health care professionals need to understand ethics and processes of ethical decision-making.

40. Summarize the difference between duty-based and virtue-based ethical theories.

ANSWER: Answer can include the following: The duty-based theory requires identifying the professional’s duty in the situation regardless of outcome, and the morally correct action is based on the required duty. The virtuebased theory requires identifying an action that a virtuous person would take, and the morally correct action is based on how virtuous the action was.

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W.Docs Chapter:9. Laws and Ethics of Patient Confidentiality.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

True / False 1. HIPAA’s privacy rules and regulations affect all health care facilities and personnel. a. True b. False ANSWER: True 2. Included in matters of privacy is the right to be left alone and to make personal choices for others. a. True b. False ANSWER: False 3. Patient-provider privilege is a legal doctrine that protects communications between a patient and a provider from disclosure in court. a. True b. False ANSWER: True 4. It is routine procedure for a patient to receive a Notice of Privacy Practices (NPP) once a year while checking in for an appointment as part of HIPAA compliance. a. True b. False ANSWER: True 5. A pregnant woman decides she wants to find out the sex of the fetus and share this with her husband, who could not come to the appointment. When she shares this information with her husband, this is a violation of HIPAA. a. True b. False ANSWER: False Multiple Choice 6. When __________ was signed into law in 1996, there was no Federal Privacy Act for medical records prior. a. confidentiality b. privacy c. HIPAA d. privileged communication ANSWER: c 7. Patient health information (PHI) files and filing systems, as well as electronic systems that manage electronic PHI, are built with high levels of security and cybersecurity. These are examples of ensuring HIPAA _________. a. violation b. compliance c. security d. breach ANSWER: b Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:9. Laws and Ethics of Patient Confidentiality.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

8. ________ who has reason to believe that a covered entity or business associate violated HIPAA’s Privacy, Security, or Breach Notification Rules may file a complaint with the Office of Civil Rights (OCR). a. A physician b. A patient c. A family member d. Anyone ANSWER: d 9. Use of _________ in health care creates an increasing number of ways that patient confidentiality can be compromised, incurring a HIPPA violation. a. technology b. locked cabinets c. protected passwords d. disclosures ANSWER: a 10. OCR issues penalties for civil violations of HIPAA Rules and considers several factors when assessing penalties, including the _______ of time the violation existed, the _______ of people affected, and the ______ of PHI disclosed. a. length; number; type b. inaccurate; largest; electronic c. accurate; smallest; files d. accurate; moderate; system ANSWER: a 11. To ______ is the act of giving up a claim, privilege, or right. a. practice b. abandon c. waive d. protect ANSWER: c 12. Under HIPAA requirements, those found guilty of wrongfully disclosing private health information face _____ years in jail and a _____ fine. a. 5; $100,000 b. 5; $250,000 c. 10; $100,000 d. 10; $250,000 ANSWER: d 13. HIPAA is the abbreviation for: a. Health Information Portability and Accountability Act b. Health Insurance Protection and Accountability Act c. Health Information Protection and Accountability Act d. Health Insurance Portability and Accountability Act ANSWER: d Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:9. Laws and Ethics of Patient Confidentiality.

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14. In what year was HIPAA signed into law? a. 1993 b. 1996 c. 1997 d. 2003 ANSWER: b 15. A method for maintaining PHI security and confidentiality in a medical facility is: a. opening up an email from an unknown sender. b. browsing unknown websites on your work computer. c. strictly complying with all computer security policies. d. sharing your password with your colleague.

ANSWER: c 16. Disclosure of PHI, not otherwise authorized by HIPAA, must be authorized in _______ by the ________. a. a phone call; patient b. a phone call; spouse c. verbatim; spouse d. writing; patient ANSWER: d 17. What legal agency is responsible for enforcing HIPAA? a. City/local government b. State government c. Federal government d. U.S. Military ANSWER: c 18. _______ is when information is not disclosed to those who are not authorized to receive it. a. Protected b. Private c. Confidentiality d. Waived ANSWER: c 19. Roe v. Wade, 410 U.S. 113 (1973), the U.S. Supreme Court held that the patient–provider relationship is protected by constitutional rights of ________. a. security b. privacy c. protection d. shared ANSWER: b 20. Covered entities are required to establish administrative, physical, and technical safeguards, to review their security risks to ensure compliance with the ________ Rule, and to record all security compliance measures undertaken. a. Administrative Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:9. Laws and Ethics of Patient Confidentiality.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

b. Security c. Complex d. Specialist ANSWER: b 21. ________ is information held by a covered entity related to the patient’s health status, their health care, or payment for their health care. a. Private health information b. Protected health information c. Privileged health information d. Confidential health information ANSWER: b 22. There are many ways to violate HIPAA, and a violation may be ______ or ________. a. accidental; waived b. intentional; shared c. secret; confidential d. intentional; accidental ANSWER: d 23. Covered entities are required to establish administrative, physical, and technical safeguards, to review their security risks to ensure ______ with the Security Rule. a. compliance b. enforcement c. breach d. waiver ANSWER: a 24. An older man is brought into the emergency room unconscious. The man’s son accompanies him and provides detailed health history to the health care providers on his behalf. This is an example of when disclosure of health information is _____ and _______. a. illegal; unnecessary b. breach; shared c. private; waived d. legal; necessary ANSWER: d 25. Two challenges to maintaining patient confidentiality include: a. usage of appropriate forms and technology safeguards. b. technology and high-profile patients. c. locked filing cabinets and protective computer screen coverings. d. proper disclosure of medical information and password-protected filing system.

ANSWER: b 26. There are _____ tiers of HIPAA violations and penalties. a. two Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:9. Laws and Ethics of Patient Confidentiality.

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b. three c. four d. ten ANSWER: c 27. Hospitals and medical offices have strict HIPAA policies against _______ patient information. a. accepting b. disclosing c. utilizing d. collecting ANSWER: b 28. What is a patient’s expectation of privacy known as in the patient-provider relationship? a. Privilege b. Etiquette c. Ethics d. Confidentiality ANSWER: d 29. Which of the following is true about the confidentiality of medical information? a. Any family member asks for test results, and you print them off from the medical office database. b. As a medical office professional, you can view the health record of anyone who comes into the office. c. It is permissible to discuss a patient’s medical information at home, provided your family knows it is confidential. d. A patient may disclose their own health information to whomever they choose.

ANSWER: d 30. Before HIPAA’s enactment, what type of law was the privacy of patient records subject to? a. Federal b. County c. State d. Judicial ANSWER: c Subjective Short Answer 31. Explain the patient-provider privilege.

ANSWER: A provider may not reveal in court confidential information obtained during treatment unless the patient voluntarily waives his or her privilege against disclosure.

32. Who can discipline a health care professional or facility for HIPAA violations?

ANSWER: Only the government can discipline a health care professional or facility for HIPAA violations.

33. A health care provider requests a patient’s notes, labs, and x-rays from their recent emergency room visit. Is this disclosure of health information legally necessary; why or why not?

ANSWER: Yes, it is necessary. The health information being requested is legally necessary for continuity of care for the patient for their follow-up visit to determine the next course of action.

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34. List the three kinds of information protected under HIPAA. ANSWER: (1) Electronic media; (2) written documents; (3) the spoken word 35. Define the three major purposes of HIPAA. ANSWER: Answers should include the following: (1) To protect and enhance the rights of consumers by providing them access to their health information and controlling the inappropriate use of that information; (2) to improve the quality of health care in the U.S. by restoring trust in the health care system among consumers, health care professionals, and the multitude of organizations and individuals committed to the delivery of care; (3) to improve the efficiency and effectiveness of health care delivery by creating a national framework for health privacy protection that builds on efforts by states, health systems, and individual organizations and individuals.

36. A local hospital’s health information system is hacked by an unknown party, and the private health information of over 15,000 patients is compromised. Describe what the hospital must do according to HIPAA’s Breach Notification Rule.

ANSWER: HIPAA’s Breach Notification Rule requires that covered entities and their business associates provide notice after a breach of unsecured protected health information. Unsecured protected health information is PHI that has not been protected from disclosure to unauthorized persons. The notice must be sent to the affected individuals and the U.S. Department of Health and Human Services’ Secretary. Where a breach affects more than 500 residents of a state, covered entities are also required to provide notice to the media. The rule requires that business associates notify the hiring covered entities if a breach occurs.

37. List two conditions that allow patient information to be disclosed.

ANSWER: (1) When a patient voluntarily waives (gives up) his or her privilege against disclosure, and (2) when a patient files a medical malpractice cause of action. In a typical patient–provider privilege, a provider cannot reveal confidential patient information in a legal proceeding unless the patient waives their privilege against disclosure. The patient–provider privilege belongs to the patient, not the provider. So, a provider may not waive the privilege. When a patient files a medical malpractice lawsuit, for example, the nature of the case requires that medical records be available, and the patient–provider privilege is implicitly waived.

38. A HIPAA Privacy Rule violation occurs when a member of the health care provider’s staff improperly discloses the simple fact that the President is a patient of their practice. Explain how this is a violation of HIPAA and why they cannot share this information.

ANSWER: It would be a violation of HIPAA for a health care professional to disclose any confidential information about the President. Health care providers are required to keep the information of all patients confidential per HIPPA. The media is always interested in gathering confidential information about public figures largely because the public is interested in hearing about it. Health care providers are required to keep the information of all patients confidential, even if the patient is the most popular Hollywood actor, the latest internet celebrity, the highest-paid athlete, or the local politician.

39. Discuss the challenges that media face in maintaining confidentiality.

ANSWER: Answer should include the following: printing of nonfactual information, libel, lawsuits, slander, etc.

40. Discuss and provide at least two examples of a situation in which privacy could be violated.

ANSWER: Examples could include: the simple clerical matter of sending a “checkup reminder,” loudly projecting why a patient is coming for an office visit, making copies of patients’ records, providing information to non-related individuals without consent. Other examples are possible.

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W.Docs Chapter:10. Professional Ethics and the Living.

TB-Applied Law & Ethics in Health Care[1E,Pardew]

True / False 1. When patients travel domestically or internationally to seek medical care that is priced lower, or not available locally, they are participating in medical tourism. a. True b. False ANSWER: True 2. The subjects of the Tuskegee study were offered proper treatment to cure their illness. a. True b. False ANSWER: False 3. The first successful human-to-human organ transplant was a liver transplant, and now it is the most commonly transplanted organ. a. True b. False ANSWER: False 4. The COVID-19 pandemic produced a dilemma of more patients that needed an ICU bed than there were ICU beds available across the country; this is an example of the ethical issue of allocation of resources. a. True b. False ANSWER: True 5. One ethical question that arises from “community-based” research is the potential conflict of interest between the researcher’s best interest and the pharmaceutical company’s demands. a. True b. False ANSWER: False Multiple Choice 6. The halting of the clinical trial for remdesivir, an antiviral drug used to treat COVID-19, during mid-research, provided an example of: a. poor drug manufacturing. b. undeniable drug benefits. c. complications in medical research. d. incomplete study data.

ANSWER: b 7. Those administering health care are obligated to take actions that benefit patients, even if those actions interfere with or neglect the patient’s _________________. a. autonomy b. paternalism c. standards d. well-being ANSWER: a Copyright Cengage Learning. Powered by Cognero.

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W.Docs Chapter:10. Professional Ethics and the Living.

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8. Which of the following is a problem presented to the provider due to the use of organs from the living? a. The level of benefit to the patient b. The complicated surgery involved c. The infliction of pain on one person for another’s benefit d. The low demand for organs ANSWER: c 9. Providing for people’s needs yet giving them no responsibility or control over their destiny is the definition of what? a. Autonomy b. Allocation c. Preferentiality d. Paternalism ANSWER: d 10. ___________ is the objective of eradicating or slowing the spread of a disease that occurs when a high enough percentage of the population is immune to the disease, and it can no longer spread. a. Recovery from illness b. Herd immunity c. Acquired immunity d. Eradication ANSWER: b 11. In managed care, __________ act as gatekeepers to control the cost-effectiveness of services offered to members and control access to specialists. a. pharmacists b. accountants c. primary care physicians d. case workers ANSWER: c 12. According to this chapter, managed care is a response to which of the following? a. The need to allocate limited health care resources. b. Increased patient costs for preventative medicine. c. Adequate choice of providers. d. High health care costs.

ANSWER: a 13. According to The Uniform Anatomical Gift Act, in the absence of a gift by the deceased, who of the following has the power to give the body or any of its contents? a. Attending physician b. Coworker of the deceased c. Spouse d. Case manager ANSWER: c 14. In 2005, ________ transplants began in France.

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a. heart b. face c. corneal d. lung ANSWER: b 15. In which year did the first human kidney transplant occur? a. 1940 b. 1954 c. 1964 d. 1974 ANSWER: b 16. In which year was the first human heart transplant attempted? a. 1964 b. 1965 c. 1974 d. 1975 ANSWER: a 17. As a result of the Nuremberg Code, research on human subjects is carefully reviewed and regulated due to the ___________. a. potential for a cure b. age of the participants c. nature of the experiment d. potential for harm ANSWER: d 18. Any individual of sound mind and eighteen years of age or more may give all or any part of their body; the gift to take effect upon death. This is one of the provisions of the: a. Uniform Anatomical Gift Act. b. Donate Life Act. c. Nuremberg Code. d. Clinical Trials Act. ANSWER: a 19. Medical transplants are divided into three categories, depending on the tissue used. A transplant procedure from one person to another person is known as a: a. homograft. b. autograft. c. biograft. d. heterograft.

ANSWER: a 20. The transplant of animal tissue into a human is known as a: a. autograft.

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b. biograft. c. homograft. d. heterograft.

ANSWER: d 21. Select the year in which the Uniform Anatomical Gift Act was passed. a. 1960 b. 1962 c. 1964 d. 1968 ANSWER: d 22. What is medical tourism? a. A vacation to visit and inspect hospitals in other countries. b. A trip to a location away from your home to have a medical procedure performed. c. A vacation to a place where there is a medical crisis. d. A trip to give medication to family members living in other countries.

ANSWER: b 23. Which of the following statements about transplants is accurate? a. There is a low demand for donor organs. b. All states use some form of The Uniform Anatomical Gift Act, and many allow individuals to indicate their choice to donate on their drivers’ licenses. c. Using live donors to obtain organs presents a few problems. d. The trafficking of human organs for profit is unfavored but regulated.

ANSWER: b 24. Which of the following statements is true regarding conducting “community-based” research in a private medical office versus clinical trials in an academic medical center? a. The costs of “community-based” research are much less than the same trials in an academic medical center. b. Results are produced much slower than in an academic medical center. c. The trend to move research away from academic medical centers and into “community-based” research started in the 1970s. d. This trend does not raise ethical questions about the objectivity of the research.

ANSWER: a 25. Paternalism is defined as: a. a means of independence and self-reliance. b. not interfering with a person’s independence. c. working hand in hand with the concept of autonomy. d. in conflict with the concept of autonomy.

ANSWER: d 26. What are the two primary reasons for medical tourism? a. Lower-priced medical care and a vacation b. The procedure is not available locally and newer hospitals Copyright Cengage Learning. Powered by Cognero.

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c. Newer hospitals and more physicians who perform the procedure d. Lower-priced medical care and the procedure is not available locally ANSWER: d 27. The Tuskegee Experiment caused a public uproar that led to the creation of an Ad Hoc Advisory Panel to review the experiment. The panel found that the men had agreed freely to be examined and treated, but there was no evidence that researchers had informed them of the study or its real purpose. This is an example of ___________. a. informed consent b. autonomy c. a lack of informed consent d. medical research ANSWER: c 28. What is the Nuremberg Code? a. A set of numbers used to access Nuremberg’s prisons b. An experiment performed on human subjects c. A language used in experimental research d. A set of guidelines for experimental medical research on human subjects ANSWER: d 29. What is the name of transplantation of a person’s own tissue from one part of the body to another? a. Autograft b. Homograft c. Heterograft d. Humograft ANSWER: a 30. If there is a shortage of ICU beds, patients in the unit usually have ________ length of stay than when there is a surplus. a. a shorter b. a longer c. the same d. an unpleasant ANSWER: a Subjective Short Answer 31. Why was the Nuremberg Code developed?

ANSWER: Society has developed guidelines to deal with experimental medical research. As a result of the medical atrocities conducted by Nazi German doctors on prisoners during World War II, the Nuremberg Code was drafted.

32. Why is there a conflict of interest for a physician when entering into an experimental protocol with a drug company?

ANSWER: On one side is the best interest of the patient; on the other, the pharmaceutical demands for protocol fulfillment. Ethical questions arise regarding the motives of privately practicing providers largely because they follow clinical plans designed by the pharmaceutical company rather than their own medical judgment.

There is an inherent conflict of interest when faced with balancing the best interest of the patient against satisfying the pharmaceutical company’s demands and the need to be paid for the experiments.

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33. What are some of the concerns with data collected in drug trials conducted outside of the United States?

ANSWER: As a result, conducting drug trials in locations outside the United States with weak or no regulation has resulted in scrutiny of the data collected. Varying standards of medical care, issues of translation, inadequately trained researchers, and fraud are some of the factors that raise concerns about data collected outside the United States.

34. Define autonomy.

ANSWER: Autonomy means allowing individuals control over themselves.

35. Explain organ trafficking.

ANSWER: Organ trafficking is a broad concept that includes several illegal activities, of which the main goal is to profit from human organs and tissue, for the sole purpose of transplantation. These activities include trafficking of human beings for the purpose of organ removal, transplant tourism, and trafficking in organs and tissues.

36. List three ethical conflicts created by managed care as discussed in this chapter.

ANSWER: Answers can include the following: (1) From the patient’s perspective, the single greatest threat posed by this shift is the potential for managed care systems to cut needed care to save health care dollars; (2) MCOs can dictate the specific brands and types of medication prescribed under a certain plan, protocol for diagnostic evaluations, as well as specific providers; (3) because the health care industry is determined to cut costs, MCOs emphasize drug treatment over counseling; (4) health care providers, who are paid on a capitation basis, who realize bonuses for fiscal restraint or who have portions of their salary withheld to control costs, make less money with a seriously ill patient; (5) many MCOs have adopted authorization requirements, where the MCO must approve certain procedures before the PCP orders them.

37. List some of the ethical issues surrounding the topic of transplants discussed in this chapter.

ANSWER: Answers can include the following: (1) Using live donors; (2) inflicting pain on one person for another’s benefit; (3) organ demand has increased; (4) selling organs is illegal, but organ trafficking has increased; (5) There are also strict protocols that govern organ harvesting, which do not always provide the needed protection for the prospective donor.

38. List and discuss some of the ethical issues surrounding funding in health care.

ANSWER: Answers can include the following: (1) Financial resources for health care are limited. (2) What is an adequate level of health care? (3) Should everyone have the opportunity to get a transplant, if needed? (4) Should everyone have the opportunity to get proper nutrition, exercise, and inoculations to prevent disease?

(5) On the one hand, it is costly to fund transplant operations; on the other hand, it is costly to fund school lunch programs for undernourished children. Values and ethics become involved in this discussion. Because society does not have unlimited funds for health care, ethical choices dictate the outcome.

39. List three benefits of conducting “community-based” research as opposed to clinical trials in an academic medical setting.

ANSWER: The costs of conducting “community-based” research is less than the same trials in an academic medical center. In addition, the research organizations conducting the trials for the pharmaceutical companies are able to produce results more quickly than an academic medical center. Additional benefits are (1) adding a level of continuity and personal contact to the process; (2) providing an enormous pool of potential research subjects; and (3) allowing patients and their health care providers access to current and scientifically advanced therapies.

40. What was the Tuskegee Experiment?

ANSWER: The Tuskegee Experiment was a study that involved poor, Black men. It was conducted without the benefit of patients’ informed consent. Researchers told the men they were being treated for “bad blood,” a term used to describe several ailments, including syphilis, anemia, and fatigue. They did not receive the proper Copyright Cengage Learning. Powered by Cognero.

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treatment needed to cure their illness. In exchange for taking part in the study, the men received free medical exams, free meals, and burial insurance. The outrage over this study prompted the creation of rules and regulations that govern experiments using human subjects.

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True / False 1. Amniocentesis allows a physician to perform genetic testing on premature babies to look for defects. a. True b. False ANSWER: False 2. In experiments with monkeys, transplanting fetal tissue into the brain of an animal with symptoms similar to Parkinson’s disease has successfully controlled the symptoms. a. True b. False ANSWER: True 3. Today’s technology has reached the point where a fertilized egg can be cloned and implanted for incubation until birth. a. True b. False ANSWER: True 4. Tay-Sachs disease is a genetically defective enzyme that causes a blood disorder and early death in 1 of 3,500 persons of Greek ancestry. a. True b. False ANSWER: False 5. There are several thousand human genetic diseases, 500 of which are linked to a defect in a single gene. a. True b. False ANSWER: True Multiple Choice 6. Which of the following describes a procedure in which a sperm sample is taken from a donor who is not the partner of the woman seeking to become pregnant? a. Homologous artificial insemination b. Heterologous artificial insemination c. Amniocentesis d. In vitro fertilization ANSWER: b 7. In the event of wrongful death of a fetus, which of the following may recover a stillborn child’s estate? a. Survival action b. The Unborn Victims of Violence Act c. Baby Doe law d. Federal law ANSWER: a 8. Which genetic disorder often causes fatal chronic lung problems?

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a. Cystic fibrosis b. Sickle cell anemia c. Hemophilia d. Tay-Sachs disease ANSWER: a 9. Which of the following is used to identify whether a parent’s known genetic defect is present in an embryo produced by in vitro fertilization? a. Amniocentesis b. Preimplantation genetic diagnosis c. DNA sampling d. Embryonic stem cell research ANSWER: b 10. What prevents withholding of medical care from an infant with noncongenital anomalies? a. Baby Doe law b. State law c. The Constitution d. Hospital policy ANSWER: a 11. During the separation of marital property, which court case determined that the surviving embryos would be discarded in accordance with the terms of the in vitro fertilization agreement? a. Roe v. Wade b. Roman v. Roman c. Griswold v. Connecticut d. Katz v. United States ANSWER: b 12. Which of the following holds genetic information responsible for the development and performance of an organism? a. DNA b. Genes c. Embryonic stem cells d. Fetal tissue ANSWER: a 13. Wrongful death is death caused by _____. a. malpractice b. negligence c. parens patriae d. sanctity ANSWER: b 14. Investigating an individual’s genetic makeup may be used for _________ purposes, such as discrimination or for _________ purposes, such as treatments. a. inappropriate; valuable Copyright Cengage Learning. Powered by Cognero.

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b. right; wrong c. ethical; moral d. individual; global ANSWER: a 15. What key element is often the reason for debate surrounding the use of embryonic stem cells for research? a. Religion b. Political views c. Culture d. Federal and state regulations ANSWER: a 16. What argument best describes an advocate’s perspective of embryonic stem cell research? a. Embryonic research does not tamper with the natural progression of fetal development b. Embryonic research may aid in developing more efficient treatments for severe diseases c. Embryonic research is more ethical than somatic research d. Embryonic research aligns with most religious beliefs ANSWER: b 17. What religion does not support embryonic stem cell research under the belief that “the moment of conception is also the beginning of the entity of the human person?” a. Judaism b. Buddhism c. Catholicism d. Protestant ANSWER: c 18. Select the type of samples necessary for genetic testing. a. Solid tissue, blood, skin, saliva b. Solid tissue, nucleated cells, urine, blood c. Solid tissue, hair, saliva d. Solid tissue, nucleated cells, saliva, blood ANSWER: d 19. Which of the following is an example of genetic testing? a. IVF b. Autografts c. DNA d. Amniocentesis ANSWER: d 20. Which of the following can be used to choose a child’s sex? a. Amniocentesis b. Preimplantation genetic diagnosis c. Cloning d. In vitro fertilization Copyright Cengage Learning. Powered by Cognero.

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ANSWER: b 21. The United States is pluralistic. What does this mean in the context of this chapter? a. It restrains debate. b. It allows for multiple positions on ethical issues. c. It allows for a single position on ethical issues. d. It allows for healthy debate.

ANSWER: b 22. Reproductive _______ involves identically duplicating an organism. a. in-vitro fertilization b. insemination c. cloning d. amniocentesis ANSWER: c 23. The human right to _______ is grounded in the basic moral tenet that each individual has an incalculable worth. a. abortion b. privacy c. conceive d. life ANSWER: b 24. Which of the following statements about human reproductive cloning is true? a. There are no federal regulations related to human reproductive cloning. b. There are federal regulations related to human reproductive cloning. c. All states have laws that prohibit human reproductive cloning. d. Human reproductive cloning is legal in all U.S. states.

ANSWER: a 25. Children may be conceived by parents for their assistance in the treatment of another family member with a serious illness. What are these children called? a. Siblings b. Savior babies c. Anencephalic babies d. Tay-Sachs babies ANSWER: b 26. One debate regarding _______ is that an individual’s incalculable worth extends to the fetus. a. cloning b. embryonic stem cell research c. preimplantation genetic diagnosis d. abortion ANSWER: d 27. What type of claim will plaintiffs typically file when they sue for the loss of a frozen embryo?

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a. Wrongful death b. Survival action c. Medical malpractice d. Property damage ANSWER: d 28. Which of the following are derived from human embryos or fetal tissues and are self-replicating? a. DNA b. Embryonic stem cells c. Genes d. Molecules ANSWER: b 29. In the Roe v. Wade Supreme Court decision, what was the deciding factor? a. A woman may seek an abortion only if she has the permission of her spouse (or parents, if the woman is a minor). b. States may decide how to regulate all abortions. c. Women have a right to privacy in a first-trimester abortion. d. Abortions are only legal in the first trimester.

ANSWER: c 30. The debate over the use of embryonic stem cells for research emanates from the fact that the definition of ________ is unclear. a. a fetus b. a life c. morals d. personhood ANSWER: d Subjective Short Answer 31. What options are available to a couple when a diagnosis confirms that the man does not have enough active sperm to fertilize the woman’s egg?

ANSWER: 1) Adoption; 2) homologous artificial insemination; or 3) Heterologous artificial insemination.

32. What are genetic data banks used for?

ANSWER: Genetic data banks are usually developed for clinical research and public health programs.

33. Describe the dilemma of sanctity versus quality of life.

ANSWER: This is an ethical dilemma that considers whether living with the disease or disorder is better or worse than living without one.

34. What type of artificial insemination procedure involves a sperm sample from a woman’s partner?

ANSWER: This is called homologous artificial insemination.

35. What is the Unborn Victims of Violence Act?

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ANSWER: It is a federal law that makes it a crime to harm a fetus while assaulting a pregnant woman during the commission of a federal crime.

36. The Society for Assisted Reproductive Technology justifies preimplantation diagnosis under what circumstances?

ANSWER: The Society for Assisted Reproductive Technology, whose members provide preimplantation diagnosis, says it is “ethically justified” to prevent serious adult diseases for which “no safe, effective interventions are available.”

37. What court case settled a custody dispute under the decision that frozen embryos were considered property and not human life?

ANSWER: In the Roman v. Roman case, the appellate court ultimately upheld the terms of the written IVF consent agreement that included a provision to discard the embryos should the parties divorce.

38. What ethical questions should be considered in relation to in vitro fertilization?

ANSWER: 1) Should in vitro fertilization be offered to only those who can afford it? 2) Is it ethical to allow anyone regardless of age to undergo in vitro fertilization?

39. When using assisted reproductive technology to conceive, what options may a woman have to consider if her partner dies and the first attempt to conceive is unsuccessful?

ANSWER: 1) Continue artificial implantation with the remaining embryos; 2) Impregnate a surrogate; or 3) Discard the embryos 40. What options may a couple have to consider when the woman is unable to conceive but has healthy eggs?

ANSWER: 1) Implant an embryo in a family member to carry a child to term; or 2) Implant the couple’s embryo in a stranger to carry a child to term for a fee

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True / False 1. A variety of influences shape our thoughts and feelings about death and dying, including family, religion or spirituality, the media, society, and life experiences. a. True b. False ANSWER: True 2. A living will is intended to extend the right to refuse specific treatments in the future event where the individual becomes incompetent. a. True b. False ANSWER: True 3. The only way a health care proxy can be revoked is if the patient notifies the agent or health care provider verbally. a. True b. False ANSWER: False 4. A DNR order only works if the health care provider knows it exists. a. True b. False ANSWER: True 5. A health care proxy asserts an individual’s right to accept or refuse treatment and gives direction to relatives, friends, and medical professionals. a. True b. False ANSWER: False Multiple Choice 6. Recently, the criteria for considering a person dead under the Uniform Determination of Death Act (UDDA) has been reconsidered. What criteria are being reviewed? a. Who should determine whether a person is dead or not. b. Whether a person is dead at the cessation of brain function. c. Whether a person is dead at the cessation of circulatory function. d. Whether biological criteria should be the only criteria in determining death.

ANSWER: d 7. In which situation is it crucial to have a clear determination of death? a. Family relation issues b. Tax issues c. Life insurance issues d. Cultural issues ANSWER: c Copyright Cengage Learning. Powered by Cognero.

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8. Palliative care is best defined by: a. a patient’s right to die being documented. b. compassionate care for all patients. c. appointing a caregiver in a case of incompetency. d. care in keeping a terminally ill patient comfortable.

ANSWER: d 9. A health care proxy can be referred to as which of the following? a. Power of attorney b. Executor of will c. Living will d. Surrogate ANSWER: d 10. A patient is declared never to regain consciousness. They are continuing to be fed by artificial means. There is family and state conflict, as well as public debate about whether or not the feeding tubes and protocol should be stopped. What is the ethical dilemma? a. Right to life versus right to death b. Obligation to uphold life versus obligation to prevent suffering c. Obligation to serve the patient versus obligation to serve the family’s wishes d. Duty to feed people who need artificial feeding versus patient autonomy ANSWER: b 11. Which of the following is the definition of cardiopulmonary arrest? a. Cessation of normal functioning of the breathing and lungs b. Cessation of normal functioning of the cognitive thinking and lungs c. Cessation of normal functioning of the heart and lungs d. Cessation of normal functioning of the kidneys and lungs ANSWER: c 12. Which of the following is an advance directive? a. Assisted suicide b. Patient Self Determination Act c. Hospice care plan d. Living will ANSWER: d 13. A document signifying a principal to delegate to another person the authority to act on the principal’s behalf is known as: a. health care proxy. b. durable living will attorney. c. durable power of attorney. d. advance directive.

ANSWER: c

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14. After treating a patient who suffered ______________ using CPR, patients may be literally brought back to life after the traditional signs of a death have appeared. a. terminal illness b. cardiopulmonary arrest c. brain injury d. AIDS ANSWER: b 15. Assisted suicide laws fall under the jurisdiction of _____. a. state law b. federal law c. contract law d. euthanasia statutes ANSWER: a 16. The number of states that recognize some version of the durable power of attorney is _____. a. 35 b. 40 c. 45 d. 50 ANSWER: d 17. The term for actively assisting someone to terminate their life at their request is which of the following? a. Suicide b. Death with dignity c. Euthanasia d. Removing life support ANSWER: c 18. In terms of patients being fed artificially, the Vatican’s position is: a. feeding should continue or discontinue at the patient’s explicit wishes. b. feeding should discontinue or continue at the family’s explicit wishes. c. feeding should discontinue due to potential suffering. d. feeding should continue; a person in a vegetative state has fundamental human dignity.

ANSWER: d 19. The Uniform Determination of Death Act attempts to define when a person: a. has ceased circulation. b. may die. c. is considered dead. d. has spiritual death.

ANSWER: c 20. Living wills are: a. created by living people for themselves. b. created by living people for their family members.

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c. executed by living people for themselves. d. executed by living people for their health care providers.

ANSWER: a 21. Hospitals must provide written information to patients upon admission, informing them of their rights under state law to executive advance directives. This is a provision of which act? a. HIPAA b. PSDA c. Uniform Probate Codes d. Uniform Power of Attorney Act ANSWER: b 22. Termination of life support systems is considered: a. an individual decision. b. an intentional act. c. an advance directive. d. death with dignity.

ANSWER: b 23. What does a DNR order do? a. It halts only feeding by artificial means. b. It halts all treatment. c. It gives a family member control of the patient’s affairs if the patient cannot. d. It halts cardiopulmonary resuscitation.

ANSWER: d 24. Which is a provision of the PSDA? a. Hospitals must provide verbal information to patients upon admission, informing them of their rights to executive advance directives. b. Hospitals must provide verbal information about how to carry out advance directives. c. Hospitals should not document whether an advance directive exists for a patient due to privacy. d. Hospitals must educate their staff and community on advance directives.

ANSWER: d 25. A person who is fatally ill with a condition for which there is no reliable cure is considered ___________ ill. a. extremely b. terminally c. living d. euthanasia ANSWER: b 26. What is an advance directive? a. One person making a decision for another. b. Written instructions about a person’s future medical care. c. A promise that specifically named results will occur.

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d. A prior sworn statement by a witness to be used in court as testimony taken under oath and subject to crossexamination.

ANSWER: b 27. Under the PSDA, each entity is required to maintain ____________________ policies and procedures concerning advance directives and provide information to patients at the time of admission or enrollment. a. verbal and written b. written c. verbal or written d. verbal ANSWER: b 28. Euthanasia is also known as: a. the right to die. b. physician-assisted suicide. c. a good death. d. a mercy killing.

ANSWER: d 29. A purist is a person who: a. follows a patient’s preferences. b. follows a family’s preferences. c. follows rules above all else. d. cares for patients.

ANSWER: c 30. In order to meet the criteria for an adult to accelerate their death under a death with dignity act, they must have: a. a terminal illness. b. a serious illness. c. chronic pain. d. a genetic disorder.

ANSWER: a Subjective Short Answer 31. Who accepts living wills as the right to refuse artificial life-sustaining procedures?

ANSWER: Living wills are accepted by courts, health care providers, the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, and lawyers.

32. When was the PSDA implemented?

ANSWER: The PSDA was implemented in 1990.

33. What criteria must an individual meet in order to execute a living will?

ANSWER: To execute a living will, a person must be competent.

34. What is the definition of assisted suicide?

ANSWER: Assisted suicide occurs when one person makes it possible for another person to commit suicide.

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35. What is the ethical dilemma related to the decision to keep or remove life support?

ANSWER: The ethical conflict in these cases is the tension between the obligation to prevent death and the obligation to prevent suffering.

36. List one reason why ethical issues arise around the definition of “brain death.”

ANSWER: Answer should include: There may be a personal religious belief component in death. These beliefs may be in conflict with the Uniform Determination of Death Act (UDDA) definition of brain death, which leads to questions concerning the ethical implications of following science when it conflicts with religious beliefs.

The student may cite the case of Nayim Carter, whose parents’ religious beliefs were that he could recover from his condition.

37. What are some of the arguments made against euthanasia?

ANSWER: Answers can include the following: (1) mistake in diagnosis; (2) difficulty in determining if euthanasia is voluntary, for example, when there is an undue influence exerted on the patient by a member of the family or beneficiary of a will for financial reasons; (3) slippery slope argument, for example, with the growth of managed care there may be more pressure to hasten death for those who are elderly, uneducated, on welfare, or disabled; (4) altering the role of physicians to include the practice of killing patients would bring about a psychological upheaval in the doctor–patient relationship, and patients would become less trustful of their physician’s role as healer.

38. The Death with Dignity Act has been a source of debate for many years. Name five states that have implemented the act.

ANSWER: Answers will be among: California, Colorado, District of Columbia, Hawaii, Maine, New Jersey, New Mexico, Oregon, Vermont, and Washington 39. List the situations in which the determination of death is crucial.

ANSWER: Answers should include: executing wills and distributing estates, life insurance, tort lawsuits, organ donation, and criminal matters involving death.

40. List three types of advance directives discussed in this chapter.

ANSWER: There are three major forms of advance directives: living will, durable power of attorney, and health care proxy.

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