ETHICS PRE-FINAL Flashcards
(131 cards)
1
Q
In _________, the U.S. Congress enacted HIPAA, which required, among other things, the establishment of Standards for Privacy of Individually Identifiable Health Information.
A
August 1996
2
Q
These standards, which have become known as simply the ________
A
Privacy Rule
3
Q
Privacy Rule, added a major dimension to the need to treat medical records and information as _______
A
confidential
4
Q
_______ was developed, with public comment and input, in the years after enactment of HIPAA.
A
Privacy Rule
5
Q
HIPAA
A
Health Insurance Portability and Accountability Act of 1996
6
Q
The final rule was issued in
A
March 2002
7
Q
Updates to the Privacy Rule are likely to continue, making it ________ that the practitioner remain up to date with the latest requirements of the rule.
A
imperative
8
Q
The primary goal of the ______ was to strike a balance between protecting individuals’ health information and not impeding the exchange of informa- tion needed to provide quality health care and protect the pub- lic’s health and well-being.1
A
rule
9
Q
The ________ applies to all health care providers, health plan providers (with some exceptions, such as small employer plans with fewer than 50 participants administered solely by the employer), and health care clearinghouses.
A
Privacy Rule
10
Q
_______ is an entity that processes insurance claims for payment.
A
health care clearinghouse
11
Q
The practitioner in clinical practice need not be concerned with particular exceptions because, in most cases, basic patient confidentially requires a standard at least _____ to the strictest interpretation of the Privacy Rule.
A
equal
12
Q
The basic goal of the ______ is to protect all “individu- ally identifiable health information,”
A
Privacy Rule
13
Q
basic goal of the Privacy Rule is to protect all “individually identifiable health information,” commonly referred to as __________
A
protected health information
14
Q
_______ includes any record or information that would or could identify or reveal (1) an individual’s past, present, or future physical or mental health or condition; (2) the provision of health care to the individual; or (3) the past, present, or future payment for the provision of health care to the individual.
A
Protected information
15
Q
_____________ includes information in any format, which may include patient charts (electronic or paper), faxes, e-mails, or other records.
A
Protected health information
16
Q
The ______ provides avenues for the normal and appropriate conduct of health care treatment and business for all “covered entities,” individuals, and organizations that have a legitimate need to access and use the information.
A
Privacy Rule
17
Q
______ of the individual is not required for these covered entities.
A
Consent
18
Q
RTs are required by their scope of practice to work under competent
______
A
medical supervision
19
Q
_______ This requirement creates not only a professional relationship but also a legal one.
A
medical supervision
20
Q
If the RT is employed by the physician, the physician is _______
A
liable for the RT’s actions
21
Q
Under the laws of some states, the supervising physician may still be liable even if the RT is employed by the hospital where the legal theory involves a _____
A
failure to supervise
22
Q
The legal basis for this liability is rooted in ______
A
centuries-old common law
23
Q
Under modern law, an employer is deemed a master, and an employee is deemed a servant. This principle, sometimes called _______
A
vicarious liability
24
Q
vicarious liability, is premised on this centuries- old concept expressed in Latin as _______
A
respondeat superior
25
respondeat superior
“let the master answer”
26
Under the ______ of medical supervision, the physician assumes responsibility for the wrongful actions of the RT as long as such negligence occurred in the course of the employer- employee relationship.
doctrine
27
For this liability to apply, two conditions must be met:
(1) the act must be within the scope of employ- ment, and (2) the injury caused must be the result of an act of negligence.
28
If the RT acted outside of his or her scope of prac- tice, as outlined by licensure laws or by institutional regulations, the court would have to decide whether the physician would _____
still be liable
29
under the principle of ________, the hospital, as a corporate entity, could be held responsible for the actions of its employees.
respondeat superior
30
Either the _______ is usually named as the defendant for the acts of the practitioner.
hospital or the physician
31
with the increased application of state licensure regulations governing respiratory care, and especially with the development of respiratory care protocols giving RTs more ______, this relative protection from liability is changing rapidly.
autonomy
32
As RTs are given more discretion and are permitted to exercise inde- pendent judgment, their decision making is likely to be more frequently called into ______
question in court
33
One measure of professionalism is the extent to which the group is willing to direct its own development and regulate its own activities.
Scope of Practice
34
_____ is carried out mainly through professional associations and state licensure boards, which attempt to ensure that professionals exhibit minimum levels of competence.
self-direction
35
Basic Elements of a Practice Act.
most acts address the following elements:
• Scope of professional practice
• Requirements and qualifications for licensure
• Exemptions
• Grounds for administrative action
• Creation of examination board and processes
• Penalties and sanctions for unauthorized practice
36
In _______ , there is always a clause specifying a scope of practice.
licensure legislation
37
The _______ give general guidelines and parameters for the clinician’s practice.
scope- of-practice statutes
38
Deviation from these statutes could be a source of ________ as the specialty seeks to add new duties.
legal problems
39
_______ must know the limits of their scope of care and seek amendments to the licensure regulations as they expand their practice.
Practitioners
40
Ideally, the original language of a licen- sure law should be broad enough to account for changes in practice without requiring _______
continual amendment
41
Continuing education and _______ of the practice act are essential to ensure compliance with both the statute and evolving rules of the practice act.
regular review
42
One unique area that allows practice without the direc- tion of a competent physician is that of rendering emergency medical care to _____
injured persons
43
_______ protect citizens from civil liability for any errors they make while attempting to give emergency aid.
Good Samaritan laws
44
Most states have legislated _______ statutes to encourage individuals to give needed emergency medical assistance.
Good Samaritan
45
It is necessary for this aid to be given in _____ and free of gross negligence or _______.
good faith /willful misconduct
46
__________ generally apply only to roadside accidents and emergency situations outside the hospital, although this is not always the case.
Good Samaritan rules
47
The ______ has sometimes been used by physicians inside a health care organization who respond to an emergency on a patient who is not their own.
doctrine
48
in California, the statute for RTs specifically extends protection only where the acts of the RT are “outside both the place and the _____
course of employment
49
A good example of the interaction of ethics and the law in respiratory care is the ______ of the field into home care and durable medical equipment supply.
diversification
50
This ______ has led to new relationships between these elements of the health care system and has created the potential for unethical and unlawful activity.
diversification
51
If a practitioner accepts some payment, such as a finder’s fee or percentage of the total lease costs for referring patients to a particular home care company or equipment service, he or she should be prepared to face charges of ________ and _____
unethical and perhaps illegal practice.
52
Generally, these statutes say that anyone who knowingly or willfully solicits, receives, offers, or pays directly or indirectly any payment in return for Medicare business is guilty of a ________
criminal offense
53
Violation of these stat- utes carries the potential for
prison, a substantial fine, or both.
54
In addition, violation of the statutes by an organization can result in ________ and other federal health care programs.
exclusion from Medicare
55
In recent years, hospitals have been encouraged to appoint a ___________ to oversee the hospital’s business practices and ensure that the hospital conforms to the law.
corporate compliance officer (CCO)
56
In most hospitals with a working compliance plan, the _____ is freely available to discuss legal or ethical issues arising in the course of care.
CCO
57
Appointed by the board of directors and reporting both to the hospital administration and to the board, the _____ often can address legal issues quickly and competently.
CCO
58
Most hospitals use a _______ to allow employees who wish to remain anonymous to report wrongful activity.
toll-free anonymous number
59
If the practitioner is aware of others who are engaged in these practices, he or she should report these activities to the appropriate state or ______
federal health care agency
60
To aid the clini- cian in maintaining an ethical stance on these new issues, the _____ has established a position statement about ethical per- formance of respiratory home care.
AARC
61
All ____ should know in detail the requirements of their respira- tory care practice act. They should know what is expected of them in terms of obtaining licensure and in the requirements to remain licensed.
RTs
62
Section 3758.5.
Reporting Violations
63
_________
If a licensee has knowledge that another person may be in viola- tion of, or has violated, any of the statutes or regulations admin- istered by the board, the licensee shall report this information to the board in writing and shall cooperate with the board in furnishing information or assistance as may be required.
Section 3758.5. Reporting Violations
64
Some states also require that employers make reports not only on individuals terminated for cause but also on the _______
supervisors of the RTs
65
Section 3758.6.
Report on Supervisor
66
In addition to the reporting required under Section 3758, an employer shall also report to the board the __________ and title of the person supervising the licensee who has been suspended or termi- nated for cause, as defined in subdivision (b) of Section 3758.
name, profes- sional licensure type and number,
67
The failure of an employer to make a report required by this section is punishable by an administrative fine not to exceed $10,000 per violation.
Section 3758.6. Report on Supervisor
68
The second thing all RTs should do to protect themselves
against licensure issues is to _________ that covers professional discipline.
purchase an insurance policy
69
Most policies available for pur- chase by RTs provide for coverage of both _____ and ______
malpractice liability and professional discipline.
70
the California Board for Respiratory Care, reveals that the most frequent causes of pro- fessional discipline are as follows:
• Substance abuse
• Domestic violence
• Sexual abuse
• Gross incompetence
71
Even in cases in which the cause of discipline is rooted in domestic violence or sexual abuse of another person, some form of substance abuse is often a ______
contributing factor
72
_________ (driving while intoxicated, driving while impaired) are often the most frequent violation that brings an RT face to face with his or her professional board.
Alcohol violations
73
RTs with _______ or a significant ______ are almost certain to come before their professional board.
alcoholism / drug habit
74
A supervisor who fails to report a substance abuser of any kind is asking for legal trouble, in the form of either a ________ or a visit from the professional board.
damages lawsuit
75
Academic RTs should be especially vigi- lant with students and should insist on substance ________ for any student who appears to have such a problem.
abuse counseling
76
Sometimes human resources
_______ and _______ do not see the value in addressing these kinds of problems and may counsel against discipline for impaired workers.
personnel and administrators
77
Some- times supervisors ignore the behaviors that should be _____
red flags
78
Any ______ will tell you that it is far better to defend a wrongful termination lawsuit than a wrongful death lawsuit.
good attorney
79
If approached by the professional board, an RT should never talk to investigators without an _____
attorney present
80
Every investi- gation is by its nature oppressive and burdensome, and an attor- ney ensures that the RT’s rights are ______ and ____
respected and protected
81
Often in cases in which an RT has violated the professional code or engaged in conduct that merits discipline, an ______ can help negotiate a better resolution than the RT could without the help of a professional.
attorney
82
_____ are in a unique position to help protect patients from mul- tiple harms. Sometimes they have a duty to speak out about problems or issues in the department.
RTs
83
Usually working with a _____ is the most effective way to effect change inside an orga- nization.
CCO
84
sometimes the person who speaks out and identifies a problem still faces _____
retaliation
85
Several ________ protect RTs who, because of their respect for ethical issues, speak out about wrongdoing.
federal laws
86
PPACA
Patient Protection and Affordable Care Act
87
In ______, Congress passed the PPACA in an attempt to reform health care.
2010
88
Challenges to the ______ are still finding their way through the state and federal courts, and results to date have been mixed.
PPACA
89
One thing that the statute did was improve ________ for hospital workers
whistle- blower protections
90
Section 1558 of the PPACA amends the _______by adding Section 18C,
Fair Labor Standards Act of 1938 (FLSA)
91
(FLSA)
Fair Labor Standards Act
92
which provides that an employer cannot discriminate “against any employee with respect to his or her compensation, terms, conditions, or other privileges of employ- ment”
Labor Standards Act of 1938
93
1. Provided, caused to be provided, or is about to provide or cause to be provided to the employer, the Federal Govern- ment, or the attorney general of a State information relating to the violation of, or any act or omission the employee reasonably believes to be a violation of, any provision of this title;
2. Actually did or is about to assist, participate, or testify in a proceeding about such violation; or
3. Objected to or refused to participate in any activity or task that the employee “reasonably believed” to be in violation of the statute or any rule or regulation promulgated under the statute.
Patient Protection and Affordable Care Act
94
Any employee who believes that he or she has been dis- charged or discriminated against in violation of Section 18C of the FLSA is entitled to seek relief using the same procedures provided in 15 U.S.C. §2087(b), which contains the extensive whistleblower protections contained in the __________ Act of 2008.
Consumer Product Safety Improvement Act of 2008
95
These procedures include filing a complaint concerning _______ or retaliation with the Department of Labor, going through an administrative process to determine whether the employee’s conduct protected by Section 18C was “a contributing factor in the unfavorable per- sonnel action”
discrimination
96
_______ explicitly limits application of Section 18C only to violations of the statute’s central provisions related to medical care in hospital and clinic settings.
Section 1558
97
Employees who report fraud, waste, or violations in traditional health care settings fall under the protections afforded by ______
Section 1558
98
In most cases, an employee needs legal advice to pursue remedies under this section of the _____
FLSA
99
the _________ is usually thought of as a “union” statute
National Labor Relations Act (NLRA)
100
the ______ provides protections to hospital workers whether they are organized into a union or not
NLRA
101
when an RT approaches the supervisor on behalf of all the workers on the second shift to request that shift differ- entials be increased, that RT—who is engaged in what is called _______
protected concerted activity
102
“_____________”—cannot be discharged for acting on behalf of the other RTs in the department.
protected concerted activity
103
When an RT is discharged for such an offense, the RT has ______ in which to make a complaint to the local office of the National Labor Relations Board.
180 days
104
No _____ is necessary to make such a complaint.
attorney
105
Buried in the banking section of the United States Code is a little-known statute called the ____
False Claims Act (FCA)
106
The statute forbids making _____ against the gov- ernment and provides for severe sanctions for people who do.
false claims
107
Someone making a ______ against a government health care program can be made to repay three times the amount of the ______
false claim
108
government health care program can be made to repay three times the amount of the false claim plus a civil penalty of _______ per false claim.
$5500 to $11,000
109
Similar to the whistleblower protections built into the PPACA, the ______ contains language that prevents retaliation against an employee who gathers information or supports a government case against his or her employer.
FCA
110
Remedies may include ______ and back pay.
reinstatement
111
Perhaps the most ______ part of the statute is the part that permits an employee with knowledge of fraud or false billing to file a lawsuit against the company or organization engaging in fraud.
powerful
112
The _____ investigates such lawsuits and frequently intervenes in them.
government
113
Where the government intervenes, the employee who blows the whistle stands to receive an award of up to ___% of the amount the government recovers.
25%
114
In recent years, the United States has recovered greater than ______ in fraudulently paid claims, most of which came from employees who blew the whistle on the fraud of their employers or competitors.
$3 billion
115
The ______ industry is experiencing rapid change relating to how services are funded and how patients and health care workers interact.
health care
116
These changes are occurring at the same time that _______ are reemerging as significant com- ponents of how health care should be structured and delivered.
ethical considerations
117
Managed care affects the ethical decision-making process. Although the effect is not negative, it forces health care workers to take a new look at ethical dilemmas to arrive at both the best ______ and _______
ethical outcome and the best managed care outcome.
118
______ no longer freely choose who will deliver health care services to them.
Patients
119
_________ practitioners must consider not only the best services to deliver to patients but also the best managed care outcome.
Health care
120
If ______ is to be of any value, it must account for the reality of human experience and take into account changes in the health care system.
ethical reasoning
121
include (1) factual premises and beliefs, such as the definition of death; (2) legal concepts, such as tort laws; (3) externally imposed mandates or expectations, such as hospital accreditation stan- dards; and (4) the best managed care outcome.
Specific considerations
122
In many instances, such considerations uphold our _____ convictions and provide support for a given _____ .
moral / action
123
The real challenge to RTs arises when ______ principles dictate one course of action and factual knowledge, legal concepts, or external expectations dictate another.
moral
124
______ demanded that professionals acknowledge the social context of their activities and recognize their obligations toward the segment of society that they profess to serve.
Socrates
125
As our analysis of ethical reasoning and the law has made clear, only by ____________ basic principles of human values can the RT resolve the difficult questions of pro- fessional behavior consistently.
identifying, justifying, and prioritizing
126
To the extent that clearly articu- lated principles guide our ______ and _____ , all involved will be well served.
choices and actions
127
The letters ____ are used to indicate respiratory care practitioner. They also suggest three important characteristics of the RT when confronted with ethical dilemmas:
Respect
Compassion
Professionalism
128
In recognition of the right of competent adults to exercise choices concerning their health care, all 50 states and the Dis- trict of Columbia have adopted some form of health care _______
advance directives
129
Although the federal government acknowledged the need for advance directives with the 1991
Patient Self-Determination Act
130
with the 1991 Patient Self-Determination Act by requiring that all hospitals receiving Medicaid or Medicare funds ascertain whether patients have or wish to have ______,
advance directives
131
the ________ instruments are state regulated.
advance directive
