HSA 365 Final Exam Questions With
Complete Solutions
Ethics - ANSWER Community standards of right and wrong. Norms of conduct.
Moral principles enforced by sanctions
What influences ethics - ANSWER individual
beliefs - fam, friends, religion etc.
organization
laws
community
goals/standards of "code of ethics"
Ethical Integrity - ANSWER By John Abbott Worthley. Figuring out, with integrity,
what the "right thing" is and dealing with conflicting
"Right things"
always doing the right thing - eve in trivial situations
Macro Ethics - ANSWER Focuses on the Profession. Concerns the extraordinary
(NOT everyday). Grand scale realities that probes issues of *direct power* and
often concerns "hot button"/bioethical issues (big things, make media)
Examples of Macro Ethics - ANSWER Use of fetal tissue for stem cell research or
hospital dumping of Medicaid or uninsured patients
Micro Ethics - ANSWER Focuses on the individual professional. Concerns the
common and routine. Recognizes day-to-day "humdrum" situations such as,
probes *indirect power* and
Emphasizes contextual / interpersonal issues
Micro Ethics as Health Administrator - ANSWER Accepted standards of right
and wrong in the day-to-day. Also power / influence with:The Patient / Client and
The Staff.
3 Major elements in Health Care Effects - ANSWER 1 - Dogma
2 - Development
3 - Dilemmas
Dogma - ANSWER Situations that have
clear right vs. wrong. Acting ethically is simply doing the right thing. May be
significant pressure (internal / external) not to right thing. Stresses
rules/principles/codes
,Dogma in Macro Ethics - ANSWER Insurance fraud & abuse and misrepresenting
organizational finances to clients / Board / investors
Dogma in Micro Ethics - ANSWER Stealing a bottle of pain killers from your
facility's pharmacy for a sick neighbor
Development - ANSWER We sense there is a
right thing to do,
but not yet determined
precisely what
the right thing is
Development in Macro Ethics - ANSWER Terry Schiavo case: A Florida woman in
coma was brain dead. Parents wanted machine off, but hospital was scared to
turn off machine for manslaughter attributed to them
Development in Micro Ethics - ANSWER Accepting gifts from suppliers
Dilemmas - ANSWER When one right thing competes with another right thing.
Each side believes their way is ethically correct,
which creates ethical conflict
Dilemmas in Macro Ethics - ANSWER Does our community Hospitals agree to
stop performing abortions so we can merge with regional Catholic Work?
Dilemmas in Micro Ethics - ANSWER Does manager bend the staff attendance /
policies / etc. sometimes, usually, or always?
Nominal Ethics - ANSWER Standards that are minimally recognized, not
enforced
Example of Nominal Ethics - ANSWER going 40 in a 35 - not getting pulled over
Normative Ethics - ANSWER What should be done
Descriptive Ethics - ANSWER What is actually done
Metaethics - ANSWER Study of ethical systems
Ethics vs. Legal - ANSWER 4 quadrants of Legal & Ethical, Ethical & illegal,
Illegal & Unethical, and Legal & unethical
Quadrant I - Ethical and Legal - ANSWER Doctor - Patient confidentiality, Billing
people correctly, Truthful in medical history / notes, Providing general health
,care services (being beneficent), Publicly advertising and requesting bids from
multiple suppliers before making purchases
Quadrant III - Unethical and illegal - ANSWER Embezzlement (stealing money
from company), Discrimination in hiring, Distributing narcotics to patients for
questionable medical necessity, Misrepresenting Medicare claims (Medicare
fraud)
Quadrant II - Ethical and illegal - ANSWER Stem cell research, Medical Marijuana
where it is not actually legal, Assisted Suicide, breaching gag rule (1988-1993)
Quadrant IV - Unethical and legal - ANSWER Abortion (first trimester), not
treating the uninsured, not offering assistance to accident victims
Joint Commission - ANSWER Private nonprofit agency created by the American
Hospital Association.
They did not want government to come in and regulate the hospital. Have quality
inspection: Decide what rating hospital should receive
Tom Beauchamps & James Childress - ANSWER Proposed a linkage of moral
philosophies to ethical principles to personal or organizational guidelines to
specific personal actions
Ethics Pyramid - ANSWER (bottom to top)
Moral Philosophies --> Ethical Principles --> Rules --> Actions
Moral Philosophies - ANSWER General moral perspectives that have influenced
our culture and thought. Often abstract and general. The core underneath how
we act
Builds an ethical structure
Ethical Principles - ANSWER Derived from all or most of the moral philosophies.
Common Principles that form the underpinning for delivery of health care
services.
Examples of Ethical Principles - ANSWER -Respect for persons (patients)
-No maleficence (do no harm)
-Treat people fairly (justice)
Rules or Guidelines - ANSWER Personal, professional, or organizational
guidelines that *Set Boundaries* on our actions
Examples of Rules or Guidelines - ANSWER -Professional Codes of Ethics
-Organizational Ethics Committees
-Organizational Policies
, Ethical Actions - ANSWER Specific judgment or actions taken by you as a
specific manager to a specific ethical issue
Moral Philosophies Cores - ANSWER -Utilitarianism
-Deontology
-Natural Law (John Rawls' Theory)
-Casuistry
Other Moral Philosophies - ANSWER Not relevant to build ethical standards in
health services but may be referred to regulatory: Nihilism and Relativism.
Nihilism - ANSWER nothing is morally correct (Fatalism)
Relativism - ANSWER everything is morally correct and equivalent depending on
the circumstance
Utilitarianism - ANSWER 19th Century - Jeremy Bentham and John Stuart Mills.
Measure "goodness" by the outcome ("The end justifies the means"). Also is
Cost/benefit analysis.
The action that brings about the
most good is the morally correct choice
Deontology - ANSWER Characterized by Immanuel Kant
(18th Century).
Our moral relationship to others - based on "duty."
An action is moral if it arises from goodwill (no matter the outcome)
golden rule
Duty - ANSWER If an action is universal (right in all circumstances)
moral relationships
Natural Law - ANSWER Characterized by Thomas Aquinas (1200s) - originally
Aristotle. Ethics are based on a fundamental concern for human good.
Humans will act rationally to do good.
do good and avoid evil
community laws develop from rational humans seeking to do good.
Casuistry - ANSWER Case-based reasoning
in historical context.
Articulated by Albert Jonsen &
Stephen Toulmin (1988). Uses precedents & guidelines as guides to ethical
decisions. Parallel to development of law clinical standards of care
Basic Ethical Principles - ANSWER 1 - Respect for Persons
2 - Beneficence
3 - Nonmaleficence
Complete Solutions
Ethics - ANSWER Community standards of right and wrong. Norms of conduct.
Moral principles enforced by sanctions
What influences ethics - ANSWER individual
beliefs - fam, friends, religion etc.
organization
laws
community
goals/standards of "code of ethics"
Ethical Integrity - ANSWER By John Abbott Worthley. Figuring out, with integrity,
what the "right thing" is and dealing with conflicting
"Right things"
always doing the right thing - eve in trivial situations
Macro Ethics - ANSWER Focuses on the Profession. Concerns the extraordinary
(NOT everyday). Grand scale realities that probes issues of *direct power* and
often concerns "hot button"/bioethical issues (big things, make media)
Examples of Macro Ethics - ANSWER Use of fetal tissue for stem cell research or
hospital dumping of Medicaid or uninsured patients
Micro Ethics - ANSWER Focuses on the individual professional. Concerns the
common and routine. Recognizes day-to-day "humdrum" situations such as,
probes *indirect power* and
Emphasizes contextual / interpersonal issues
Micro Ethics as Health Administrator - ANSWER Accepted standards of right
and wrong in the day-to-day. Also power / influence with:The Patient / Client and
The Staff.
3 Major elements in Health Care Effects - ANSWER 1 - Dogma
2 - Development
3 - Dilemmas
Dogma - ANSWER Situations that have
clear right vs. wrong. Acting ethically is simply doing the right thing. May be
significant pressure (internal / external) not to right thing. Stresses
rules/principles/codes
,Dogma in Macro Ethics - ANSWER Insurance fraud & abuse and misrepresenting
organizational finances to clients / Board / investors
Dogma in Micro Ethics - ANSWER Stealing a bottle of pain killers from your
facility's pharmacy for a sick neighbor
Development - ANSWER We sense there is a
right thing to do,
but not yet determined
precisely what
the right thing is
Development in Macro Ethics - ANSWER Terry Schiavo case: A Florida woman in
coma was brain dead. Parents wanted machine off, but hospital was scared to
turn off machine for manslaughter attributed to them
Development in Micro Ethics - ANSWER Accepting gifts from suppliers
Dilemmas - ANSWER When one right thing competes with another right thing.
Each side believes their way is ethically correct,
which creates ethical conflict
Dilemmas in Macro Ethics - ANSWER Does our community Hospitals agree to
stop performing abortions so we can merge with regional Catholic Work?
Dilemmas in Micro Ethics - ANSWER Does manager bend the staff attendance /
policies / etc. sometimes, usually, or always?
Nominal Ethics - ANSWER Standards that are minimally recognized, not
enforced
Example of Nominal Ethics - ANSWER going 40 in a 35 - not getting pulled over
Normative Ethics - ANSWER What should be done
Descriptive Ethics - ANSWER What is actually done
Metaethics - ANSWER Study of ethical systems
Ethics vs. Legal - ANSWER 4 quadrants of Legal & Ethical, Ethical & illegal,
Illegal & Unethical, and Legal & unethical
Quadrant I - Ethical and Legal - ANSWER Doctor - Patient confidentiality, Billing
people correctly, Truthful in medical history / notes, Providing general health
,care services (being beneficent), Publicly advertising and requesting bids from
multiple suppliers before making purchases
Quadrant III - Unethical and illegal - ANSWER Embezzlement (stealing money
from company), Discrimination in hiring, Distributing narcotics to patients for
questionable medical necessity, Misrepresenting Medicare claims (Medicare
fraud)
Quadrant II - Ethical and illegal - ANSWER Stem cell research, Medical Marijuana
where it is not actually legal, Assisted Suicide, breaching gag rule (1988-1993)
Quadrant IV - Unethical and legal - ANSWER Abortion (first trimester), not
treating the uninsured, not offering assistance to accident victims
Joint Commission - ANSWER Private nonprofit agency created by the American
Hospital Association.
They did not want government to come in and regulate the hospital. Have quality
inspection: Decide what rating hospital should receive
Tom Beauchamps & James Childress - ANSWER Proposed a linkage of moral
philosophies to ethical principles to personal or organizational guidelines to
specific personal actions
Ethics Pyramid - ANSWER (bottom to top)
Moral Philosophies --> Ethical Principles --> Rules --> Actions
Moral Philosophies - ANSWER General moral perspectives that have influenced
our culture and thought. Often abstract and general. The core underneath how
we act
Builds an ethical structure
Ethical Principles - ANSWER Derived from all or most of the moral philosophies.
Common Principles that form the underpinning for delivery of health care
services.
Examples of Ethical Principles - ANSWER -Respect for persons (patients)
-No maleficence (do no harm)
-Treat people fairly (justice)
Rules or Guidelines - ANSWER Personal, professional, or organizational
guidelines that *Set Boundaries* on our actions
Examples of Rules or Guidelines - ANSWER -Professional Codes of Ethics
-Organizational Ethics Committees
-Organizational Policies
, Ethical Actions - ANSWER Specific judgment or actions taken by you as a
specific manager to a specific ethical issue
Moral Philosophies Cores - ANSWER -Utilitarianism
-Deontology
-Natural Law (John Rawls' Theory)
-Casuistry
Other Moral Philosophies - ANSWER Not relevant to build ethical standards in
health services but may be referred to regulatory: Nihilism and Relativism.
Nihilism - ANSWER nothing is morally correct (Fatalism)
Relativism - ANSWER everything is morally correct and equivalent depending on
the circumstance
Utilitarianism - ANSWER 19th Century - Jeremy Bentham and John Stuart Mills.
Measure "goodness" by the outcome ("The end justifies the means"). Also is
Cost/benefit analysis.
The action that brings about the
most good is the morally correct choice
Deontology - ANSWER Characterized by Immanuel Kant
(18th Century).
Our moral relationship to others - based on "duty."
An action is moral if it arises from goodwill (no matter the outcome)
golden rule
Duty - ANSWER If an action is universal (right in all circumstances)
moral relationships
Natural Law - ANSWER Characterized by Thomas Aquinas (1200s) - originally
Aristotle. Ethics are based on a fundamental concern for human good.
Humans will act rationally to do good.
do good and avoid evil
community laws develop from rational humans seeking to do good.
Casuistry - ANSWER Case-based reasoning
in historical context.
Articulated by Albert Jonsen &
Stephen Toulmin (1988). Uses precedents & guidelines as guides to ethical
decisions. Parallel to development of law clinical standards of care
Basic Ethical Principles - ANSWER 1 - Respect for Persons
2 - Beneficence
3 - Nonmaleficence
