Deck 4: Truth-Telling and Confidentiality

Question 1

For an act-utilitarian, the morality of truth-telling and confidentiality must be judged

A) according to relevant rules.
B) by reference to patient rights.
C) case by case.
D) by abstract principles.

Answer 1

C

Question 2

Many skeptics of full disclosure have argued that physicians have no duty to tell patients the truth because

A) patients are well-informed.
B) patients are not true moral agents.
C) patients are incapable of understanding the truth.
D) there is no truth to disclose.

Answer 2

C

Question 3

Some proponents of full disclosure argue that

A) the truth is rarely important.
B) patients are never upset by knowing the truth.
C) patients are incapable of understanding the truth.
D) conveying the "whole truth and nothing but the truth" is unnecessary.

Answer 3

D

Question 4

In the Hippocratic Oath, the physician's respect for confidentiality is

A) clearly expressed.
B) rejected.
C) never mentioned.
D) ambiguously expressed.

Question 5

The physician's duties of confidentiality and preventing harm are

A) never in conflict.
B) sometimes in conflict in HIV cases.
C) never in conflict in HIV cases.
D) suspended in HIV cases.

Question 6

A(n) _______ can argue for confidentiality using the right to privacy-autonomous persons have a right to control access to information about themselves and to intrusion into their private affairs.

A) consequentialist
B) nonconsequentialist
C) act-utilitarian
D) rule-utilitarian

Question 7

A(n) _______ would judge the morality of truth-telling and confidentiality on a case-by-case basis.

A) Kantian
B) virtue ethicist
C) act-utilitarian
D) rule-utilitarian

Question 8

A(n) _______ might argue that the greatest amount of good is produced when physicians tell patients the truth about their condition with care and sensitivity. So, physicians have a duty to truth-telling.

A) Kantian
B) virtue ethicist
C) act-utilitarian
D) rule-utilitarian

Question 9

A(n) _______ might argue in favor of confidentiality by pointing out that if a physician cultivates an abiding character trait of fidelity, they will be more likely to keep their promises to patients and to maintain their confidences.

A) Kantian
B) virtue ethicist
C) act-utilitarian
D) rule-utilitarian

Question 10

A(n) _______ would argue that lying to patients is a clear violation of the principle of autonomy and is not permissible under any circumstances.

A) Kantian
B) virtue ethicist
C) act-utilitarian
D) rule-utilitarian

Question 11

Imagine you are an ER doctor. An adult patient comes in with serious injuries and is the apparent victim of abuse. You consider whether you ought to reveal this information to authorities, and so are balancing your duty to confidentiality against a duty

A) to warn.
B) of truth-telling.
C) to informed consent.
D) to utility.

Question 12

Imagine you are a physician. You tell your patient she has tested positive for HIV and that she should tell her spouse, who could become infected through sexual intercourse. She says she will not disclose her HIV status to anyone. You consider whether you ought to reveal this information to her spouse, and so are balancing your duty to confidentiality against a duty

A) to warn.
B) of truth-telling.
C) to informed consent.
D) to utility.

Question 13

You are a doctor in a burn unit. One of your patients has severe burns on most of his body. His prognosis for survival is good, but you know his recovery will be extremely painful and require many surgeries over the next ten to twenty years. You consider whether you ought to reveal the full details of his prognosis and treatment given that it will cause anxiety, fear, and might make his recovery even more difficult. You are balancing your duty to do no harm against a duty

A) to warn.
B) of truth-telling.
C) to informed consent.
D) to utility.

Question 14

A doctor who withholds crucial facts about a patient's diagnosis and avoids precise statements about their prognosis to protect them mentally and emotionally is

A) acting in accordance with the categorical imperative.
B) acting paternalistically.
C) giving false information.
D) respecting confidentiality.

Question 15

The main argument in favor of truth-telling rests on the principle of

A) beneficence.
B) justice.
C) utility.
D) autonomy.

Question 16

Disclosure of confidential medical information has exposed some patients to discrimination from insurance companies and employers.

Question 17

Physicians agree that the obligation to respect confidentiality is absolute.

Question 18

Views toward truth-telling when people are seriously ill rarely vary.

Question 19

In today's health care system, complete confidentiality is feasible.

Question 20

Kantian ethics implies an unambiguous duty to truth-telling and confidentiality.

Question 21

The obligation of truth-telling has been enshrined in codes of medical ethics from ancient times.

Question 22

Moral dilemmas about disclosure and truth-telling in medicine often involve conflicts between a physician's duty to do no harm and the obligation of veracity.

Question 23

Confidentiality concerns patients imparting information to health professionals who promise, implicitly or explicitly, not to disclose that information to others.

Question 24

The obligation of confidentiality has been enshrined in codes of medical ethics from ancient times.

Question 25

The only arguments for confidentiality are consequentialist arguments.

Question 26

The law reflects an absolutist view of confidentiality.

Question 27

In Kantian ethics, the morality of truth-telling and confidentiality are unambiguous.

Question 28

A major threat to the traditional conception of confidentiality is bureaucratized health care systems.

Question 29

A Kantian would argue that the main reason for confidentiality is that disclosure of confidential medical information could have negative effects on the lives of patients. It might expose patients to discrimination, disrupt their personal relationships, and subject them to shame or public ridicule.

Question 30

Someone insisting that any breach of confidentiality undermines trust between physicians and patients and amounts to impermissible deception is arguing that the obligation to respect confidentiality is prima facie.

Question 31

Skeptics of full disclosure often argue that physicians have no duty to tell patients the truth because patients are incapable of understanding the whole truth. Explain this argument in detail and offer one common objection to it.

Question 32

Provide a consequentialist argument for confidentiality.

Question 33

How would a Kantian assess the morality of the "duty to warn" in the context of confidentiality?

Question 34

Explain how act- and rule-utilitarian arguments regarding the morality of truth-telling would differ.

Question 35

Provide a basic outline of the Tarasoff v. Regents of the University of California case, the result, and the bioethical conflict at its heart.

Question 36

The Following Questions For Readings: "On Telling Patients the Truth," Mack Lipkin
-According to Lipkin, it is usually impossible to tell patients the whole truth because

A) they are unsophisticated.
B) the stress of being sick can distort patients' thinking.
C) patients have no medical training.
D) doctors lack the ability to explain medical concepts in a way that patients can understand.

Question 37

The Following Questions For Readings: "On Telling Patients the Truth," Mack Lipkin
-Lipkins's attitude toward truth-telling is

A) paternalistic.
B) anti-paternalistic.
C) sympathetic.
D) divisive.

Question 38

The Following Questions For Readings: "On Telling Patients the Truth," Mack Lipkin
-Lipkin says that the crucial question in truth-telling is whether the

A) deception is successful in disguising the truth.
B) patient appreciates the reasons for the deception.
C) deception is intended to benefit the patient or the doctor.
D) deception is unintended.

Question 39

The Following Questions For Readings: "Is It Ever OK to Lie to Patients?" Shelly K. Schwartz
-Schwartz says that physicians are often forced to balance compassion with

A) mercy.
B) culture.
C) cruelty.
D) the patient's right to know.

Question 40

The Following Questions For Readings: "Is It Ever OK to Lie to Patients?" Shelly K. Schwartz
-Schwartz says that the most common argument against obligatory truth-telling is

A) the regret the doctor may feel for having told the whole truth.
B) the distrust between doctor and patient that truth-telling causes.
C) truth-telling causes depression and early death.
D) the impact it may have on the patient's physical or emotional state.

Question 41

The Following Questions For Readings: "Is It Ever OK to Lie to Patients?" Shelly K. Schwartz
-Schwartz says that most studies over the last decade found that patients who were told candidly they are going to die

A) lived as long as those who were not told.
B) did not live as long as those who were not told.
C) lived longer than those who were not told.
D) required extensive psychological counseling.

Question 42

The Following Questions For Readings: "Why Privacy Is Important," James Rachels
-Rachels says there is a close connection between our ability to control who has access to us and information about us and our

A) ability to regulate our exposure to social media.
B) patterns of behavior.
C) ability to define our goals and sense of meaning.
D) ability to create and maintain different sorts of social relationships with different people.

Question 43

The Following Questions For Readings: "Why Privacy Is Important," James Rachels
-Rachels argues that privacy is necessary if we are to

A) prevent embarrassment to ourselves.
B) have peace of mind.
C) maintain the variety of social relationships with other people that we want to have.
D) maintain the social status that we have come to enjoy.

Question 44

The Following Questions For Readings: "Why Privacy Is Important," James Rachels
-Rachels says that if we are to maintain a system of different relationships with different people, we need to

A) separate our associations.
B) unite our associations.
C) make our associations productive.
D) ignore certain associations.

Question 45

The Following Questions For Readings: "Confidentiality in Medicine-A Decrepit Concept," Mark Siegler
-Siegler says we should establish the distinction between information about the patient that generally will be kept confidential regardless of the interests of third parties and information that

A) will be released only in partial form.
B) has known errors and discrepancies.
C) will be exchanged among members of the health care team in order to provide care for the patient.
D) will never be exchanged among members of the health care team in order to provide care for the patient.

Question 46

The Following Questions For Readings: "Confidentiality in Medicine-A Decrepit Concept," Mark Siegler
-According to Siegler, confidentiality is important because it shows respect for the patient's individuality and privacy and nurtures

A) trust in the technological means of maintaining private information.
B) the bond of trust between patient and doctor.
C) the traditional concept of medical confidentiality.
D) the patient's sense of safety.

Question 47

The Following Questions For Readings: "Confidentiality in Medicine-A Decrepit Concept," Mark Siegler
-Siegler argues that in this era of high-tech health care, the traditional ideal of patient-physician confidentiality

A) exists in a very weak form.
B) has been redefined.
C) exists in practice.
D) does not exist in practice.

Question 48

The Following Questions For Readings: Tarasoff v. Regents of the University of California, Supreme Court of California
-In the Tarasoff case, the court ruled that when a patient poses a serious threat to others, the professional duties of confidentiality can be

A) especially strong.
B) overridden.
C) misconstrued.
D) unassailable.

Question 49

The Following Questions For Readings: Tarasoff v. Regents of the University of California, Supreme Court of California
-In the Tarasoff case, the court said that the risk that unnecessary warnings may be given is

A) too high a price to pay.
B) a reasonable price to pay for the lives of possible victims.
C) an unreasonable price to pay for the lives of possible victims.
D) a factor to be disregarded.

Question 50

The Following Questions For Readings: Tarasoff v. Regents of the University of California, Supreme Court of California
-In the Tarasoff case, the court ruled that some considerations

A) cannot establish a duty to warn.
B) will always undermine a duty to warn.
C) can establish a duty to warn.
D) are relative to cultures.