PSY 456 CHAPTER 6

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1. (p. 214) By acknowledging the inevitability of death we
A. can prepare for it.
B. become sad and worried.
C. are more open to near death experiences.
D. may divest of financial burdens.

A. can prepare for it.

2. (p. 214) In which of the following is the individual’s right to autonomy violated? A. An older woman who refuses to undergo back surgery
B. An older man whose physician and family coerce him to have foot surgery C. An infant whose parents elect for surgery to correct a congenital heart defect
D. An athlete who seeks a second opinion based on his coach’s suggestion

B. An older man whose physician and family coerce him to have foot surgery

3. (p. 214-215) Three principles of medical ethics are
A. competence, information, non-maleficence.
B. autonomy, beneficence, justice. C. impartiality, prognosis, support.
D. public acceptance, honesty, freedom.

B. autonomy, beneficence, justice.

4. (p. 215) What is a fundamental principle in medical care which involves doing good or conferring benefits that enhance personal or social well-being? A. Autoficence
B. Comfort measures only (CMO) C. Beneficence
D. Medical heroics

C. Beneficence

5. (p. 215) What is a fundamental principle in medical care which is the injunction to "do no harm?"
A. Nonmaleficence
B. Beneficence
C. Assistance
D. Etiologicality

A. Nonmaleficence

6. (p. 215) Informed consent is based on a patient’s competency to give consent, adequate understanding of proposed treatment, and
A. faith in the doctor’s advice.
B. consent must be given freely. C. appropriateness of treatment goals. D. the agreement of family or close friends.

B. consent must be given freely.

7. (p. 216) What year did informed consent achieve formal legal definition?
A. 1929
B. 1945
C. 1957
D. 1963

C. 1957

8. (p. 216) Informed consent ideally occurs within a context where the
A. health-care provider will decide what is best.
B. patient and health-care provider share in decision making.
C. patient decides whether to follow the advice of the doctor.
D. patient seeks a second opinion.

B. patient and health-care provider share in decision making.

9. (p. 216) A study in 1961 found that, __________ doctors had a strong tendency to withhold information.
A. few
B. most
C. military
D. hospital-based

B. most

10. (p. 219) The SUPPORT STUDY was designed to
A. help families find an appropriate hospice program.
B. aid hospitals in developing end-of-life protocols.
C. unionize hospital personnel.
D. assess communication between physician and patient at the end-of-life.

D. assess communication between physician and patient at the end-of-life.

11. (p. 219) Patients at the end-of-life may not want disruptive medical interventions. The preference can be recognized in a medical setting by designating the patient as
A. prognosis and preferences.
B. tacit communications.
C. comfort measures only.
D. withhold and withdraw.

C. comfort measures only.

12. (p. 222) Ethical questions regarding the "right to die" first came to public attention in the landmark court case involving A. Nancy Beth Cruzan. B. Karen Ann Quinlan. C. Nancy Ellen Jobes. D. Elizabeth Bouvia.

B. Karen Ann Quinlan.

13. (p. 222) All of the following occurred with Karen Ann Quinlan EXCEPT A. Quinlan’s parents requested that she be removed from a mechanical respirator. B. the request of Karen’s parents was opposed by the hospital officials and resulted in a judicial suit.
C. the Supreme Court of New Jersey ruled in favor of the hospital officials and Karen remained on the respirator.
D. Karen’s case became the focal point for issues pertaining to "death with dignity."

C. the Supreme Court of New Jersey ruled in favor of the hospital officials and Karen remained on the respirator.

14. (p. 222) The controversy surrounding the Karen Ann Quinlan case centered on the
A. abuse of prescription drugs. B. separation of church and state.
C. issue of transplantation.
D. right to forgo life-sustaining treatment.

D. right to forgo life-sustaining treatment.

15. (p. 222) What position did the state of Missouri initially take in the Nancy Beth Cruzan case?
A. It contended that Nancy’s parents did not have the right to remove artificial feeding.
B. It contended that the medical center did not have the right to remove Nancy’s feeding tube.
C. It deferred to federal law requiring Nancy to be sustained by artificial feeding. D. It deferred to medical professionals to determine Nancy’s fate.

A. It contended that Nancy’s parents did not have the right to remove artificial feeding.

16. (p. 223) What is a state of profound unconsciousness lasting a few days or weeks?
A. Persistent vegetative state
B. Minimally conscious state
C. Coma
D. Post-coma unresponsiveness

C. Coma

17. (p. 223) What disorder of consciousness has been characterized as "awake but unaware" and also has been called "hopelessly conscious?"
A. Coma
B. Vegetative state
C. Locked-in syndrome
D. Minimally conscious state (MCS)

B. Vegetative state

18. (p. 224) The case of Terry Schiavo was compounded by the fact that
A. her husband argued that she was conscious, and not in a PVS (persistent vegetative state).
B. the U.S. Supreme Court declined to grant judicial review.
C. she was subpoenaed to testify at a congressional "field hearing."
D. she had not completed her advance directive.

D. she had not completed her advance directive.

19. (p. 227) Studies of the Oregon Death with Dignity Act show that the decision to request a prescription for lethal medication was associated mainly with patients’ concerns about loss of dignity, loss of ability to have an enjoyable life, and loss of
A. cognitive functioning.
B. independence in toileting.
C. youthful looks.
D. autonomy.

D. autonomy.

20. (p. 227) Currently, physician-assisted death is permitted by legislation enacted in
A. California and Ohio.
B. Nevada and Michigan.
C. Oregon and Washington.
D. New York and Pennsylvania.

C. Oregon and Washington.

21. (p. 227) In May 2013, which state senate passed and the governor signed the Patient Choice and Control at End-of-Life Act?
A. North Carolina
B. New Mexico
C. Vermont
D. New Hampshire

C. Vermont

22. (p. 227) Which act allows physicians to prescribe lethal medication to terminally ill patients?
A. California Patient Compassion Act (CPCA)
B. Oregon Death with Dignity Act (ODDA) C. United States Terminal Sedation Act (USTSA)
D. New York Samaritan Death Act (NYSDA)

B. Oregon Death with Dignity Act (ODDA)

23. (p. 228) Who provided aid-in-dying to more than 100 people and led a crusade to legalize physician-assistant suicide? A. Thomas Youk
B. Jack Kevorkian
C. John Pridonoff
D. Madeline Jacobs

B. Jack Kevorkian

24. (p. 229) In the medical management of pain, what rule states that a harmful effect of treatment, even if it results in death, is permissible if the harm is not intended and occurs as a side effect of a beneficial action?
A. Oregon Death with Dignity rule
B. Rule of double effect
C. Euthanasia rule
D. Rule of beneficence

B. Rule of double effect

25. (p. 229) Euthanasia comes from the Greek
A. quick death.
B. easy death.
C. forever sleep.
D. deliberate death.

B. easy death.

26. (p. 230) Which industrialized countries are identified in the text as permitting euthanasia to patients who request death?

1. United States and Japan
2. Netherlands and Belgium
3. Belgium and Luxembourg
4. United Kingdom and Japan

A. 1 and 2
B. 2 and 3
C. 1 and 4
D. 2 and 4

B. 2 and 3

27. (p. 230) Which of the following statements presents a case against euthanasia using the "wedge" or "slippery slope" argument?
A. "Euthanasia may or may not be moral, but by permitting it we may unwittingly pave the way for acts that are clearly immoral."
B. "Euthanasia is contrary to the Hippocratic Oath, which pledges physicians to sustain life not take it." C. "Euthanasia may or may not be ethical, but by permitting it we may unwittingly create a burden on the judiciary when such decisions enter the legal arena." D. "Euthanasia is contrary to good ethical judgment because medical science is not infallible and a mistaken diagnosis could cause a needless death."

A. "Euthanasia may or may not be moral, but by permitting it we may unwittingly pave the way for acts that are clearly immoral."

28. (p. 234) Which of the following is a statement by a competent person about choices for medical treatment, should he or she become unable to make such decisions or communicate them in the future?
A. Holographic will
B. Advance directive
C. Natural death act
D. Beneficent consent

B. Advance directive

29. (p. 234) An advanced directive is best defined as
A. any statement made by a competent person about choices for medical treatment, should he or she become unable to make or communicate such choices.
B. an amendment to a will.
C. a situation of dying without having made a will.
D. the process by which an estate is settled and distributed in advance of the death.

A. any statement made by a competent person about choices for medical treatment, should he or she become unable to make or communicate such choices.

30. (p. 234) The living will is a
A. type of conditional will.
B. donation of gifts from an estate before the benefactor is deceased.
C. type of advance directive.
D. naming of an estate trustee in case of death.

C. type of advance directive

31. (p. 234) A living will allows an individual to
A. describe the things they want to do before they die.
B. refuse life-sustaining treatment in the event he or she is terminally ill. C. communicate instructions to their family for estate and funeral planning.
D. require a physician to keep them alive at all costs.

B. refuse life-sustaining treatment in the event he or she is terminally ill.

32. (p. 234) Which state became the first to adopt a Natural Death Act giving legal recognition to the living will?
A. California
B. Florida
C. New Jersey
D. New Mexico

A. California

33. (p. 234) Which state was the first to give legal recognition to the living will? A. California
B. Florida
C. New Jersey
D. New Mexico

A. California

34. (p. 237) Which organization created the Five Wishes document?
A. Aging with Dignity
B. Florida Bar Association
C. American Medical Association D. American Association of Retired Persons

A. Aging with Dignity

35. (p. 237) What document combines a living will and a health care power of attorney?
A. Double Power Will
B. Physician Order for Life-Sustaining Treatment
C. Viatical settlement
D. Five Wishes

D. Five Wishes

36. (p. 238) The Patient Self-Determination Act requires providers of services under Medicare and Medicaid to do which of the following?
A. Inform patients of their rights to appoint a health care proxy and draw up written instructions regarding treatment.
B. Refuse admission to patients who fail to sign an advance directive.
C. Document the patient’s Five Wishes. D. Determine patient’s length of stay.

A. Inform patients of their rights to appoint a health care proxy and draw up written instructions regarding treatment.

37. (p. 242) According to Barton Bernstein, the first legal stage in cases of terminal illness
A. occurs immediately after the patient dies.
B. involves the patient in long-range planning and arranging legal and financial affairs.
C. involved writing one’s Five Wishes. D. involves delivering the will for probate.

B. involves the patient in long-range planning and arranging legal and financial affairs.

38. (p. 242) According to Barton Bernstein, the second legal stage in cases of terminal illness involves which of the following activities?
A. Deliver the will for probate
B. Survivors obtain sufficient funds to cover immediate expenses
C. Notify the attorney and insurance representatives
D. Medical personnel being notified if the dying patient intends to make an organ donation or anatomical gift

D. Medical personnel being notified if the dying patient intends to make an organ donation or anatomical gift

39. (p. 243) What type of will is made orally?
A. Conditional will
B. Holographic will
C. Nuncupative will
D. Verbal will

C. Nuncupative will

40. (p. 243 and 247) A codicil relates to A. rewriting a will.
B. amending a will.
C. making an oral will.
D. formalizing a will.

B. amending a will.

41. (p. 243 and 248) What is the condition when a person dies without having left a valid will?
A. Intestate
B. Attestation
C. In holographic
D. Testator

A. Intestate

42. (p. 245) The conventional written legal document used for specifying a person’s wishes for the distribution of his or her estate after death is a/an
A. ethical will.
B. nuncupative will.
C. formally executed will.
D. testament.

C. formally executed will.

43. (p. 246-247) How can a will be amended?
A. It cannot be amended after it is signed. B. It must be completely replaced if a change is requested.
C. By executing a codicil.
D. By the executor during the reading of the will.

C. By executing a codicil.

44. (p. 248 and 251) In attempting to settle an estate, the court will make a determined effort to locate heirs. If none can be found the proceeds go to the A. United Way.
B. local non-profit family bereavement care center.
C. state.
D. federal government.

C. state.

45. (p. 248) If a person dies without leaving a valid will, his or her property will be distributed according to
A. familial wishes.
B. federal rules.
C. state rules.
D. whatever the spouse requests.

C. state rules.

46. (p. 251) According to the laws of intestate succession, when no surviving heirs can be found, then proceeds from the estate go to
A. charity.
B. the state.
C. the IRS.
D. the executor.

B. the state.

47. (p. 253) The potential benefits of life insurance include all of the following EXCEPT it
A. usually makes funds available immediately after death.
B. increases social security benefits.
C. may reduce stress.
D. may provide relief and a sense of security to the bereaved spouse and other dependents.

B. increases social security benefits.

48. (p. 253) In the United States, the first insurance company was established
A. by the Presbyterian Synod for its ministers.
B. by the Catholic Archdiocese for its nuns and priests.
C. by the City of New York for its firefighters.
D. by the federal government for its soldiers.

A. by the Presbyterian Synod for its ministers.

49. (p. 253) When was the first life insurance company established in the United States?
A. 1759
B. 1859
C. 1863
D. 1763

A. 1759

50. (p. 254) What type of settlement allows a person with terminal illness to sell his or her life insurance policy before death and receive a percentage of its face value? A. volume
B. viatical
C. compensatory
D. percentage

B. viatical

51. (p. 214) Personal autonomy is restricted when passengers on an airline are required to wear seat belts.
TRUE or FALSE

TRUE

52. (p. 216) Physicians in the 1960s tended to withhold information regarding a life threatening condition.
TRUE or FALSE

TRUE

53. (p. 222) The New Jersey Supreme Court allowed Karen Ann Quinlan’s parents to discontinue her artificial respiration.
TRUE or FALSE

TRUE

54. (p. 222) In the case involving Nancy Beth Cruzan in 1990, the Missouri Supreme Court ultimately ruled that her parents could have her feeding tube removed. TRUE or FALSE

TRUE

55. (p. 225) The right to refuse treatment remains constitutionally protected even when a patient is unable to communicate. TRUE or FALSE

TRUE

56. (p. 225) Passive euthanasia is the bringing about of death through the administration of lethal injection.
TRUE or FALSE

FALSE

57. (p. 225) There is no medical or ethical distinction between withholding and withdrawing treatment.
TRUE or FALSE

TRUE

58. (p. 231) Some people view removal of artificial nutrition and hydration as intentional killing.
TRUE or FALSE

TRUE

59. (p. 235) By the end of the twentieth century, less than half of the U.S. had passed some form of living will legislation. TRUE or FALSE

FALSE

60. (p. 235) Most Americans lack living wills.
TRUE or FALSE

TRUE

61. (p. 235) Living wills contain physician orders and must be followed by emergency medical technicians.
TRUE or FALSE

FALSE

62. (p. 237) The health care proxy must be an attorney not a relative to carry out your wishes.
TRUE or FALSE

FALSE

63. (p. 240) Do-not-resuscitate orders are a type of advance directive.
TRUE or FALSE

TRUE

64. (p. 241) Paramedics and EMT’s are legally required to initiate CPR unless there is clear evidence of a valid DNR order. TRUE or FALSE

TRUE

65. (p. 244) State laws specify a minimum age of 21 to make a legal will.
TRUE or FALSE

FALSE

66. (p. 244) Financial advisors do not recommend the "family love letter" as it often contains emotional information and confuses EOL issues and personal desires after death.
TRUE or FALSE

FALSE

67. (p. 245) Ethical wills are a twentieth century, new means to pass on wisdom, love, and personal values.
TRUE or FALSE

FALSE

68. (p. 250) Statistics show that most people die without leaving a will.
TRUE or FALSE

TRUE

69. (p. 256) End-of-life issues and decisions are a private matter bearing directly on families and do not affect the realm of public policy.
TRUE or FALSE

FALSE

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