The four rules of professional–patient relationships set forth and explained by Beauchamp and Childress are:
- a. Autonomy, privacy, respect, and confidentiality
b. Veracity, privacy, beneficence, and nonmaleficence
c. Respect for autonomy, nonmaleficence, beneficence, and justice
d. Veracity, privacy, confidentiality, and fidelity
What is Beauchamp and Childress's understanding of the place of veracity as a moral obligation?
- a. 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].
b. Beauchamp and Childress claim that it isn't clear whether veracity is an absolute and independent obligation or a special application of another principle.
c. Beauchamp and Childress think that veracity is an independent principle and virtue, on the same level as respect for autonomy, beneficence, nonmaleficence, and justice.
d. 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?
- a. The patient was in need of “effective reassurance.”
b. 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.
c. 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.
d. 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:
- a. Physicians should place a premium on seeking alternative, nondeceptive courses of action, such as formal appeals, and should work to alter unduly restrictive systems.
b. Deception of third-party payers can never be justified.
c. Physicians should practice fidelity to their patients by doing whatever it takes to make sure the appropriate tests and treatments are paid for.
d. 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:
- a. Familial
b. Relational
c. Medical
d. Confidential
Beauchamp and Childress state that the following is one justification of a right to privacy:
- a. Privacy is a basic right of its own.
b. A system of medical care would fall apart without respect for privacy.
c. Violation of privacy violates the principle of nonmaleficence.
d. 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. A person who does not have authorization views a patient's medical record on a hospital computer.
b. 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.
c. A therapist calls a suicidal patient's family members to ask them to look out for the patient's well-being.
d. 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?
- a. Cases in which a patient may harm him- or herself if health care workers do not intervene
b. Cases in which HIV might be spread from one individual to another
c. Cases in which an illness may be spread quickly by an infected individual
d. 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?
- a. Earlier codes stated that nurses were obligated to carry out physicians' orders; current codes stress nurses' obligations to clients and the general public.
b. Earlier codes stressed nurses' obligations to clients and the general public; current codes stress nurses' obligations to physicians.
c. Earlier codes counseled nurses always to remain loyal to their colleagues; later codes dropped this counsel.
d. 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?