End-of-Life Care: Legal and Ethical Considerations for Healthcare Professionals

Question 1

Which advance directive document enables an individual to designate a representative to make medical decisions on their behalf if they lose decision-making capacity?

Accepted Answer

Power of Attorney for Health Care

Answer

Living Will

Answer

Do Not Resuscitate (DNR) Order

Answer

Last Will and Testament

Question 2

Which of the following statements regarding the legal status of euthanasia in the United States is accurate?

Accepted Answer

It is legal in some states but not others.

Answer

It is legal in all 50 states.

Answer

It is illegal in all 50 states.

Answer

It is not addressed by law in any state.

Question 3

Which of the following is NOT a legal requirement for valid informed consent in end-of-life care?

Accepted Answer

The patient's family must consent to the treatment.

Answer

The patient must possess decision-making capacity.

Answer

The patient must be provided with sufficient and relevant information.

Answer

The healthcare professional must obtain the patient's signature.

Question 4

What was the significance of the Terri Schiavo case in the context of end-of-life care?

Accepted Answer

It clarified the legal tests for determining patient capacity.

Answer

It established the right to refuse medical treatment in all circumstances.

Answer

It legalized euthanasia in the United States.

Answer

It had no significant impact on end-of-life care law.

Question 5

What is the primary goal of palliative care?

Accepted Answer

To alleviate pain and suffering and improve quality of life

Answer

To cure or reverse the underlying disease

Answer

To prolong life at all costs

Answer

To provide emotional and spiritual support

Question 6

What is the difference between euthanasia and assisted suicide?

Accepted Answer

Euthanasia is active, while assisted suicide is passive

Answer

Assisted suicide is active, while euthanasia is passive

Answer

There is no legal distinction between the two

Answer

Euthanasia is legal in all 50 states, while assisted suicide is illegal

Question 7

Which of the following cases established the right to refuse medical treatment?

Accepted Answer

Cruzan v. Director, Missouri Department of Health

Answer

Roe v. Wade

Answer

Griswold v. Connecticut

Answer

Planned Parenthood v. Casey

Question 8

The main purpose of a do-not-resuscitate (DNR) order is to:

Accepted Answer

Prevent resuscitation attempts in the event of cardiac arrest

Answer

Allow only comfort care measures

Answer

Terminate life support

Answer

Automatically initiate hospice care

Question 9

What is the primary objective of palliative care in end-of-life situations?

Accepted Answer

To enhance the patient's quality of life through symptom management and emotional support

Answer

To cure the underlying disease

Answer

To extend the patient's life indefinitely

Answer

To facilitate the patient's death through assisted suicide

Question 10

Analyze the ethical implications of euthanasia and assisted suicide. Consider the importance of patient autonomy while also addressing the responsibilities of healthcare professionals.

Accepted Answer

Euthanasia and assisted suicide should be permitted only under strict legal and medical safeguards to balance patient autonomy and ethical concerns.

Answer

Euthanasia and assisted suicide should be legalized without restrictions to promote patient autonomy.

Answer

Euthanasia and assisted suicide should be prohibited in all cases to uphold the sanctity of life.

Question 11

What is the legal principle that protects healthcare professionals from liability when following a patient's advance directives?

Accepted Answer

Informed consent

Answer

Medical necessity

Answer

Substituted judgment

Answer

Best interests standard

Question 12

Which of the following is the primary goal of palliative care?

Accepted Answer

To provide comfort and relieve suffering

Answer

To cure the patient's underlying disease

Answer

To prolong the patient's life

Answer

To hasten the patient's death

Question 13

A patient with terminal cancer has requested that their ventilator be turned off. Their family objects to this decision. Which of the following is the most likely legal outcome?

Accepted Answer

The patient's wishes will be honored.

Answer

The family's objections will prevail.

Answer

The court will appoint a guardian to make the decision.

Answer

The healthcare professional will decide based on their own religious beliefs.

Question 14

In a situation where a patient's wishes for end-of-life care are not clear, how should healthcare professionals proceed?

Accepted Answer

Consult with an ethics committee or legal counsel.

Answer

Assume the patient does not want any life-sustaining treatment.

Answer

Follow the wishes of the patient's family.

Answer

Rely on their own personal values.

Question 15

What is the primary goal of palliative care?

Accepted Answer

To alleviate suffering and improve quality of life

Answer

To cure the underlying disease

Answer

To prolong life

Answer

To provide emotional support to family members

Question 16

In which Supreme Court case was the constitutional right to refuse life-sustaining treatment established?

Accepted Answer

Cruzan v. Director, Missouri Department of Health

Answer

Roe v. Wade

Answer

Griswold v. Connecticut

Answer

Washington v. Glucksberg

Question 17

Which ethical principle emphasizes respect for patient autonomy?

Accepted Answer

Autonomy

Answer

Beneficence

Answer

Nonmaleficence

Answer

Justice

Question 18

What is the key legal distinction between euthanasia and assisted suicide?

Accepted Answer

Euthanasia involves a physician directly administering a lethal substance, while assisted suicide involves the patient self-administering the substance.

Answer

Euthanasia is illegal in all US states, while assisted suicide is legal in some states.

Answer

Euthanasia is considered a crime, while assisted suicide is not.

Answer

There is no legal distinction between euthanasia and assisted suicide.

Question 19

What is the role of the healthcare team in providing compassionate end-of-life care?

Accepted Answer

To respect patient wishes and provide emotional support

Answer

To ensure the patient receives all necessary medical interventions

Answer

To make decisions on behalf of the patient

Answer

To encourage the patient to continue life-sustaining treatment

Question 20

Hospice care prioritizes emotional and spiritual support for patients and their families during end-of-life care. Describe how hospice care achieves this objective.

Accepted Answer

Provides counseling and support groups for patients and families to address emotions and offer mutual support.

Accepted Answer

Offers spiritual guidance and support to help patients find meaning and peace during their final days.

Answer

Administers pain medication and other medical treatments to alleviate physical suffering.

Question 21

Which of the following is NOT a recognized advance directive under the Patient Self-Determination Act?

Accepted Answer

Organ donation registry

Answer

Physician orders for life-sustaining treatment (POLST)

Answer

Durable power of attorney for healthcare

Answer

Living will

Question 22

Palliative care focuses primarily on:

Accepted Answer

Relieving suffering and improving quality of life for patients facing serious or life-limiting illnesses

Answer

Finding a cure for underlying disease conditions

Answer

Providing only basic end-of-life support

Question 23

In Cruzan v. Director, Missouri Department of Health, the U.S. Supreme Court ruled that:

Accepted Answer

Competent patients have a constitutional right to refuse life-sustaining treatment, even if it will lead to their death

Answer

Euthanasia is always illegal

Answer

Patients cannot refuse treatment if their family or healthcare providers believe it's in their best interest

Question 24

According to the doctrine of double effect, it is ethically permissible to administer a medication that has both a desired and an undesired outcome, IF:

Accepted Answer

The primary intention is to relieve suffering, the desired outcome outweighs the undesired outcome, and all other reasonable alternatives have been considered

Answer

The patient consents to the treatment

Answer

The undesired outcome is strictly unavoidable

Question 25

A criticism of the "slippery slope" argument against physician-assisted suicide is that it:

Accepted Answer

Assumes that a single act will inevitably lead to a series of similar acts without considering intervening factors

Answer

Relies on emotional rather than logical reasoning

Answer

Ignores the principle of patient autonomy

Question 26

The American Medical Association's (AMA) current stance on euthanasia is:

Accepted Answer

Strongly opposed

Answer

Neutral

Answer

Supportive for patients meeting specific criteria

Question 27

The legal framework surrounding end-of-life care exists primarily to:

Accepted Answer

Safeguard patient autonomy while ensuring responsible and ethical decision-making

Answer

Guarantee uniform care for all patients, regardless of their wishes

Answer

Restrain patient choices and prioritize healthcare provider preferences

Question 28

Which of the following is NOT a legally recognized advance directive in the United States?

Accepted Answer

Oral statement

Answer

Durable power of attorney for healthcare

Answer

Living will

Answer

Medical directive

Question 29

The primary goal of palliative care is to:

Accepted Answer

Provide comfort and support to patients facing a serious illness, regardless of prognosis.

Answer

Prolong life at all costs

Answer

Cure the underlying illness

Question 30

Which of the following is a legal requirement for euthanasia in the United States?

Accepted Answer

None of the above

Answer

Patient must have a written request

Answer

Patient must be of sound mind

Answer

Patient must be terminally ill

Question 31

According to the Patient Self-Determination Act (PSDA), competent patients have the right to:

Accepted Answer

Make informed decisions about their medical treatment, including refusing treatment.

Answer

Receive treatment against their will

Answer

Be guaranteed a cure for their illness

Question 32

The doctrine of double effect allows healthcare professionals to:

Accepted Answer

Administer medication that has both a beneficial and a harmful effect, as long as the intended outcome is the beneficial one and the harmful effect is foreseen but not intended.

Answer

Ignore the wishes of competent patients

Question 33

Which of the following is a potential legal defense against a wrongful death lawsuit in the context of end-of-life care?

Accepted Answer

Patient consent, demonstrating that the patient willingly accepted the risks and potential outcomes of their care.

Answer

Negligence

Answer

Lack of informed consent

Answer

Contributory negligence

Question 34

The primary role of a healthcare proxy in end-of-life care is to:

Accepted Answer

Make medical decisions on behalf of an incapacitated patient, following their previously expressed wishes or best interests.

Answer

Provide physical care for the patient

Answer

Advocate for the patient's wishes

Question 35

Which of the following factors should be considered when making end-of-life decisions?

Accepted Answer

All of the above

Answer

Medical prognosis

Answer

Patient's wishes

Answer

Ethical principles

Question 36

The withdrawal of life-sustaining treatment is generally considered to be:

Accepted Answer

Legally and ethically permissible if the patient is terminally ill and has made a valid decision to refuse treatment, documented through an advance directive or expressed wishes.

Answer

Illegal under all circumstances

Question 37

According to the Patient Self-Determination Act in the United States, which of the following is true?

Accepted Answer

Hospitals are required to inform patients of their right to make end-of-life care decisions

Answer

Healthcare providers can override patient preferences for end-of-life care

Answer

Healthcare providers are prohibited from discussing end-of-life care options with patients

Question 38

Which of the following is NOT a stated goal of palliative care?

Accepted Answer

Curing the underlying disease

Answer

Providing emotional and spiritual support to patients and their families

Answer

Improving the overall quality of life for patients with serious illnesses

Answer

Managing pain and other distressing symptoms

Question 39

Euthanasia can be defined as:

Accepted Answer

Intentionally ending a patient's life to relieve incurable suffering

Answer

Allowing a patient to die naturally without medical intervention

Answer

Providing comfort and support to a patient facing end-of-life issues

Question 40

Which of the following is a valid legal defense for healthcare providers who assist in a patient's suicide?

Accepted Answer

None of the above

Answer

The patient's consent

Answer

The healthcare provider's belief that the patient is suffering

Answer

The patient's terminal illness

Question 41

When making end-of-life care decisions, healthcare professionals should prioritize:

Accepted Answer

The patient's wishes and values

Answer

The wishes of the patient's family

Answer

Their own personal beliefs

Answer

The hospital's policies and procedures

Question 42

Palliative sedation is a medical intervention that:

Accepted Answer

Uses medication to reduce a patient's consciousness and relieve refractory suffering

Answer

Is always used to hasten a patient's death

Answer

Is only provided to patients who are terminally ill

Question 43

Which of the following is a primary advantage of having a healthcare proxy?

Accepted Answer

It ensures that someone will make medical decisions on behalf of the patient if they become unable to do so

Answer

It guarantees that the patient's wishes will always be honored

Question 44

The concept of 'double effect' in end-of-life care refers to:

Accepted Answer

An action that has both a desired and an undesired effect, where the desired effect is morally justified

Answer

The use of multiple medications to relieve a patient's pain

Question 45

A patient with terminal cancer, deemed legally competent, requests that their physician provide medication to end their life due to significant pain. However, their signed living will refuses life-sustaining treatment. Under US law, which statement most accurately describes the physician's legal and ethical obligations?

Accepted Answer

The physician cannot legally fulfill the patient's request for assisted suicide but must address their pain and suffering through palliative care.

Answer

The physician must honor the patient's request based on the principle of patient autonomy outlined in the living will.

Question 46

Which of the following is a primary distinction between a living will and a durable power of attorney for healthcare?

Accepted Answer

A living will outlines the patient's wishes for medical treatment, while a durable power of attorney designates an individual to make medical decisions on their behalf.

Answer

A living will takes effect only upon the patient's death, while a durable power of attorney is applicable during their lifetime.

Question 47

In a situation where a patient in a persistent vegetative state has no advance directives and their family is in disagreement about continuing life-sustaining treatment, what is the most appropriate legal recourse for resolving the dispute?

Accepted Answer

The case may be brought before a court, which will consider ethical principles, medical evidence, and family testimony to make a decision in the patient's best interests.

Answer

The physician is legally obligated to continue life-sustaining treatment until a unanimous family decision is reached.

Question 48

Which of the following situations would be considered a potential violation of the Patient Self-Determination Act (PSDA)?

Accepted Answer

A hospital refuses admission to a patient due to their lack of a completed living will.

Answer

A physician engages in a discussion of treatment options with a terminally ill patient, highlighting both benefits and risks.

Answer

A nurse provides emotional support to a patient and their family as they navigate challenging end-of-life decisions.

Question 49

In medical ethics, the concept of 'double effect' is most relevant to which end-of-life care practice?

Accepted Answer

Administering pain medication that may incidentally hasten a patient's death.

Answer

Withholding or withdrawing life-sustaining treatment at the patient's request.

Answer

Providing comfort care measures such as massage and aromatherapy.

Question 50

Which of the following is a significant ethical concern related to the increasing availability of life-sustaining technologies in end-of-life care?

Accepted Answer

Prolonging life beyond the point of meaningful existence and potentially increasing suffering.

Answer

Eliminating the need for palliative care and hospice services.

Answer

Reducing healthcare costs associated with end-of-life care.

Question 51

Regarding the legal status of euthanasia in the United States, which statement is most accurate?

Accepted Answer

Euthanasia is generally illegal, although some states have authorized physician-assisted suicide under specific conditions.

Answer

Euthanasia is legal nationwide for patients with terminal illnesses and unbearable suffering.

Question 52

Which of the following is NOT a core component of palliative care?

Accepted Answer

Providing curative treatments to eliminate the underlying disease.

Answer

Managing pain and other distressing symptoms.

Answer

Providing emotional and spiritual support to the patient and family.

Question 53

When providing end-of-life care to patients from diverse cultural backgrounds, a major ethical challenge is:

Accepted Answer

Respecting cultural beliefs and practices regarding death and dying while ensuring informed consent and patient autonomy.

Answer

Ensuring all patients receive the same standardized end-of-life care regardless of their cultural background.

Question 54

Which of the following best describes the function of hospice care within the continuum of end-of-life care options?

Accepted Answer

Hospice care provides comfort and support to patients with a life expectancy of six months or less.

Answer

Hospice care offers experimental treatments and interventions to extend life.

Answer

Hospice care primarily focuses on curing the patient's underlying illness.