AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. October 2003, Volume 5, Number 10.

Test Questions

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Test Questions: Psychiatry

October 2003, Volume 5, Number 10

1. When a court subpoenas patient records in a child custody case, the American Psychiatric Association encourages the psychiatrist to:

A. Obtain the patient's permission to discuss the request with his or her attorney.
B. Testify in court about the patient's fitness rather than turning over the records.
C. Ask the patient's attorney to request a private meeting with the judge in chambers.
D. All of the above.
E. A and B.
F. A and C.

2. The following are reasonable arguments for not coercing defendants in criminal cases who have severe mentally disorders to take psychotropic drugs:

A. Convicted criminals can be punished in the US whether or not they are judged competent to adequately understand and participate in the criminal proceeding against them.
B. The defendants' or their counsels' wish to present the defendants' true mental state to the jury.
C. The defendants' fear that psychotropic drugs might compromise their cognition and interfere with their ability to consult with their counsel.
D. B and C.

3. Psychiatrists often face the ethical dilemma of protecting the confidentiality of their patients versus cooperating with third parties or the state to protect others.

A. True
B. False

4. Over the last 50 years, interest in psychiatry as a career specialty among US medical students has:

A. Increased
B. Remained the same
C. Decreased

5. According to a policy forum article in this issue, inequality between reimbursement for treatment for mental illness and treatment for physical illness:

A. Is present in only about 8 percent of insurance plans.
B. Is preserved, in part, by federal legislation that prevents states from regulating self-insured employer health plans.
C. Is resisted by Congress because the numbers of Americans who need mental health services does not justify providing coverage.
D. Prompted President Bush to ask Congress for "parity" legislation in 2002.
E. A and C.
F. B and C.
G. B and D.

6. Outpatient commitment:

A. Is a voluntary program for helping individuals with mental illness without confining them to hospitals or institutions.
B. Involves a court order and can result in inpatient commitment if the patient doesn't comply with treatment plans.
C. Is a controversial alternative to voluntary outpatient treatment.
D. A and C.
E. B and C.

7. In prescribing psychotropic drugs for adolescents, psychiatrists are concerned about:

A. "Medicalizing" feelings that are a normal part of adolescent maturation.
B. Suppressing anxiety, a mechanism that plays an important biological role in perception of and response to threat.
C. Relying on pharmacological treatment as the sole intervention for anxiety disorders in youth.
D. Physical side effects of drugs which, in themselves, can add to teenagers' distress.
E. All of the above.
F. A and D.
G. A, C and D

8. Psychiatrists who are consulted to help decide issues of involuntary hospital admission must first determine competency. With patients whom they judge to be competent, psychiatrists should respect a refusal to be hospitalized, even when the decision appears to be irrational and life-threatening.

A. True
B. False

9. A physician's right to breach patient confidentiality when the patient threatens imminent harm to an identifiable third party:

A. Has been acknowledged by legislation in 23 states.
B. Is accepted as ethical conduct by the AMA and APA codes of conduct.
C. Has been attacked on the basis that it prevents those who most need psychiatric help from seeking it.
D. Has been attacked on the basis that professional ethics may make greater demands on members of the profession than the law demands.
E. All of the above.
F. A, B and C.

10. The proponents and opponents of electroconvulsive therapy for treating severe depression that is intractable to other therapies disagree about:

A. ECT's safety and side effects.
B. ECT's short- and long-term efficacy.
C. The possibility of obtaining fully informed, uncoerced consent for ECT.
D. All of the above.
E. A and C.

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