CMD CMD Ethics & Medical Decision-Making 1 — Questions and Answers
Question 1: Which ethical principle requires a Medical Director to act in the best interest of residents even when their preferences conflict with family wishes?
- Beneficence (Correct answer)
- Non-maleficence
- Justice
- Autonomy
Correct answer: Beneficence
Beneficence obligates the Medical Director to prioritize the resident's well-being above competing interests.
Question 2: A resident with intact decision-making capacity refuses a recommended antibiotic. The Medical Director's ethically correct action is to:
- Administer the antibiotic anyway to prevent harm
- Document the refusal and respect the resident's decision (Correct answer)
- Transfer the resident to a hospital immediately
- Consult with the family to override the refusal
Correct answer: Document the refusal and respect the resident's decision
Respecting autonomy means a competent resident's informed refusal must be honored and documented.
Question 3: Which document legally authorizes a designated person to make healthcare decisions for an incapacitated long-term care resident?
- Living will
- DNR order
- Durable power of attorney for healthcare (Correct answer)
- Advance beneficiary notice
Correct answer: Durable power of attorney for healthcare
A durable power of attorney for healthcare designates a surrogate decision-maker when the resident loses capacity.
Question 4: When a family demands aggressive life-sustaining treatment that the care team believes is medically futile, the Medical Director should FIRST:
- Immediately comply with all family demands
- Convene an ethics committee consultation (Correct answer)
- Discharge the resident to a hospital
- Issue a unilateral DNR order
Correct answer: Convene an ethics committee consultation
Ethics committee consultation provides a structured, neutral forum to address conflicts over medically futile treatment.
Question 5: Under OBRA regulations, a long-term care facility must inform residents of their right to formulate advance directives. This requirement reflects which ethical principle?
- Justice
- Non-maleficence
- Autonomy (Correct answer)
- Fidelity
Correct answer: Autonomy
Mandating advance directive counseling upholds autonomy by ensuring residents can direct their future care.
Question 6: A Medical Director discovers a physician colleague has been prescribing controlled substances inappropriately for nursing home residents. The first required step is to:
- Ignore it if no immediate harm is evident
- Report findings to the facility administrator and follow facility policy (Correct answer)
- Personally confront the colleague publicly
- Contact the DEA directly without notifying administration
Correct answer: Report findings to the facility administrator and follow facility policy
Medical Directors have a duty to report colleague misconduct through established facility and professional channels.
CMD CMD Ethics & Medical Decision-Making 1
Which ethical principle requires a Medical Director to act in the best interest of residents even when their preferences conflict with family wishes?