Deck 5: Nonmaleficence

Question 1

The principle of nonmaleficence obligates us to:

A) Treat people fairly
B) Refrain from causing harm to others
C) Offer help to those in need
D) Respect other people's choices

Answer 1

B

Question 2

The maxim Primum non nocere is often proclaimed as the fundamental principle in the ______________ tradition.

A) Christian
B) Western philosophical
C) Holistic health
D) Hippocratic

Answer 2

D

Question 3

Examples of moral rules supported by the principle of nonmaleficence include all of the following except:

A) Do not kill
B) Do not cause offense
C) Do not deprive others of the goods of life
D) Prevent harm to other people

Answer 3

D

Question 4

If a physician forgets that a patient does not want to receive certain types of information yet discloses that information anyway, this is an example of:

A) Recklessness
B) Advertent negligence
C) Inadvertent negligence
D) The rule of double effect

Question 5

In the controversial case of Charlie Gard, the UK government rejected the parent's request to seek treatment abroad, on the following grounds:

A) Treatment would be futile
B) Treatment would have a low probability of benefit and a high probability of harm
C) Treatment would be too expensive
D) A & B
E) B & C

Question 6

Which of the following is a relevant moral distinction in deciding whether a medical intervention is ordinary (obligatory) or extraordinary (nonobligatory)?

A) Whether the procedure is simple or complex
B) Whether the procedure is natural or artificial
C) Whether the procedure is beneficial or burdensome
D) Whether the procedure is noninvasive or highly invasive

Question 7

In a groundbreaking case in 1976, the New Jersey Supreme Court ruled it permissible for a guardian to disconnect ______________'s respirator and allow him/her to die.

A) Terri Schiavo
B) Joseph Saikewicz
C) Janet Adkins
D) Karen Ann Quinlan

Question 8

Which of the following is not a condition that must be met in order for an act to be morally justified under the rule of double effect?

A) The act must be good, or at least morally neutral, independent of consequences.
B) The bad effect of the action is not directly intended.
C) The good effect of the action outweighs the bad effect.
D) The bad effect must be a means to the good effect.
E) The bad effect must not be a means to the good effect

Question 9

Undertaking a futile intervention, such as cardiopulmonary resuscitation (CRP), on a patient that has almost no chance of recovery:

A) Is ethically unacceptable because of harm to the patient
B) Is ethically unacceptable because it is a waste of time and resources
C) Is morally required if the patient's family wants the physician to "do anything" to keep a patient alive
D) Might be justified, within limits, as an act of compassion and care for the patient's grief-stricken family

Question 10

__________________ believe(s) that quality-of-life judgments shift the focus from whether treatments benefit patients to whether patients' lives are beneficial to them-a shift that opens the door to active, involuntary euthanasia.

A) Ronald Dworkin
B) Beauchamp and Childress
C) Paul Ramsey
D) Timothy Quill

Question 11

"Letting die" is prima facie acceptable in medicine under which of the following conditions?

A) The physician has determined that the social worth of the patient is no longer high enough to justify treatment.
B) Either the patient or his or her authorized surrogates have validly refused a medical technology.
C) A medical technology is useless, in the strict sense of medical futility.
D) All of the above
E) Both B and C

Question 12

In order to judge whether an act of either killing or letting die is justified or unjustified, we need to know information about:

A) The actor's motive
B) The act's consequences
C) The patient's preferences
D) The circumstances
E) All of the above

Question 13

According to Beauchamp and Childress, the main problem with slippery-slope arguments is:

A) They are typically politically motivated
B) They rely on speculative predictions for which there is scant evidence
C) They mistakenly assume that prohibitions are both instrumentally and symbolically important
D) Their heavily metaphorical character
E) All of the above

Question 14

About what percentage of those patients who request assistance in dying under the Oregon Death with Dignity Act (ODWDA) decide not to ingest the prescribed drug?

A) 1%
B) 10%
C) 33%
D) 50%
E) 85%

Question 15

According to Beauchamp and Childress, autonomous requests of patients for aid-in-dying should be respected under ____________ circumstances.

A) No
B) Some
C) All

Question 16

Physician _____________'s action in prescribing barbiturates to a patient who had refused treatment for leukemia was an example of justified assistance in dying because it satisfied all nine justifying conditions listed by Beauchamp and Childress.

A) Jack Kevorkian
B) Peter Pronovost
C) Paul Ramsey
D) Timothy Quill

Question 17

Which of the following is not listed among the conditions that are sufficient for justified physician assistance in ending life?

A) A voluntary request by a competent patient
B) An ongoing patient-physician relationship
C) A considered rejection of alternatives
D) Unacceptable suffering by the patient
E) A court-appointed third party must be present

Question 18

An increasingly popular procedure for facilitating health care decisions in the case of diminished competency is the use of _______________, a type of advance directive in which one person assigns another person authority to perform specified actions on his or her behalf.

A) Durable power of attorney (DPA)
B) Living will
C) Court-appointed guardianship
D) Defrayed responsibility

Question 19

Which of the following do Beauchamp and Childress suggest should be considered the presumptive authority when a patient is considered incompetent to make decisions about medical care?

A) Courts
B) Institutional committees
C) The patient's physician
D) The patient's closest family member

Question 20

The problems of broad consent and group harm are illustrated by the case of diabetes research on the ____________ Indians.

A) Cherokee
B) Havasupai
C) Navajo
D) Hopi

Question 21

Obligations of nonmaleficence are always more stringent than obligations of beneficence.

Question 22

Because secure anonymization is notoriously difficult to achieve, even anonymized biological samples can harm some personal and group interests and may violate the investigator-subject relationship.

Question 23

Obligations of nonmaleficence include not only obligations not to inflict harms but also obligations not to impose risks of harm.

Question 24

Whereas recklessness involves unintentionally but carelessly imposing risks of harm, inadvertent negligence involves intentionally imposing unreasonable risks of harm.

Question 25

It is not possible to be too overprotective when regulating research involving human subjects.

Question 26

According to Beauchamp and Childress, the distinction between withholding medical treatments and withdrawing medical treatments once begun is an important moral distinction and should be retained in medical practice.

Question 27

According to Beauchamp and Childress, the distinction between ordinary and extraordinary treatment is only relevant to the degree that it points to a quality-of-life criterion that balances benefits against burdens.

Question 28

U.S. courts since the 1970s have generally placed medically administered nutrition and hydration under the same substantive and procedural standards as other medical treatments such as the respirator.

Question 29

Physicians have no obligation to provide pointless, futile, or contraindicated treatments.

Question 30

In making judgments regarding quality of life, Beauchamp and Childress support a broad conception of "best interest" that includes the welfare of the patient's family.

Question 31

According to Beauchamp and Childress, nothing about either killing or allowing to die necessarily entails judgments about an act's actual wrongness or rightness.

Question 32

According to Beauchamp and Childress, if an act is justified then the corresponding rule of practice or public policy also must be justified.

Question 33

According to Beauchamp and Childress, if a person freely authorized death, making an autonomous judgment that cessation of pain and suffering through death constitutes a personal benefit rather than a setback to interests, then active aid-in-dying at the person's request involved neither harming nor wronging.

Question 34

An incompetent patient's closest family member should always have final authority as a surrogate decision maker.

Question 35

Although it cannot be found in his written works, the maxim "Above all [or first], do no harm" is attributed to ______________.

Question 36

A _______ is a thwarting, defeating, or setting back of some party's interests.

Question 37

In cases of risk imposition, both law and morality recognize a standard of _______ _______, which involves taking appropriate measures to avoid causing harm as the circumstances demand of a reasonable and prudent person.

Question 38

___________ involves a departure from standards that determine due care in given circumstances.

Question 39

Professional _____________ is an instance of negligence that involves failure to follow professional standards of care.

Question 40

Technologies that are used to supply nutrition and hydration using needles, tubes, catheters, and the like have often been referred to as ____________ technologies.

Question 41

Traditionally, actions that result in a merely foreseen, unintended bad result could be justified under the rule of _________ _________.

Question 42

Traditionally, under the rule of double effect, actions that result in a ___________ but __________ bad effect can be morally justified if the good effect outweighs the bad effect and is not a direct result of the action.

Question 43

Typically, the term "_________" refers to a situation in which irreversibly dying patients have reached a point at which further treatment provides no physiological benefit or is hopeless and becomes optional. Due to the ambiguity of its use, the authors suggest avoiding this term in favor of more precise language.

Question 44

Under the ___________ Death with Dignity Act (ODWDA), physicians are permitted, under law, to write prescriptions for a lethal medication at a patient's request.

Question 45

The key issue in requests for aid-in-dying is whether valid requests render it permissible for a physician to lend aid-in-dying, rather than whether physicians are ____________ to lend assistance in dying.

Question 46

Lawyers, physicians, and writers in bioethics have almost universally condemned the actions of ______ ______, whose "death machine" was used to assist in patient suicide without administering adequate medical or psychological examinations to determine patient competence.

Question 47

_____________ care refers to a type of medicine with a primary focus on relief of pain and suffering.

Question 48

In the event that a patient loses the capacity to make decisions about medical care, a _________ must be chosen to make decisions on his or her behalf.