Virtual Mentor. November 2003, Volume 5, Number 11.

Test Questions

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Test Questions: Public Health Ethics

November 2003, Volume 5, Number 11

1. Which of the following are appropriate statements in a discussion with a patient who has just learned she is HIV-positive:

1. It is important that you notify your sexual partner(s) that they should also be tested for HIV. You should do this when you feel comfortable; as your physician I will never reveal your HIV-status to anyone.
2. I understand that it is extremely difficult to notify your sexual partners of your HIV-status but you have to do it; it is the responsible and loving thing to do.
3. You may be legally liable if you continue to have sex with your partner without informing him or her that you are HIV-positive.
4. It is imperative that I know your partners have been informed of your status. Let's discuss ways of talking to them about the importance of getting tested.
5. A and B
6. B, C, and D

2. Flu vaccine is recommended for which of the following categories of patients:

1. All children who are younger than 1 year old.
2. Patients between 10 and 40 years old who are HIV-positive.
3. Women who are in their first trimester of pregnancy during flu season
4. Patients who live in nursing homes.
5. A and B
6. B, C, and D

3. All states allow parents medical and religious exemptions to having their children vaccinated.

1. True
2. False

4. In their article "The Unbearable Rightness of Beside Rationing: Physician Duties in a Climate of Cost Containment" Ubel and Arnold propose all of the following about bedside rationing except

1. Physicians should make resource allocation decisions based solely on medical costs and benefits
2. Physicians should ration only services that are marginally beneficial.
3. Physicians should be trained in cost-effective analysis.
4. Physicians are obligated to explain to their patients why and how rationing decisions are made.
5. Physicians should compare the cost of all treatments to the cost of alternative treatment options.

5. In cases where a physician suspects that a patient is being abused by spouse or partner the physician should:

1. Never involve legal or public health authorities; the patient will contact the police herself if she wants them involved.
2. Try to elicit the patient's voluntary disclosure but if the patient is unwilling disclose and it is likely her life is endanger, the abuse should be reported to protect her.
3. Approach the patient in a nonjudgmental and supportive manner to elicit voluntary disclosure of abuse and offer legal, health care, and other resources on violence.
4. The physician should encourage the patient to get out of the abusive relationship, but if the patient refuses, the physician should stop inquiring about the situation.
5. A and D.

6. The AMA has not found concierge medical practices to be inconsistent with a pluralistic means of health care delivery but has identified ethical
concerns that warrant careful attention.

1. True
2. False

7. According to Upshur, all of the following are part of the 4 criteria that must be met before quarantine can be ethically justified except:

1. Knowledge of how the disease is spread.
2. Less restrictive means for controlling the spread of infections have been considered insufficient to protect the public.
3. Plan for social support of those who are quarantined
4. Knowledge of the effectiveness of quarantine in preventing the spread of the particular disease at hand.
5. Transparency in communication with the public

8. Williams offers which of the following as a reason why physicians should engage in brief behavioral counseling:

1. It is an important part of offering patients their full treatment options.
2. Patients may not realize the extent to which their behaviors endanger their health.
3. They can have great impact on the burden of disease caused by behaviors like smoking, overeating, and excessive alcohol consumption.
4. All of the above.
5. A and C.

9. In the Grimes v Kennedy-Kreiger case, the court suggested that the researchers were legally liable for which of the following:

1. Not including in the informed consent form the foreseeable risk that the children in the study might have increased lead levels in their blood.
2. Not informing the study's participants when they found dangerously high levels of lead in their blood.
3. Involving children in a nontherapeutic study.
4. All the above.
5. A and B.

10. Which of the following may be an obstacle to the successful integration of genomics into health care:

1. Low genetic literacy of the public.
2. Low genetic literacy of health professionals.
3. Genetic technology that improves health but is not available to all patients.
4. All of the above.

virtualmentor@ama-assn.org.