CAPS I MIDTERM EXAM 250 QUESTIONS &
CORRECT ANSWERS LATEST 2025
What is the first step in a clinician's approach to clinical ethical reasoning?
State the problem plainly.
What data categories should you gather and organize in clinical ethical reasoning?
Medical facts, medical goals, patient goals/preferences, and context.
After gathering data, what two questions must you ask in the clinician's approach?
Is the problem ethical? Is more information or dialogue needed?
Name three kinds of reasons you can use to support the best course of action in
ethical reasoning.
Ethical principles, consequences (outcomes/utilitarian reasoning), and professional
guidelines (including virtues and comparable cases).
What are the four Topics in the "Four Topics" approach?
Medical Indications, Patient Preferences, Quality of Life, Contextual Features.
What principle(s) do Medical Indications primarily address?
Beneficence and nonmaleficence.
What main principle does Patient Preferences address?
Respect for autonomy.
What issues are assessed under Quality of Life in the Four Topics?
Prospects with/without treatment, biases in evaluation, whether QOL judgments
justify changing treatment plans, plans for comfort if forgoing life-sustaining
treatment.
What kinds of issues belong to Contextual Features?
,Conflicts of interest, family or third-party interests, confidentiality limits,
financial/resource allocation, legal/religious/public health considerations,
research/education implications.
Define moral pluralism and one key implication for clinical practice.
Moral pluralism is the fact that people disagree about foundational beliefs and
sources of ethical authority; implication: clinicians need humility and respect in
shared decision-making.
List the four basic principles of biomedical ethics.
Beneficence, Nonmaleficence, Respect for Autonomy, Justice.
How does a prima facie principle differ from an absolute principle?
A prima facie principle holds unless outweighed by stronger competing principles
in a particular situation.
Give an example of a tension between beneficence and nonmaleficence.
Prescribing anticoagulation for atrial fibrillation (benefit of stroke prevention) vs
increased bleeding risk (harm).
What is relational autonomy?
A view of autonomy that recognizes patients' decisions are often supported or
shaped by relationships and may require help from others to exercise.
What is role fidelity and why is it important?
Role fidelity is prioritizing obligations specific to one's professional role (e.g.,
clinician's primary responsibility to individual patients); it supports a division of
moral labor and fairness across roles.
Name three virtues expected of healthcare professionals.
Honesty, compassion, integrity (also benevolence, courage, temperance, fidelity to
trust, practical wisdom).
How are principles and virtues related?
They are complementary: principles provide rules or duties; virtues shape the
agent's character and motivation to apply principles well.
What is conscience in the clinical context?
, A combination of moral reasoning, moral emotion, and moral motivation that
orients a clinician to right and wrong and to the obligation to do good.
What is moral distress and one common cause in clinical training?
Moral distress is feeling constrained from doing what one believes is right;
commonly caused by hierarchical pressures or institutional constraints.
What is utilitarian (consequentialist) reasoning in ethics?
An approach that judges actions by their consequences, aiming to maximize
overall good (greatest good for the greatest number).
Name two challenges of consequence-based (utilitarian) reasoning.
Predicting all relevant consequences and avoiding sacrifice of individuals for the
greater good without person-respecting justice.
Why must treatment decisions arise from goals-of-care discussions rather than
focusing only on interventions?
Because overall goals (cure, prolong life, maintain function, comfort, achieve life
goals) guide which interventions are appropriate and align care with patient values.
List the mnemonic CLFCLFC and what it stands for (goals of care).
Cure, Live longer, Function/quality/independence, Comfort, Life goals, Family
support/caregiver support, Clarify diagnosis/prognosis.
Give three examples of specific, measurable treatment goals for chronic pain.
Increased ability to perform ADLs, fewer missed work days, attending a
meaningful activity (e.g., going to a family event).
When a patient lacks capacity and has no surrogate, which Four Topics questions
become most urgent?
Patient Preferences (prior expressed wishes), Quality of Life (best interests),
Contextual Features (legal/ethical safeguards).
What steps should you follow when you suspect an ethical problem might instead
be poor communication or interpersonal conflict?
Re-evaluate: check for poor communication, strained relationships, or incomplete
exploration of medical alternatives before labeling it an ethical problem.
CORRECT ANSWERS LATEST 2025
What is the first step in a clinician's approach to clinical ethical reasoning?
State the problem plainly.
What data categories should you gather and organize in clinical ethical reasoning?
Medical facts, medical goals, patient goals/preferences, and context.
After gathering data, what two questions must you ask in the clinician's approach?
Is the problem ethical? Is more information or dialogue needed?
Name three kinds of reasons you can use to support the best course of action in
ethical reasoning.
Ethical principles, consequences (outcomes/utilitarian reasoning), and professional
guidelines (including virtues and comparable cases).
What are the four Topics in the "Four Topics" approach?
Medical Indications, Patient Preferences, Quality of Life, Contextual Features.
What principle(s) do Medical Indications primarily address?
Beneficence and nonmaleficence.
What main principle does Patient Preferences address?
Respect for autonomy.
What issues are assessed under Quality of Life in the Four Topics?
Prospects with/without treatment, biases in evaluation, whether QOL judgments
justify changing treatment plans, plans for comfort if forgoing life-sustaining
treatment.
What kinds of issues belong to Contextual Features?
,Conflicts of interest, family or third-party interests, confidentiality limits,
financial/resource allocation, legal/religious/public health considerations,
research/education implications.
Define moral pluralism and one key implication for clinical practice.
Moral pluralism is the fact that people disagree about foundational beliefs and
sources of ethical authority; implication: clinicians need humility and respect in
shared decision-making.
List the four basic principles of biomedical ethics.
Beneficence, Nonmaleficence, Respect for Autonomy, Justice.
How does a prima facie principle differ from an absolute principle?
A prima facie principle holds unless outweighed by stronger competing principles
in a particular situation.
Give an example of a tension between beneficence and nonmaleficence.
Prescribing anticoagulation for atrial fibrillation (benefit of stroke prevention) vs
increased bleeding risk (harm).
What is relational autonomy?
A view of autonomy that recognizes patients' decisions are often supported or
shaped by relationships and may require help from others to exercise.
What is role fidelity and why is it important?
Role fidelity is prioritizing obligations specific to one's professional role (e.g.,
clinician's primary responsibility to individual patients); it supports a division of
moral labor and fairness across roles.
Name three virtues expected of healthcare professionals.
Honesty, compassion, integrity (also benevolence, courage, temperance, fidelity to
trust, practical wisdom).
How are principles and virtues related?
They are complementary: principles provide rules or duties; virtues shape the
agent's character and motivation to apply principles well.
What is conscience in the clinical context?
, A combination of moral reasoning, moral emotion, and moral motivation that
orients a clinician to right and wrong and to the obligation to do good.
What is moral distress and one common cause in clinical training?
Moral distress is feeling constrained from doing what one believes is right;
commonly caused by hierarchical pressures or institutional constraints.
What is utilitarian (consequentialist) reasoning in ethics?
An approach that judges actions by their consequences, aiming to maximize
overall good (greatest good for the greatest number).
Name two challenges of consequence-based (utilitarian) reasoning.
Predicting all relevant consequences and avoiding sacrifice of individuals for the
greater good without person-respecting justice.
Why must treatment decisions arise from goals-of-care discussions rather than
focusing only on interventions?
Because overall goals (cure, prolong life, maintain function, comfort, achieve life
goals) guide which interventions are appropriate and align care with patient values.
List the mnemonic CLFCLFC and what it stands for (goals of care).
Cure, Live longer, Function/quality/independence, Comfort, Life goals, Family
support/caregiver support, Clarify diagnosis/prognosis.
Give three examples of specific, measurable treatment goals for chronic pain.
Increased ability to perform ADLs, fewer missed work days, attending a
meaningful activity (e.g., going to a family event).
When a patient lacks capacity and has no surrogate, which Four Topics questions
become most urgent?
Patient Preferences (prior expressed wishes), Quality of Life (best interests),
Contextual Features (legal/ethical safeguards).
What steps should you follow when you suspect an ethical problem might instead
be poor communication or interpersonal conflict?
Re-evaluate: check for poor communication, strained relationships, or incomplete
exploration of medical alternatives before labeling it an ethical problem.
