AAPL Landmark - Questions on Institutional Treatment Guidelines Flashcards
What does the principle of “least restrictive alternative” refer to?
A. Keeping someone in jail or prison no longer than his or her sentence
B. allowing individuals the freedom to choose their treatment setting
C. The minimum restriction of liberty needed to ensure safety
D. Using justice as a means of enforcing the law.
C. The minimum restriction of liberty needed to ensure safety
In order to remove life-sustaining treatment from an incompetent individual without existing advance directives, the required burden of proof is:
A) Preponderance of the evidence
B) Clear and Convincing evidence
C) Beyond a reasonable doubt
D) With reasonable medical certainty.
B) Clear and Convincing evidence
What is substituted judgement?
A. When a guardian or judge determines the choice a currently incompetent individual would make if he or she were competent
B. When a doctor is asked to determine the most medically appropriate treatment for an incompetent individual
C. When a judge is asked to determine what treatment choice the majority of people in the same medical position as the incompetent individual would make.
D. When an incompetent individual’s next of kin makes the decision about treatment for that individual.
A. When a guardian or judge determines the choice of currently incompetent individual would make if he or she were competent
What USSC case made dangerousness a required part of the standard for civil commitment?
A) Lessard v. Schmidt
B) Lake v. Cameron
C) O’Connor v. Donaldson
D) Addington v. Texas
C) O’Connor v. Donaldson
The final decision in Youngberg v. Romeo was rendered by which court?
A. U.S. District Court
B. U. S. Court of Appeals
C. U.S. Supreme Court
D. Family Court
C. U.S. Supreme Court
Youngberg recognized that persons subject to involuntary commitment proceedings have a liberty interest, protected under the Due Process Clause, to safety and to freedom from bodily restraint.
Is physician-assisted suicide allowable under the American Medical Association (AMA) guidelines?
A) Yes
B) No
C) The AMA does not comment on physician-assisted suicide
D) The AMA allows physician-assisted suicide in certain circumstances.
B) No
In Rouse v. Cameron, the Washington DC, statutory right to treatment that applied to civilly committed patients was found to also apply to which other class of individuals?
A) Ind. with developmental disabilities
B) Insanity acquittee
C) Prisoners
D) Pretrial detainees.
B) Insanity acquittee
The DC Circuit Court of Appeals determined that insanity acquitees had the same right to treatment as if they were civilly committed.
As delineated in Application of the President and Directors of Georgetown University, can medical professionals provide emergency life-saving medical treatment to an incompetent person against his or her will?
A) Yes, physicians are always permitted to treat incompetent individuals as long as it is the appropriate medical treatment, even in a non-emergency situation.
B) Yes. If the medical treatment is life-saving and there is imminent risk of death, physicians can provide treatment.
C. Yes, but only if there is a judicial court order for treatment
D. No. Medical Professional are never permitted to treat individuals against their will. even if the individual is incompetent,.
B) Yes. If the medical treatment is life-saving and there is imminent risk of death, physicians can provide treatment.
In Wyatt v. Stickney, the US District Court ruled that the minimal constitutional requirements for the treatment of committed patients were:
A) Humane psychological and physical environment, qualified staff in numbers sufficient to administer adequate treatment, right to legal representation
B) a Humane psychological and physical environment, qualified staff in numbers sufficient to administer adequate treatment, and adequate funding.
C) Qualified staff in numbers sufficient to administer adequate treatment, individualized treatment plans, and adequate funding.
D) Humane psychological and physical environment, qualified staff in numbers sufficient to administer adequate treatment and individualized treatment plans.
D) Humane psychological and physical environment, qualified staff in numbers sufficient to administer adequate treatment and individualized treatment plans.
The USSC has found which of the following to be a compelling argument against physician-assisted suicide?
A) The difference between letting a patient die and making a patient die
B) Competent individuals should have a right to choose their manner of death
C) Competent people can refuse life-saving treatments.
D) All of the above
A) The difference between letting a patient die and making a patient die.
In Washington v. Glucksberg and Vacco v. Quill the USSC emphasized the difference noted.
The minimal legal burden of proof for civil commitment in the US is:
A) Beyond a reasonable doubt
B) Reasonable medical certainty
C) Preponderance of the evidence
D) Clear and convincing evidence
E. Without due cause
D) Clear and convincing evidence
Decided in Addington V. Texas
In the Matter of Richard Roe, III was a case involving an outpatient minor. Based on that case, does a guardian have the authority to consent to forcible medication of his or her ward?
A) No. Medications cannot be administered against someone’s will if the person is not hospitalized.
B) No. Only a court can determine if forcible medication can be ordered for an outpatient.
C) Yes, The courts appoint a guardian, and this guardian even has the authority to consent for medically appropriate treatment, even if it is against the ward’s wishes.
D) Yes. A review between the guardian and the ward’s physician is appropriate.
B) No. Only a court can determine if forcible medication can be ordered for an outpatient.
What type of circumstance allows an individual the right to an adversarial hearing?
A) If a minor, when one’s parents apply for voluntary admission
B) All voluntary admissions, regardless of the age of the individual
C) When facing involuntary hospitalization
D) When a request for release from the medical unit is denied.
C) When facing involuntary hospitalization.
Lessard v. Schmidt guaranteed a right to a hearing. Parham v. J.R., however, found that voluntary admission of a minor was constitutional.
According to the USSC, physician-assisted suicide:
A) Is constitutional under the 14th Amendment
B) Reasonably allows an individual to exercise his or her autonomy
C) Should not be an issue decided at the Supreme Court level
D) Is not rationally related to legitimate government interests
E. Is akin to allowing a patient to die of natural causes.
D) Is not rationally related to legitimate government interests.
In Washington v. Glucksberg (WA) and Vacco v. Qiull (NY), the Court distinguished between letting a patient die and assisting in their death, noting that it was not in the government’s interest.
Of the following choices, which legal or ethical principles are most at odds in civil commitment proceedings?
A. Nonmaleficence versus police power
B. Beneficence v. autonomy
C. Autonomy v. police power
D. Autonomy versus nonmaleficence
E. Justice v. beneficence
C. Autonomy v. police power.
According to Washington v. Glucksberg and Vacco v. Quill, state bans on physician assisted suicide do not violate:
A) 8th Amendment
B) 1st amendment
C) 14th Amendment
D) Sixth Amendment
E) 2nd Amendment
C) 14th Amendment
In Rennie v. Klein, a treatment-driven model of adjudicating cases involving treatment refusal was adequate. What reasoning was used?
A) The courts should decide these cases based on substituted judgment
B) Professional judgment should guide treatment refusal decisions
C) The judicial system should tightly monitor all clinical decisions regarding treatment refusal.
D) Specific treatment should be implemented once an order to medicate someone against his or her will is obtained.
B) Professional judgment should guide treatment refusal decisions
The New Jersey Admin bulletin protected patients’ rights and that medication over objection was a professional decision.
Protections for patients involuntarily committed to a psychiatric hospital include:
A) Right to legal representation
B) Right to leave the hospital AMA
C) Right to choose their doctor
D) Right to choose the hospital to which they are committed.
A) Right to legal representation
A hospitalized patient of yours is in a persistent vegetative state following a major car accident and is receiving artificial nutrition and hydration to stay alive. He does not have any written advance directives, but his older brother wishes to remove the feeding tube and allow his brother’s life to take a natural course, even if that ends in death. What would be the best first step?
A) Tell the brother that the tube can never be removed.
B. Consult the hospital risk management department.
C. Talk to other family members about their wishes.
D. Remove the feeding tube.
B. Consult the hospital risk management department.
Cruzan v. MO DMH, a family member cannot automatically make decisions for incompetent family members unless they have clear and convincing evidence of the family member’s wishes.
Does an incompetent individual have the right to refuse life-prolonging medical treatment?
A) Yes, but only if that individual had made his or her desire to avoid such treatment known before becoming incompetent.
B) Yes, but only if it is shown that the majority of people in a similar situation would refuse such treatment.
C. No. If treatment can prolong life, and the individual is incompetent, he or she cannot refuse such treatment.
D. Yes. Even if the individual has never been competent, a legally appointed guardian can make the decision.
D. Yes. Even if the individual has never been competent, a legally appointed guardian can make the decision.
Superintendant of Belchertown state school v. Joseph Saikewicz. The SC of Mass
Which of the following statements best describes the procedure for civilly committing an individual being released from prison?
A. The individual must be assessed by at least three psychiatrists, all board certified by ABPN.
B. The individual should be afforded the right to a jury trial the same as for nonprisoners being civilly committed.
C. The individual should be released from prison into the community before being assessed for civil commitment
D. The individual should be found in need of civil commitment beyond a reasonable doubt.
B. The individual should be afforded the right to a jury trial the same as for nonprisoners being civilly committed.
Baxstrom v. Herold.
The USSC defined what standard for determining 14th Amendment violations of due process for civilly committed, intellectually disabled individuals.
A) Substantial necessity
B) Professional judgment
C) Compelling necessity
D) Reasonable medical certainty
E. Preponderance of the evidence
B) Professional judgment
Youngberg v. Romeo was a USSC case where they determined professional judgement was the standard used for due process rights of civilly committed or ID.
