Chapter 08: Complexity at the End of Life: The Ethical and Legal Challenges
Keatings: Ethical & Legal Issues in Canadian Nursing, 4th Edition
MULTIPLE CHOICE
1. Which of the following statement best describes assisted suicide?
a.
It is a form of withdrawal of treatment.
b.
It is a passive process, and the patient is mentally competent.
c.
It is an active process, and the patient is mentally incompetent.
d.
It is an active process, and the patient is mentally competent.
ANS: D
Feedback
A Incorrect—Assisted suicide does not necessarily involve withdrawal of
treatment.
B Incorrect—This statement does not accurately describe assisted suicide.
C Incorrect—This statement does not accurately describe assisted suicide.
D Correct! In assisted suicide, active steps are taken to end the life of a debilitated
but mentally competent patient who requests the help of another person.
DIF: Cognitive level: Comprehension
2. Which of the following situation is an example of an ethical dilemma that can arise for a
team on a medical unit while caring for a terminally ill patient who is near death?
a.
The family wishes that the patient will live longer.
b.
The family requests intravenous (IV) fluids for hydration of the patient.
c.
The family requests administration of narcotics for the patient’s pain relief.
d.
The family refuses to allow the patient’s transfer to a palliative care unit.
ANS: B
Feedback
A Incorrect—A family’s wish that a terminally ill patient live longer is not
unethical and is a normal aspect of grief and loss.
B Correct! Hydrating the patient may create respiratory discomfort, potentially
prolonging his or her suffering and postponing death; therefore, this request is an
example of an ethical dilemma for the nurse and the team.
C Incorrect—Administering narcotics prescribed for pain management is not
unethical.
D Incorrect—This may conflict with the nurse’s values, but it is not unethical
because the patient can still receive palliative care on the medical unit.
DIF: Cognitive level: Synthesis
3. Which of the following activities will help ensure the dignity of older adult clients,
regardless of their capacity?
a.
Use terminology that older adult clients can understand, such as “diapers.”
b.
Engage in conversation with older adult clients about their lives.
, c.
Take over control from older adult clients as much as possible to conserve their
energy.
d.
Call older adult clients by their first name only.
ANS: B
Feedback
A Incorrect—Using the term “diapers” is disrespectful and demeaning to older
adults.
B Correct! Engaging in conversation with older adult clients about their lives helps
these clients feel valued. Older adults need stimulation and socialization and
want to share their stories and to be treated with the respect they have earned
throughout their lives.
C Incorrect—Giving older adult clients as much control as possible allows them to
feel valued and helps ensure that their dignity is preserved.
D Incorrect—Calling older adult clients by their first name may be disrespectful,
depending on the clients’ culture and background. If the nurse is unsure, it is
more appropriate to use the entire name or only the family name. When possible,
it is preferable to ask clients about their wishes in this regard.
DIF: Cognitive level: Synthesis
4. Some persons in Canada disagree with the Medical Assistance in Dying (MAID), legislation,
based on the ethical principle of the sanctity of life. What principle might support the
argument of others who disagree with this view?
a.
Autonomy
b.
Veracity
c.
Informed choice
d.
Responsibility and accountability
ANS: A
Feedback
A Correct! Autonomy is the right of individuals to make decisions that affect their
lives. The MAID legislation is based on this principle and requires the explicit
consent of the person making the request for an assisted death.
B Incorrect—Veracity is the duty to tell the truth. This ethical principle is central
to ensuring trust within the nurse–patient or nurse–client relationship but would
not likely be in conflict for nurses working with the dying.
C Incorrect—Informed choice is not an ethical principle but is based on the
principle of autonomy.
D Incorrect—Responsibility and accountability is a professional standard, not an
ethical principle.
DIF: Cognitive level: Synthesis
5. A nurse administers larger doses of narcotics prescribed for pain control, which hastens
a terminally ill patient’s death. In which of the following acts has the nurse participated?
a.
Medical Assistance in Dying
b.
Assisted suicide
Keatings: Ethical & Legal Issues in Canadian Nursing, 4th Edition
MULTIPLE CHOICE
1. Which of the following statement best describes assisted suicide?
a.
It is a form of withdrawal of treatment.
b.
It is a passive process, and the patient is mentally competent.
c.
It is an active process, and the patient is mentally incompetent.
d.
It is an active process, and the patient is mentally competent.
ANS: D
Feedback
A Incorrect—Assisted suicide does not necessarily involve withdrawal of
treatment.
B Incorrect—This statement does not accurately describe assisted suicide.
C Incorrect—This statement does not accurately describe assisted suicide.
D Correct! In assisted suicide, active steps are taken to end the life of a debilitated
but mentally competent patient who requests the help of another person.
DIF: Cognitive level: Comprehension
2. Which of the following situation is an example of an ethical dilemma that can arise for a
team on a medical unit while caring for a terminally ill patient who is near death?
a.
The family wishes that the patient will live longer.
b.
The family requests intravenous (IV) fluids for hydration of the patient.
c.
The family requests administration of narcotics for the patient’s pain relief.
d.
The family refuses to allow the patient’s transfer to a palliative care unit.
ANS: B
Feedback
A Incorrect—A family’s wish that a terminally ill patient live longer is not
unethical and is a normal aspect of grief and loss.
B Correct! Hydrating the patient may create respiratory discomfort, potentially
prolonging his or her suffering and postponing death; therefore, this request is an
example of an ethical dilemma for the nurse and the team.
C Incorrect—Administering narcotics prescribed for pain management is not
unethical.
D Incorrect—This may conflict with the nurse’s values, but it is not unethical
because the patient can still receive palliative care on the medical unit.
DIF: Cognitive level: Synthesis
3. Which of the following activities will help ensure the dignity of older adult clients,
regardless of their capacity?
a.
Use terminology that older adult clients can understand, such as “diapers.”
b.
Engage in conversation with older adult clients about their lives.
, c.
Take over control from older adult clients as much as possible to conserve their
energy.
d.
Call older adult clients by their first name only.
ANS: B
Feedback
A Incorrect—Using the term “diapers” is disrespectful and demeaning to older
adults.
B Correct! Engaging in conversation with older adult clients about their lives helps
these clients feel valued. Older adults need stimulation and socialization and
want to share their stories and to be treated with the respect they have earned
throughout their lives.
C Incorrect—Giving older adult clients as much control as possible allows them to
feel valued and helps ensure that their dignity is preserved.
D Incorrect—Calling older adult clients by their first name may be disrespectful,
depending on the clients’ culture and background. If the nurse is unsure, it is
more appropriate to use the entire name or only the family name. When possible,
it is preferable to ask clients about their wishes in this regard.
DIF: Cognitive level: Synthesis
4. Some persons in Canada disagree with the Medical Assistance in Dying (MAID), legislation,
based on the ethical principle of the sanctity of life. What principle might support the
argument of others who disagree with this view?
a.
Autonomy
b.
Veracity
c.
Informed choice
d.
Responsibility and accountability
ANS: A
Feedback
A Correct! Autonomy is the right of individuals to make decisions that affect their
lives. The MAID legislation is based on this principle and requires the explicit
consent of the person making the request for an assisted death.
B Incorrect—Veracity is the duty to tell the truth. This ethical principle is central
to ensuring trust within the nurse–patient or nurse–client relationship but would
not likely be in conflict for nurses working with the dying.
C Incorrect—Informed choice is not an ethical principle but is based on the
principle of autonomy.
D Incorrect—Responsibility and accountability is a professional standard, not an
ethical principle.
DIF: Cognitive level: Synthesis
5. A nurse administers larger doses of narcotics prescribed for pain control, which hastens
a terminally ill patient’s death. In which of the following acts has the nurse participated?
a.
Medical Assistance in Dying
b.
Assisted suicide
