CCHP Medical-Legal and Ethical Issues 2 — Questions and Answers
Question 1: A correctional nurse discovers that a colleague is falsifying medication administration records. What is the nurse's primary ethical obligation?
- Ignore it to avoid workplace conflict
- Report the behavior to supervisory or regulatory authorities (Correct answer)
- Confront the colleague privately and take no further action
- Document the observation in personal notes only
Correct answer: Report the behavior to supervisory or regulatory authorities
Nurses have an ethical and legal duty to report unsafe or fraudulent practices that endanger patient safety.
Question 2: Under HIPAA, which of the following is a permissible disclosure of incarcerated patient health information WITHOUT authorization?
- Sharing with a patient's family on request
- Disclosing to media to address public safety concerns
- Providing records to correctional officers for legitimate security purposes (Correct answer)
- Releasing information to employers outside the facility
Correct answer: Providing records to correctional officers for legitimate security purposes
HIPAA permits disclosure to correctional institutions when necessary for health and safety of the inmate or others in the facility.
Question 3: A patient in custody refuses a prescribed antipsychotic medication. The court has not issued a forced treatment order. What is the appropriate action?
- Administer the medication covertly in food
- Document the refusal and respect the patient's decision unless imminent danger exists (Correct answer)
- Immediately seek emergency forced medication
- Discharge the patient from mental health services
Correct answer: Document the refusal and respect the patient's decision unless imminent danger exists
Competent patients retain the right to refuse medication; healthcare providers must document and monitor but cannot override autonomy without a court order.
Question 4: The ethical principle of 'non-maleficence' is BEST described as:
- Treating all patients equally regardless of background
- Promoting the patient's best interests
- Avoiding actions that cause unnecessary harm (Correct answer)
- Respecting the patient's right to make decisions
Correct answer: Avoiding actions that cause unnecessary harm
Non-maleficence means refraining from causing unnecessary harm or injury to a patient.
Question 5: A correctional health provider is pressured by custody staff to share a patient's mental health diagnosis. Under what condition is this permissible?
- Whenever a security officer requests it
- Only when the information is directly necessary for the safe management of the inmate (Correct answer)
- When the warden verbally approves the disclosure
- Always, because inmates have no privacy rights
Correct answer: Only when the information is directly necessary for the safe management of the inmate
Mental health information in corrections may be shared with security staff only when it is directly relevant to maintaining the safety of the individual or others.
Question 6: Which document serves as the primary national standard for ethical practice in correctional health care?
- The American Correctional Association Policy Manual
- NCCHC Standards for Health Services in Prisons and Jails (Correct answer)
- The Federal Bureau of Prisons Clinical Guidelines
- The Joint Commission Accreditation Handbook
Correct answer: NCCHC Standards for Health Services in Prisons and Jails
NCCHC (National Commission on Correctional Health Care) standards are the recognized benchmark for ethical and quality correctional health practice.
Question 7: A death-row inmate asks the correctional physician to certify he is medically fit for execution. Which ethical stance do most professional medical organizations endorse?
- Physicians should comply because it is a legal obligation
- Physicians should participate to ensure a humane death
- Physicians should refuse participation as it violates the duty not to harm (Correct answer)
- Physicians should evaluate fitness but not report findings
Correct answer: Physicians should refuse participation as it violates the duty not to harm
The AMA and most medical associations hold that physician participation in executions violates medical ethics regardless of legality.
CCHP Medical-Legal and Ethical Issues 2
A correctional nurse discovers that a colleague is falsifying medication administration records.
What is the nurse's primary ethical obligation?