Legal & Ethical Dilemmas

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. Select the incorrect statement from the following:

a) A person has a right to die at home.
b) dying at home provides the advantage of being in a psychologically comfortable surrounding.
c) dying at home offers the patient a greater sense of control.
d) the disadvantage of dying at home is that the patient loses the right to all medical care.

2. The goal of hospice care is to:

a) prolong life
b) provide medical treatments that alleviate pain or maintain comfort throughout the dying process.
c) reduce medical costs for the dying patient

3. Home health care and hospice differ from each other in many respects. Select the incorrect statement from the following:

a) Home health care may include hospice for the dying patient.
b) All hospice programs must provide care to families as well as to the dying persons.
c) The purpose of hospice care is to treat dying persons only.
d) Both hospice and home health care provide health care in the individual's home.
e) Both hospice and home health care can include life- prolonging treatment.

4. Medicare or Medicaid generally do not cover the costs of hospice.

a) True
b) False

5. When a dying person is no longer capable of making decisions, family members have a right to ask for a discharge from the hospital.

a) True
b) False

6. All of the following statements are True except:

a) A person dying at home can change his mind and ask for life-prolonging treatment.
b) A dying patient's refusal to accept life-prolonging treatment may be considered suicide and may result in denial of life insurance benefits.
c) If a dying person changes his mind and asks for life-pro longing procedures, most health insurance plans would not cover the costs.
d) Families run legal risk when they allow the loved ones to die in their homes.

7. Advance directives are generally not honored in an emergency.

a) True
b) False

8. One of the following is not an advance directive:

a) living trust
b) living will
c) durable power of attorney for health care

9. One of the following statements is not True about the durable power of attorney for health care:

a) DPA for health care allows you to appoint an agent to act in your behalf.
b) The agent can make only the end-of-life decisions for you.
c) The agent acts only when you are unable to make decisions for yourself.
d) The agent can be anyone whom you can trust.

10. Even if you have prepared a durable power of attorney for health care it is advisable to prepare a living will for all of the following reasons except:

a) A living will gives specific directions to your agent about your wishes.
b) In the event the agent is unavailable the physician can look to the living will for guidance.
c) A living will releases the agent and caregiver from legal liability.

11. Most durable powers of attorney for health care become operative when your physician concludes that you are unable to make your own medical decisions.

a) True
b) False

12. Most advance directives are generally not honored in an emergency.

a) True
b) False

13. All advance directives have to be prepared by an attorney.

a) True
b) False

14. Who can be your agent under DPA for health care?

a) your physician
b) a close family member or a good friend
c) two or more members of your family
d) all of the above

15. Advance directives must be witnessed properly. Who can be a witness?

a) your agent
b) disinterested parties
c) your physician
d) close relatives
e) all of the above

16. Once prepared, you should store your advance directives in a safe deposit box.

a) True
b) False

17. Select the correct statement from the following:

a) When a patient refuses life support he may still be given pain medication, antibiotics, even surgery as part of palliative care.
b) Life support system generally does not include artificial nutrition and hydration.
c) Once a medical treatment is started on a terminal patient it cannot generally be stopped.
d) Withdrawing artificial nutrition and hydration often results in a painful death.

18. In many states, care providers can refuse to honor advance directives for moral or religious reasons.

a) True
b) False

19. Under many state statutes, advance directives are invalid while a woman is pregnant.

a) True
b) False

20. If you wanted someone to make financial decisions for you, you would prepare

a) power of attorney
b) durable power of attorney
c) durable power of attorney for health care
d) a and b above
e) all of the above

21. For patients at the end of life, artificial nutrition and hydration may actually contribute to the dying patient's discomfort

a) True
b) False

22. The withdrawal of artificial nutrition and hydration can lead to a long and painful death

a) True
b) False

23. Select the incorrect statement from the following:

a) A DNR order must be signed by a physician in order to be valid.
b) A DNR order is required to refuse CPR.
c) In order to avoid CPR, patient must prepare a living will.
d) A patient with DNR order may still receive other medical treatment.

24. A physician cannot write a DNR order without consulting the individual.

a) True
b) False

25. A DNR order is generally not honored during surgery.

a) True
b) False

26. There are many misconceptions regarding advance directives. Select from the following one that is not a misconception:

a) Once a person signs an advance directive, all health care decisions are made by the agent designated.
b) Signing an advance directive may deprive a person of care he or she would want.
c) Under PSDA, all health care facilities are required to obtain advance directives from patients at the time of admission.
d) Advance directives will not protect you from unwanted treatment in an emergency.
e) all of the above