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Step Q bank
Justice
Professional-patient Relationships
Principles of Bioethics
4 Box Method of Ethical analysis
100
A 74-year-old woman is brought to her primary care doctor by her adult son. The son says she has been very difficult at home and is "losing it". He seems very frustrated about her diminishing ability to take care of herself the way she used to and no longer thinks he can trust her watching his children. At her last visit you noted mild cognitive impairment. Today, she appears withdrawn and hesitates to make eye-contact with you. She lets her son do most of the talking. Which of the following is the most appropriate next step? 1. Discuss with the son the challenges of having a parent with dementia 2. Complete a mini-mental exam 3. Assess the patient's risk for depression 4. Order a head CT 5. Ask the son to step out so you can speak with the patient alone
What is 5. Ask the son to step out so you can speak with the patient alone
100
Greatest good
What is Utilitarian
100
comprehensive, accurate, and objective transmission of information, as well as the way the professional fosters the patient's understanding.
What is veracity
100
do no harm
What is Nonmaleficence
100
what is the patient's medical problem? History? Diagnosis?
What is medical indications
200
A 26-year-old patient presents to your office with rhinorrhea that you believe to be viral in origin. He respectfully requests treatment with antibiotics, and he demonstrates an understanding of the risks, benefits, and alternatives to treatment. His mental status is intact, and you believe him to have full decision-making capacity. Which of the following is the best course of action? 1. Prescribe ciprofloxacin 2. Prescribe amoxicillin 3. Prescribe zidovudine 4. Refer the patient to an infectious disease specialist 5. Deny the patient's request
What is 5. Deny the patient's request
200
equal distribution of health care goods
What is egalitarian
200
providers should not discuss patients personal health issues with others unless permission has been given. This is an obligation of clinicians AND institutions.
What is confidentiality
200
self rule that is free from both controlling inference by others and from limitations.
What is autonomy
200
what are the prospects, with or without treatment, for return to normal life?
What is Quality of life
300
Last night you admitted a 72-year-old woman with severe COPD in respiratory distress. She is currently intubated and sedated and her family is at bedside. At the completion of morning rounds, the patient's adult son asks that you and the team take a minute to pray with him for his mother. What is the most appropriate response? 1. "I'm sorry, but this is a public hospital, so we cannot allow any group prayers." 2. "I appreciate what you are experiencing and am happy to take a minute." 3. "I also believe in the power of prayer, so I will pray with you and insist that the rest of team joins us." 4. "While I cannot offer you my prayers, I will work very hard to take care of your mother." 5. "I don't feel comfortable praying for patients, but I will happily refer you to pastoral care."
What is 2 "I appreciate what you are experiencing and am happy to take a minute."
300
community derived standards
What is communitarian
300
Clinicians have the obligation to be loyal to the patients whom they care for.
What is Fidelity.
300
Beneficence is an action done to benefit others. What are the three goals of beneficence in bioethics?
What is one ought to prevent harm. one ought to remove harm. one ought to do or promote good.
300
Are there religious or cultural factors?
What is Contextual features
400
A 16 year-old girl presents to her OB/GYN for management of her pregnancy. The patient is 10 weeks pregnant and the physician recommends that she began to take folate supplements. The patient is disgusted, stating that "she has taken those pills before, but they taste bad and she never will take them again." Which of the following is not a requirement of the patient for her to be able to make this decision? 1. Understanding 2. Appreciation 3. Choice 4. Reasoning 5. Minor Status
What is 5. Minor Status
400
free market
What is libertarian
400
The rule the HHS issued to implement the standards of the use and disclosure of individuals' health information.
What is the privacy rule
400
The two conditions that are necessary for autonomy.
What is liberty and agency
400
Is the patient unwilling or unable to cooperate with medical treatment?
What is patient preferences
500
A junior orthopaedic surgery resident is completing a carpal tunnel repair with the department chairman as the attending physician. During the case, the resident inadvertently cuts a flexor tendon. The tendon is repaired without complication. The attending tells the resident that the patient will do fine, and there is no need to report this minor complication that will not harm the patient, as he does not want to make the patient worry unnecessarily. He tells the resident to leave this complication out of the operative report. Which of the following is the correct next action for the resident to take? 1. Disclose the error to the patient but leave it out of the operative report 2. Disclose the error to the patient and put it in the operative report 3. Tell the attending that he cannot fail to disclose this mistake 4. Report the physician to the ethics committee 5. Refuse to dictate the operative report
What is 3. Tell the attending that he cannot fail to disclose this mistake
500
everyone should have the same opportunity to health goods
What is fair opportunity
500
Is it ever ok to tell a lie to your patient? Defend your answer with an example spoken in iambic pentameter.
What is discussion
500
write a haiku about when either nonmaleficence or beneficence takes precedence over the other (the haiku is optional)
What is if the injury inflicted is minor in compared to the benefit (beneficence over nonmaleficence). i.e. shots
500
Is there any conflict of interest on the part of the providers or the institutions?
What is contextual features