Chapter 8 Self Quiz

. The four rules of professional–patient relationships set forth and explained by Beauchamp and Childress are:

Autonomy, privacy, respect, and confidentiality

Veracity, privacy, beneficence, and nonmaleficence

Respect for autonomy, nonmaleficence, beneficence, and justice

Veracity, privacy, confidentiality, and fidelity

. What is Beauchamp and Childress's understanding of the place of veracity as a moral obligation?

Beauchamp and Childress understand obligations of veracity to be specifications of more than one of the four basic principles (respect for autonomy, nonmaleficence, beneficence, justice).

Beauchamp and Childress claim that it isn't clear whether veracity is an absolute and independent obligation or a special application of another principle.

Beauchamp and Childress think that veracity is an independent principle and virtue, on the same level as respect for autonomy, beneficence, nonmaleficence, and justice.

Beauchamp and Childress think that veracity is a specification of the principle of respect for persons' autonomy.

. In the case described by Beauchamp and Childress of a ninety-year-old patient with a squamous cell carcinoma who was extremely fearful of cancer, which of the following was NOT set forth as a justification for "intentional verbal inaccuracy" on the part of the physician who treated the patient?

The patient was in need of "effective reassurance."

The patient's family urged the physician not to tell him that the ulcer on his lip was cancer, because of the patient's fearfulness of the disease.

In the physician's judgment, it was "more truthful" to tell the patient he did not have cancer, because the patient was unable to accept the idea that he had a treatable and curable cancer.

Addressing the patient and his concerns in his own language expressed respect, not paternalistic arrogance.

. Beauchamp and Childress make the following argument about deception of third-party payers in the health care field:

Physicians should place a premium on seeking alternative, nondeceptive courses of action, such as formal appeals, and should work to alter unduly restrictive systems.

Deception of third-party payers can never be justified.

Physicians should practice fidelity to their patients by doing whatever it takes to make sure the appropriate tests and treatments are paid for.

Third-party payers may sometimes be deceived, but only those who have demonstrated callousness toward patients or unwillingness to work with physicians to provide and pay for proper diagnosis and treatment.

. Besides informational, physical, decisional, and proprietary privacy, Beauchamp and Childress propose the following kind of privacy as important in medical ethics:

Familial

Relational

Medical

Confidential

. Beauchamp and Childress state that the following is one justification of a right to privacy:

Privacy is a basic right of its own.

A system of medical care would fall apart without respect for privacy.

Violation of privacy violates the principle of nonmaleficence.

A right to privacy is derived from respect for autonomy.

. Based on Beauchamp and Childress's discussion of privacy and confidentiality, what would be an example of a breach of privacy that does not involve a breach of confidentiality?

A person who does not have authorization views a patient's medical record on a hospital computer.

One physician discusses a patient's case with another who is not involved in the patient's treatment, using the patient's name and identifying information.

A therapist calls a suicidal patient's family members to ask them to look out for the patient's well-being.

A physician talks to his or her spouse in detail about the patients under his or her care.

. What sort of cases do Beauchamp and Childress refer to as "paradigm" cases for justified breach of confidentiality?

Cases in which a patient may harm him- or herself if health care workers do not intervene

Cases in which HIV might be spread from one individual to another

Cases in which an illness may be spread quickly by an infected individual

Cases in which there is a high probability of a major harm to an identifiable individual

. How have codes of nursing ethics changed from the early to the later part of the twentieth century?

Earlier codes stated that nurses were obligated to carry out physicians' orders; current codes stress nurses' obligations to clients and the general public.

Earlier codes stressed nurses' obligations to clients and the general public; current codes stress nurses' obligations to physicians.

Earlier codes counseled nurses always to remain loyal to their colleagues; later codes dropped this counsel.

Earlier codes made no clear ethical demands on nurses; later codes incorporated expectations that nurses would act ethically and make sure that others were acting ethically as well.

. Which of the following best describes the relationship between clinical research and clinical medical practice, as discussed by Beauchamp and Childress?

Research has been heavily regulated because it has been thought to place subjects at risk for the benefit of others and to investigate unconfirmed hypotheses about diagnoses and treatments.

Medical practice is minimally regulated on grounds that it focuses on the patient's best interests and relies on interventions of proven benefit and acceptable risk.

The sharp distinction often drawn between research and medical practice is morally questionable.

All of the above

. ________ in health care refers to accurate, timely, objective, and comprehensive transmission of information, as well as to the way the professional fosters the patient's or subject's understanding.

. Disclosure of medical information over time, with sensitivity to the patient's relevant welfare interests, is called a _______ disclosure by Beauchamp and Childress.

. __________ approaches justify rules of privacy according to their instrumental value for such ends as personal development, creating and maintaining social relations, and expressing personal freedom.

. When public health authorities collect, analyze, store, and use personal health information for the purpose of tracking or preventing disease on a large scale, it is known as _______ and can constitute a risk to individual privacy.

. If a patient or research subject authorizes release of information about himself or herself to others, then no violation of rights of confidentiality occurs, although a loss of _______ does occur.

. A ______ _____ ________ exists when an impartial observer would determine that a professional's judgments, decisions, or actions are at risk of being unduly influenced by his or her personal interests.

. Designing a clinical research trial so that the subject or the investigator does not know whether the subject is in the control group or experimental group is known as ________.

. Veracity is absolutely binding as a moral principle; physicians should always be truthful with their patients about their health.

True

False

. According to Beauchamp and Childress, a choice not to know information about one's diagnosis or prognosis can be as autonomous and worthy of respect as a choice to know.

True

False

. Privacy is a matter of an agent's control over access to himself or herself.

True

False

. Breaching confidentiality for the sake of mitigating harm to a patient or to a third party can sometimes be justified.

True

False

. Generally, physicians and genetic counselors should err on the side of informing a patient's relatives about possible genetic diseases they may share with the patient, even if the patient does not consent to the disclosure.

True

False

. Physicians' obligations of fidelity to patients require that physicians care for all people affected by an epidemic disease.

True

False

. The code of the American Nurses' Association currently stresses nurses' obligations to clients and their obligations to safeguard clients and the public from unethical practices.

True

False

Quiz Content