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Chapter 6 Health-Care Ethics 1. Which company is the focus of the “$50,000 A Day, Not a Bad Payday” scenario? a. Medicatron b. Medtronic c. Meditrue d. Medisure Answer: b. Medtronic 2. What type of medical products was the focus in the “$50,000 A Day, Not a Bad Payday” scenario? a. artificial hips b. heart pacemakers c. blood pressure machines d. products for back surgery Answer: d. products for back surgery 3. What type of work was performed which paid $50,000 a day? a. heart surgeries b. back surgeries c. teaching of new surgery techniques d. consulting Answer: d. consulting 4. To perform one type of back surgery, what was the annual revenue generated by doctors in the United States based on the “$50,000 A Day, Not a Bad Payday” scenario? a. $1 billion b. $2 billion c. $3 billion d. $4 billion Answer: d. $4 billion 5. Which of the following was not included in the lawsuit filed against the medical device company? a. excessive remuneration b. fraud c. bribes d. illegal perks Answer: b. fraud 6. Which of the following is not an underlying value that should be followed by a health care professional? a. beneficence b. compassion c. dignity d. autonomy Answer: b. compassion 7. Which underlying health-care value is based on the freedom for a patient to accept or refuse treatment? a. Justice b. Autonomy c. Dignity d. Truthfulness Answer: b. Autonomy 8. Which underlying health-care value is based on the belief that decisions by the health-care workers are fair? a. Justice b. Fairness c. Honesty d. Autonomy Answer: a. Justice 9. Which underlying health-care value is based on the belief that the patient should be aware of the benefits and risks of all treatments being offered? a. Justice b. Nonmalfeasance c. Truthfulness c. Dignity Answer: c. Truthfulness 10. Which underlying health-care value is based on the belief that every action taken by a health-care worker would not cause harm to the patient? a. Justice b. Beneficence c. Nonmalfeasance d. Honesty Answer: c. Nonmalfeasance 11. Which underlying health-care value is based on the belief that every health-care worker always has the best interests of the patient in mind when decisions are made? a. Justice b. Beneficence c. Nonmalfeasance d. Dignity Answer: b. Beneficence 12. Which of the following is not one of the principles of biomedical ethics? a. Autonomy b. Dignity c. Justice d. Beneficence Answer: b. Dignity 13. Which of the following is not a question that should be asked pertaining to bioethics? a. Ownership b. Commodification c. Truthfulness d. Reductionism Answer: c. Truthfulness 14. Which doctor-patient model describes when the patient and the doctor participate equally in all health-care decisions? a. engineering model b. priestly model c. collegial model d. contractual model Answer: c. collegial model 15. Which doctor-patient model describes when the doctor carries out the wishes of the patient? a. engineering model b. priestly model c. collegial model d. contractual model Answer: a. engineering model 16. Which doctor-patient model describes the assumption that the doctor will always do what is in the patient’s best interest? a. engineering model b. priestly model c. collegial model d. contractual model Answer: b. priestly model 17. Which doctor-patient model describes when the patient and doctor enter an agreement which it is assumed that they both will be pursuing mutual goals? a. engineering model b. priestly model c. collegial model d. contractual model Answer: d. contractual model 18. The General Medical Council regulates doctors in which country? a. Canada b. United States c. United Kingdom d. Australia Answer: c. United Kingdom 19. Which President established the President’s Advisory Commission on Health Care? a. Jimmy Carter b. Gerald Ford c. Bill Clinton d. George H. Bush Answer: c. Bill Clinton 20. ACHE stands for: a. American Clinical Hospital Executives b. American College of Healthcare Executives c. American Continuous Health Execution d. American Classroom of Health Education Answer: b. American College of Healthcare Executives 21. Which of the following is not a health-care ethics self-assessment statement? a. I ensure that the promises I make are fulfilled b. I demonstrate no tolerance for any form of staff harassment c. I verify the patient’s symptoms before I start treatment d. I demonstrate respect for employees within my work environment. Answer: c. I verify the patient’s symptoms before I start treatment 22. Which of the following is not a health-care ethics self-assessment statement? a. I promote community health status improvement when I have the opportunity. b. I will not refuse any individual emergency treatment c. I place the interests of the community and my patients above my own personal interests. d. I have ethical discussions on not only medical issues, but also management and/or financial issues. Answer: b. I will not refuse any individual emergency treatment 23. The American Medical Association code of ethics is based on: a. the Principles of Medical Ethics b. the Oath of Medical Principles c. the Principles of a Physician’s Obligations d. the Moral Standing of Physicians Answer: a. the Principles of Medical Ethics 24. In 2004, what company had it membership suspended by the British Pharmaceutical Industry? a. Merck b. Pfizer c. Abbott Laboratories d. GlaxoSmithKline Answer: c. Abbott Laboratories 25. In 2004, which country industry association suspended Abbott Laboratories? a. Great Britain b. United States c. Canada d. France Answer: a. Great Britain 26. The Health Insurance Portability And Accountability Act was passed in which year? a. 1994 b. 1995 c. 1996 d. 1997 Answer: c. 1996 27. HIPAA was passed to: a. protect patients’ personal health information b. protect physicians from being sued by insurance companies c. protect physician from being sued by their patients d. protect hospitals from financial bankruptcy Answer: a. protect patients’ personal health information 28. Which of the following is not a valid reason why patient’s personal information could be released to a third party? a. public health b. emergency circumstances c. requirements of foreign country d. oversight of health-care system Answer: c. requirements of foreign country 29. Which of the following is not one of HIPAA’s Physical Safeguards? a. electronic card system b. a physical barrier between the patient and administrator c. use alternative sources for backing up information d. have top management technology package match the firm’s needs Answer: b. a physical barrier between the patient and administrator 30. Which is considered an effective type of advertising by pharmaceutical companies? a. Direct-to-cost b. Direct-to-doctor c. Direct-to-consumer d. Direct-to-hospital Answer: c. Direct-to-consumer 31. Which of the following would not be considered an appropriate gift for a doctor to consider a new drug? a. free lunch b. free dinner c. free sports tickets d. it depends on the ethical standards of the doctor Answer: d. it depends on the ethical standards of the doctor 32. Which of the following is not an advantage of an Internet pharmacy as compared with a traditional pharmacy? a. There is less intimidation for patients in ordering sensitive medications b. Patients can find price comparison easier online c. Patients can pay for their medications with Paypal d. It is more convenient to use an Internet pharmacy. Answer: c. Patients can pay for their medications with Paypal 33. Which of the following is not a disadvantage of using an Internet pharmacy as compared with a traditional pharmacy? a. Some third party payers may limit participation in Internet pharmacies b. There may not be a pharmacist available to answer questions c. The patient can not return the drugs once they have been delivered d. There could be questions about the integrity of the drugs shipped to the patient Answer: c. The patient can not return the drugs once they have been delivered 34. Which of the following is not considered a stakeholder in the health-care system? a. patient’s friends b. doctor’s union c. pharmaceutical companies d. hospitals where the patient is not located Answer: d. hospitals where the patient is not located 35. Which of the following is the physician not accountable to when making health-care decisions? a. lawyers b. professional association c. pharmaceutical companies d. private payers Answer: c. pharmaceutical companies 36. Medicaltron is the name of the company in the opening scenario “$50,000 A Day, Not a Bad Payday”. a. True b. False Answer: b. False 37. The annual sales of the company in the opening scenario “$50,000 A Day, Not a Bad Payday” is $10 billion. a. True b. False Answer: a. True 38. In the opening scenario “$50,000 A Day, Not a Bad Payday” a doctor was paid $1 million for 20 days work. a. True b. False Answer: b. False 39. The doctors receiving the high levels of compensation in “$50,000 A Day, Not a Bad Payday” were performing organ transplants. a. True b. False Answer: b. False 40. The doctors receiving the high levels of compensation in “$50,000 A Day, Not a Bad Payday” were performing back surgeries. a. True b. False Answer: a. True 41. The lawsuit in “$50,000 A Day, Not a Bad Payday” claimed that Medtronic paid millions of dollars to doctors in return for the doctors using Medtronic devices in certain types of back surgeries a. True b. False Answer: a. True 42. The average cost of the back surgery discussed in “$50,000 A Day, Not a Bad Payday” was $10,000. a. True b. False Answer: b. False 43. According to “$50,000 A Day, Not a Bad Payday”, from 2001 to 2005, Medtronic paid over $60 million to doctors for consulting services. a. True b. False Answer: b. False 44. According to “$50,000 A Day, Not a Bad Payday”, Medtronic’s own ethics rules stated that the company would only pay for modest meals and receptions for marketing to doctors. a. True b. False Answer: a. True 45. Beneficence is an underlying value of medical ethics. a. True b. False Answer: a. True 46. Compassion is an underlying value of medical ethics. a. True b. False Answer: b. False 47. Explaining the benefits and costs of a treatment is considered the "complete informed patient" underlying value of medical ethics. a. True b. False Answer: b. False 48. Always having the best interest of the patient in mind when decisions are made is the justice underlying value of medical ethics. a. True b. False Answer: b. False 49. Autonomy is a basic principle of biomedical ethics. a. True b. False Answer: a. True 50. Dignity is a basic principle of biomedical ethics. a. True b. False Answer: b. False 51. In bioethics, commodification refers to the patenting and commercial opportunities of genes research. a. True b. False Answer: a. True 52. Determining the owner of DNA is can develop into a religious issue. a. True b. False Answer: a. True 53. Reductionism refers to reducing DNA into a single cell analysis. a. True b. False Answer: b. False 54. The belief that the doctor always has the right answer is the collegial doctor-patient model. a. True b. False Answer: b. False 55. The belief that doctors are only following God’s will is the priestly doctor-patient model. a. True b. False Answer: b. False 56. The doctor carrying out the patient’s wishes is the engineering doctor-patient model. a. True b. False Answer: a. True 57. ACHE stands for American College of Hospital Executives. a. True b. False Answer: b. False 58. HIPAA stands for Health Insurance Patient and Accountability Act. a. True b. False Answer: b. False 59. The U.S. Department of Health is responsible for overseeing the enforcement of HIPAA. a. True b. False Answer: b. False 60. A pharmaceutical company giving a brochure to a doctor pertaining to a new drug is direct-to-consumer advertising. a. True b. False Answer: b. False 61. Re-ordering a drug on the Walgreen’s web site would be an example of an Internet pharmacy. a. True b. False Answer: b. False 62. The doctor’s union is considered a stakeholder in the health-care system. a. True b. False Answer: a. True 63. Each stakeholder who a physician is accountable for having the same level of importance. a. True b. False Answer: b. False 64. Does an apparent potential conflict exist among the six underlying values of medical ethics? Answer: It could be argued that indeed there could be scenarios in which different underlying values may be in conflict. For example, autonomy states that each patient has the freedom to accept or reject treatment. However, beneficence states that every decision should be based on the best interests of the patient. What would happen if a patient who has a contagious disease refuses treatment? The net result would be that the patient’s decision would not only put his or her life in jeopardy, but, it could also put other lives in jeopardy. Justice and nonmalfeasance may also potentially conflict in the actions of the doctor. For example, under any rationed drug or treatment, there will be patients who may not receive the drug treatment needed to survive. As a result, any “just rationale” for limited resources will still result in direct harm impacting those patients who do not receive the treatment. 65. From a patient’s perspective which doctor-patient model would you consider the most effective? Which one would you consider the least effective? Answer: It would appear that the collegial model would be the most effective from a patient’s perspective. The collegial model assumes an equal partnership between the doctor and the patient. While not a legal arrangement such as the contractual model, the collegial model assumes that there will be a give and take process in which each viewpoint is not only heard but is considered by the other party in the decision making process. Therefore, to fully understand the costs and benefits (truthfulness and honesty value) of a treatment or the guarantee that no harm will come to the patient (nonmalfeasance), a collegial model will help ensure that the best interests of the patient are considered (beneficence). The least effective model from the patient’s perspective would be the priestly model. In this model, the patient plays a passive role in the decision making process. Therefore, the underlying assumption is that the doctor knows exactly what the patient wants and needs and without any guidance determines the course of action for the patient. As a result, this model would be the least likely model to protect the patient’s interests based on the all the underlying ethical values: beneficence, nonmalfeasance, autonomy, justice, dignity and truthfulness and honesty 66. Is there any way to control the influence pharmaceutical companies have on the decisions made by doctors. Answer: The simple answer to this question is no. Under the current health-care system in the United States, pharmaceutical companies will continue to have a heavy level of influence on the decision making process for doctors. The reason is that in order to help patients, doctors usually need to prescribe medications, in order to prescribe medications, doctors must know the relevant facts pertaining to the drug, in order for the doctor to obtain the facts, the doctor must allow pharmaceutical representatives to explain the drug and give free samples. Of course, doctors can refuse to see pharmaceutical representatives and they are under no obligation to recommend one specific drug over another. However, doctors also are under constant pressure by their patients to prescribe drugs that are “better” than others. In addition, doctors could be held legally liable if they do not prescribe the correct treatment and it is discovered that a more effective treatment would have been better for a patient. The only way the pharmaceutical companies influence could be weakened is if the United States incorporated a universal health-care system. Under this system, the government becomes the customer of the drug and would have more bargaining power than the pharmaceutical companies. Test Bank For Understanding Business Ethics Peter Allen Stanwick, Sarah D. Stanwick 9780131735422, 9788131755365, 9781506303239, 9781452256559

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