Test on Patient Preferences and Informed Consent
Patient Preferences and Informed Consent: A Student's Guide
Test: Patient autonomy — Preferences & Decision-Making, Patient autonomy — Ethical Principles & Clinical Practice, Informed consent: patient rights, Informed consent: clinical ethics, Decisional capacity, Patient autonomy — Refusal, Religious & Cultural Issues, Surrogate decision-making clinical practice, Advance care and end-of-life planning, Managing difficult patients, Complementary medicine, Pediatric decision-making
20 questions
Question 1: The 'best interest standard' is primarily applied when a patient's preferences are known but the surrogate believes a different course of action would lead to a better outcome.
A. Ano
B. Ne
Explanation: The study materials state that 'the best interest standard' is used when the patient's preferences are unknown or unclear. When the patient's preferences are known, the 'substituted judgment' standard is applied, requiring the surrogate to use knowledge of these preferences.
Question 2: According to the study materials, which type of surrogate has the highest priority to make medical decisions for an incapacitated patient?
A. The patient's spouse, as typically ranked first by state legislation
B. An individual explicitly appointed by the patient as their surrogate or holder of a durable power of attorney
C. A guardian or conservator judicially appointed by a judge
D. The patient's adult children, if no spouse is available
Explanation: The study materials state that statutes authorize persons to appoint their own surrogates, or holders of durable powers of attorney, and 'These appointed surrogates supercede any other party, including immediate family members.' This indicates they have the highest priority.
Question 3: State legislatures can pass statutes to grant legal priority to a designated decision-maker for health care over all other parties, including next of kin, in cases of patient incapacity.
A. Ano
B. Ne
Explanation: The study materials state that 'State legislatures may pass a statute authorizing what is called 'a durable power of attorney for health care.' ... These statutes give legal priority to the designated agent over all other parties, including next of kin.'
Question 4: What is a key benefit of a state statute authorizing a durable power of attorney for health care, according to the study materials?
A. It removes the requirement for the appointed agent to be a family member.
B. It clarifies who is the appropriate decision-maker for an incapacitated relative.
C. It avoids the bureaucratic burdens and costs of appointing a guardian or conservator.
D. It limits the designated agent's decisions to only life-sustaining treatments.
Explanation: The study materials state that statutes authorizing a durable power of attorney for health care clarify the confusion about who in the family is the appropriate decision-maker for an incapacitated relative and avoid the bureaucratic burdens and costs of a legal proceeding to appoint a guardian or conservator. The agent can be a relative or a friend, not exclusively a non-family member, and their decisions are not limited only to life-sustaining treatments.
Question 5: The primary ethical justification for discharging a disruptive patient like Mr. R.A. is solely rooted in the patient's lack of mental capacity to make sound treatment choices.
A. Ano
B. Ne
Explanation: While determining mental capacity is a consideration for patients exhibiting erratic behavior, the study materials indicate that additional, primary ethical justifications for discharging disruptive patients include the patient's actions running counter to treatment goals, and the patient's behavior disrupting hospital functioning and impeding the care of other patients due to fairness concerns. Therefore, it is not the sole justification.