TEST BANK FOR ETHICS AND LAW IN DENTAL HYGIENE 3RD EDITION BY BEEMSTERBOER

TEST BANK FOR ETHICS AND LAW IN DENTAL HYGIENE 3RD EDITION BY BEEMSTERBOER Table of Contents PREFACE ......................................................................................................................................................... 2 Chapter 01: Ethics and Professionalism ............................................................................................................. 3 Chapter 02: Ethical Theory and Philosophy ..................................................................................................... 15 Chapter 03: Ethical Principles and Values ........................................................................................................ 25 Chapter 04: Social Responsibility ..................................................................................................................... 37 Chapter 05: Codes of Ethics ............................................................................................................................ 43 Chapter 07: Society and the State Dental Practice Act .................................................................................... 50 Chapter 08: Dental Hygienist–Patient Relationship .......................................................................................... 68 Chapter 09: Dental Hygienist–Dentist–Employer Relationship ......................................................................... 89 Chapter 10: Risk Management....................................................................................................................... 101 1PREFACE TEST BANK with Complete Questions and Solutions. To clarify, this is the TEST BANK, not the textbook. You get immediate access to download your test bank. You will receive a complete test bank; in other words, all chapters will be there. Test banks come in PDF format; therefore, you do not need specialized software to open them. 2Chapter 01: Ethics and Professionalism MULTIPLE CHOICE 1. When was the inception of the profession of dental hygiene? a. In ancient Greece b. In the early 1800s c. In the early 1900s d. In 1979 ANS: C The scope of practice of a dental hygienist was first established by law in Connecticut in 1915. Alfred C. Fones taught his dental assistant, Irene Newman, to treat patients and to teach them to maintain their mouths in a clean state. In 1913, Fones established the first school for dental hygienists in Bridgeport, Connecticut. The first oath written for dental hygienists called upon Apollo and Hygeia, who were the Greek god and goddess of health, respectively. A modernized version of the first oath was adopted by the Board of Trustees of the American Dental Hygienists’ Association (ADHA) in 1979. DIF: Recall REF: p. 3 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 2. Which member of the dental team is the primary oral preventive therapist? a. Dentist b. Dental hygienist c. Dental assistant d. Receptionist ANS: B The dental hygienist is the oral preventive therapist in the dental office. The dentists who pioneered this special field of endeavor had a vision of the day when dental disease could be prevented by following a system of treatment and cleanliness. The dentist is primarily concerned with restorative treatment, although he or she also shares in preventing oral disease. The dental assistant assists the dentist and may assist the dental hygienist as well. The receptionist greets patients and may help with the business and financial aspects of the practice. DIF: Recall REF: p. 4 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.4 General 3. The dental hygiene oath is revised by action of which of the following professional organizations? a. The American Dental Association (ADA) b. The American Dental Hygienists’ Association (ADHA) c. The Occupational Safety and Health Administration (OSHA) d. The Organization for Safety, Asepsis, and Prevention (OSAP) e. The Food and Drug Administration (FDA) ANS: B The first dental hygiene oath was adopted by the Board of Trustees of the American 3Dental Hygienists’ Association (ADHA) in 1979 and is still in use today. The oath may be seen at the following website ( American Dental Association has an oath for dentists. A copy of each oath may be found in the textbook. DIF: Recall REF: p. 3 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.4 General 4. Society recognizes that health care providers are held to a higher standard than legislative mandate. These higher standards are expressed in professional codes of ethics and are enforced by the legal system. a. Both statements are true. b. Both statements are false. c. The first statement is true, the second statement is false. d. The first statement is false, the second statement is true. ANS: C Health care providers are held to a higher standard than can be expressed exclusively by legislative mandate. While it is true that these higher standards are expressed in professional codes of ethics, they are enforced by those within the profession rather than by the legal system. Important components of this enforcement include self-regulation and submission to peer review. DIF: Comprehension REF: p. 4 TOP: 7.0 Professional Responsibility | 7.4 General 5. Success is measured by financial gain in the corporate world; however, for the health care professional the patient’s welfare is placed above profit. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A Because the welfare of the patient is more important than profit, society has granted the health care professional a certain status that carries prestige, power, and the right to apply special knowledge and skills. DIF: Comprehension REF: p. 4 TOP: 7.0 Professional Responsibility | 7.4 General 6. Which of the following is regarded as the most important aspect of the delivery of health care services? a. Technical skill b. Appropriate knowledge c. Critical judgment d. Caring ANS: D Although all of the choices are important, caring is regarded as the most important. Patients perceive this essence of caring and respond to it. Trust is the critical foundation for the relationship between the person seeking services and the health 4 OBJ: 2 OBJ: 1care provider. The caring that the patient seeks also gives the provider the greatest opportunity for professional service and satisfaction. DIF: Recall REF: p. 4 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.4 General 7. The publication “Medical Professionalism in the New Millennium: A Physician Charter” set out three fundamental principles, including patient welfare, patient autonomy, and the principle of social justice, because it is thought this will reinvigorate the value of professionalism. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A The Physician Charter sets out three fundamental principles that are not new but reinforce the foundation of the medical profession as one of service to others. The ethical principles of the primacy of patient welfare (beneficence and nonmaleficence) and patient autonomy are listed first; the principle of social justice is the third main tenet. The desired goal was to reinvigorate the value of professionalism that includes social responsibility, the ethic of care, and access to that care, for all members of society. DIF: Comprehension REF: p. 5 TOP: 7.0 Professional Responsibility | 7.4 General 8. Each of the following is a requirement for licensure of a dental hygienist in the United States EXCEPT one. Which one is the EXCEPTION? a. Completion of a higher education accredited program b. Graduation from a college or university c. Passed a written national board examination d. Passed a clinical national board examination ANS: D There is no clinical national board examination. The dental hygiene candidate for licensure must pass a state or regional clinical examination. Examples of regional boards include the Council of Interstate Testing Agencies (CITA), the Central Regional Dental Testing Services, Inc. (CRDTS), the Commission on Dental Competency Assessments (CDCA), the Southern Regional Testing Agency, Inc. (SRTA), and the Western Regional Examining Board (WERB). DIF: Comprehension REF: p. 5 TOP: 7.0 Professional Responsibility | 7.4 General 9. Which of the following characteristics is used to separate the professional from the layperson? a. Competency b. Quality performance c. A specialized body of knowledge and skill of value to society d. A code of ethics 5 OBJ: 3 OBJ: 3ANS: C To be considered a profession, a specific field or area of study traditionally must have several characteristics. These include a specialized body of knowledge and skill of value to society, an intensive academic course of study, set standards of practice determined and regulated by the group, external recognition by society, a code of ethics, an organized association, and a service ethic. What separates the professional from the layperson is specialized knowledge, which is exclusive to the professional group. DIF: Recall REF: p. 5 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 10. Each of the following is considered to be a true profession EXCEPT one. Which one is the EXCEPTION? a. Law b. Medicine c. Dentistry d. Culinary chef e. Ministry ANS: D Because being a professional is desirable, many careers and occupations aspire to this level. Real estate agents, auto mechanics, and culinary chefs all use the term professional to indicate a desired level of competency and quality performance. However, the true professions are still considered to be medicine, dentistry, ministry, and law because they possess all the characteristics previously listed, including a specialized body of knowledge and skill of value to society, an intensive academic course of study, set standards of practice determined and regulated by the group, external recognition by society, a code of ethics, an organized association, and a service ethic. DIF: Recall REF: p. 6 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 11. Professionalism is demonstrated through a foundation of clinical competence, communication skills, and ethical and legal understanding. Upon this foundation is built the aspiration to and wise application of the principles of professionalism. a. Both statements are true. b. Both statements are false. c. The first statement is true, the second statement is false. d. The first statement is false, the second statement is true. ANS: A The principles of professionalism are excellence, humanism, accountability, and altruism. Highlights of the Standards for Clinical Dental Hygiene Practice include assessment, dental hygiene diagnosis, planning, implementation, evaluation, and documentation. Professional traits of the dental hygienist include honesty and integrity, caring and compassion, reliability and responsibility, maturity and self- analysis, loyalty, interpersonal communication, respect for others, and respect for self. DIF: Recall REF: p. 6 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 612. Which of the following models or professionalism presents dentistry as an all- knowing profession? a. Commercial b. Guild c. Interactive ANS: B It is called the guild model because it resembles the medieval guild of old in which those who were members of the group controlled knowledge, skill, and competency. In this model the patient has dental needs and the dentist provides care to meet the needs of that patient, who is uninformed and passive in the process. The commercial model describes a relationship in which dentistry is a commodity, a simple selling and buying of services. In the interactive model, the patient and dentist are equals and have roles of equal moral status in the process of the delivery of dental care. DIF: Recall REF: p. 6 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 13. Which of the practice models described by Ozar is considered most desirable? a. Guild b. Interactive c. Commercial ANS: B According to the interactive model, patients determine their own needs and health care choices on the basis of their personal values and priorities but seek the care of the dentist because of his or her knowledge and skill. This model is preferable because it presents the patient and provider as partners who make different contributions to the partnership. This equal moral status creates an obligation for equal respect as partners working together toward attaining and maintaining oral health. DIF: Comprehension REF: p. 6 TOP: 7.0 Professional Responsibility | 7.4 General 14. Which of the following is an example of interprofessional education (IPE) in an academic health center involving two different health education organizations? a. Nursing students learn about nursing bottle caries along with dental hygiene students. b. Dental students learn about preventive fluoride along with dental hygiene students. c. Dental students learn about dental restorative procedures along with dental hygiene students. d. Dental hygiene students learn about dental preventive procedures along with dental assisting students. ANS: A The term IPE refers to occasions when students from two or more health professions learn together during all or part of their professional training with the objective of cultivating collaborative practice to improve the quality of patient care at the individual and population level. The Interprofessional Education Collaborative (IPEC) 7 OBJ: 3includes six major health education organizations: the American Association of Colleges of Nursing, American Association of Colleges of Osteopathic Medicine, American Association of Colleges of Pharmacy, American Dental Education Association, Association of American Medical Colleges, and Association of Schools of Public Health. DIF: Comprehension REF: p. 7 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.3 Patient and Professional Communication 15. Which of the following organizations is recognized by the United States Department of Education to accredit programs for dental hygiene in the United States? a. The college or university with the dental hygiene program b. The American Dental Hygiene Association (ADHA) c. The State Board of Dentistry for the respective state d. The Commission on Dental Accreditation (CODA) ANS: D The Commission on Dental Accreditation (CODA) is the specialized accrediting agency recognized by the United States Department of Education to accredit programs that provide basic preparation for licensure in dentistry, dental hygiene, and all related dental disciplines. The commission consists of 30 members and includes a representative of the ADHA. All accredited programs participate in an accreditation review every 7 years. The program prepares a self-analysis and self- study report with information about program resources, curriculum, policies, and standards. This report is submitted to the CODA in preparation for an on-site review by CODA team members. The members of the commission interview administrators, faculty, staff, and students to verify the information contained in the self-study. Next, the CODA team members create a site visit report for both the institution and the Commission. The Commission reviews the report and makes a decision to offer accreditation status without a reporting requirement or accreditation status with a reporting requirement. Programs must demonstrate compliance with Commission recommendations or risk loss of accreditation. DIF: Recall REF: p. 9 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.4 General 16. How often must a dental hygiene program undergo a formal, on-site review by the accrediting body? a. Every 10 years b. Every 7 years c. Every 3 years d. Only once, when the program is first created ANS: B A formal, on-site review is conducted every 7 years by the Commission on Dental Accreditation of the American Dental Association. All accredited dental programs have accreditation every 7 years, except for oral and maxillofacial surgery programs. These programs are reviewed every 5 years. DIF: Recall REF: p. 9 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.4 General 817. Which of the following is the correct sequence for the stages of mastery learning according to the competency continuum? a. Novice, proficient, competent b. Master, competent, novice c. Novice, competent, proficient d. Proficient, novice, competent e. Competent, novice, master ANS: C Educational theory categorizes the process of skill performance into five stages of mastery learning, also termed the competency continuum. The five stages are novice, beginner, competent, proficient, and master. The student is a novice or advanced beginner when he or she begins preclinical activities and progresses to caring for clinical patients under the supervision of faculty. The student will have achieved competency at or before graduation, meaning that he or she has the ability to perform clinical skills without faculty supervision. After graduation, the dental hygienist works toward proficiency and continues working throughout his or her professional life, toward becoming an expert. DIF: Recall REF: p. 9 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.4 General 18. Each of the following is one of the American Dental Hygiene Association (ADHA) standards for clinical dental hygiene practice EXCEPT one. Which one is the EXCEPTION? a. Implementation b. Documentation c. Recapitulation d. Assessment e. Dental hygiene diagnosis ANS: C The six ADHA standards of practice are assessment, dental hygiene diagnosis, planning, implementation, evaluation, and documentation. Implementation is the delivery of dental hygiene services to the patient. Modification of care often occurs to minimize risk, thus optimizing the outcome of the care plan. Documentation is the accurate recording of collected data, treatment planned and provided during patient care, is entered to create a permanent document. Assessment is the systematic collection, analysis, and documentation of oral and general health status and patient needs. It is comprised of patient history collection, performing a clinical evaluation, and measuring risk assessment. Dental hygiene diagnosis is the identification of an existing or potential oral health problem that the hygienist is educationally qualified and licensed to treat. Establishing, reviewing, revising, and publishing these standards are professional responsibilities that the ADHA assumes for its members to ensure that professional practice is based on the best and most scientifically accurate evidence and practice approaches. DIF: Recall REF: p. 9 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.4 General 19. Which of the following terms is used to describe that core of health care that places the needs of the patient or client ahead of those of the provider? a. Autonomy b. Justice 9c. Beneficence d. Nonmaleficence e. Veracity ANS: C The professional traits of a successful dental hygienist are found in the basics of professionalism. All of the traits are rooted in beneficence: the core of health care that places the needs of the patient or client ahead of those of the provider. Autonomy is self- determination and the ability to be self-governing and self- directing. The principle of justice is concerned with providing individuals or groups with what is owed, due, or deserved. Nonmaleficence declares that a health care provider’s first obligation to the patient is to do no harm. Veracity is defined as being honest and telling the truth. DIF: Recall REF: p. 10 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.4 General 20. An individual who demonstrates certain attributes, traits, and behaviors that embrace the best qualities of care and service is known as a a. professional. b. technician. c. vendor. d. supplier. ANS: A From the perspective of the general population, the term professional has evolved to mean an individual who demonstrates certain attributes, traits, and behaviors that embrace the best qualities of care and service. According to the Merriam- Webster dictionary, a technician is a person with a job related to the practical use of machines or science in industry or medicine, a vendor is a person who sells things, especially on the street, and a supplier is a person or entity that is a source for goods or services. DIF: Recall REF: p. 10 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.4 General 21. According to the ethicist Laurence McCullough the two virtues required in a professional person are a. honesty and integrity. b. self-effacement and self-sacrifice. c. caring and compassion. d. maturity and self-analysis. ANS: B Laurence McCullough has stated that there are two virtues required in a professional person. The first is self-effacement, which means putting aside all notions of self as better educated, socially superior, or more economically well off and focusing on the needs of the patient. The second is self-sacrifice, or putting aside or giving up one’s own interests and concerns. Honesty and integrity, caring and compassion, and maturity and self-analysis are professional traits of the dental hygienist; however, they are not the two virtues mentioned by Laurence McCullough. 10DIF: Recall REF: p. 10 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 22. Which of the following professional traits of the dental hygienist ensures that the patient should be confident that information given in written and verbal form is held in confidence and handled appropriately? a. Caring and compassion b. Reliability and responsibility c. Maturity and self-analysis d. Honesty and integrity ANS: D While it is true that all of the choices are professional traits, a relationship of trust is essential to providing care when personal health information is shared. Patients and colleagues must be able to depend on the words and actions of individuals who treat and work with them. Professional integrity is a commitment to upholding the code of ethics and the standards of care. DIF: Recall REF: p. 11 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 23. Which of the following terms means demonstrating the empathy necessary to comfort and guide the patient in the health promotion process? a. Caring b. Reliability c. Tolerance d. Loyalty e. Honesty ANS: A The ability to care for and be compassionate to each and every patient is a critical trait expected of all individuals who seek a career in a health care profession. Persons who are compassionate are merciful to all patients, including those who are unlike themselves or who are possibly difficult to understand and treat. DIF: Recall REF: p. 11 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 24. Most states have a legal requirement for continuing education for those who hold a dental hygiene or dental license because mandated continuing education helps ensure optimal health services to the public. a. Both that statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A The goal of mandated continuing education is to ensure optimal health services to 11the public by fostering continued competence. It is critical for a practitioner to be aware of the continuing education requirements for the state in which he or she practices because they vary from state to state. Information about state requirements may be found on the American Dental Hygiene Association website or on individual state dental board websites. DIF: Comprehension REF: p. 12 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 25. The trait in which the dental hygienist assesses his or her skills and takes responsibility for changing and improving those skills when necessary is called a. integrity. b. self-analysis. c. loyalty. d. reliability. e. interpersonal communication. ANS: B Self-analysis is assessment of skills and taking responsibility for changing and improving them when necessary. Professional integrity is a commitment to upholding the code of ethics and the standards of care. Loyalty is protecting and promoting the interests of a person, group, or organization. Reliability is meeting the obligations of time and duty, keeping appointments and meeting established schedules. The foundation of trust lies in communication and the ability of the patient to speak and be heard. DIF: Recall REF: p. 11 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 26. Loyalty is defined as a. to treat all patients without discrimination. b. to work toward the goals of attaining and maintaining oral health for each patient. c. protecting and promoting the interests of a person, group, or organization. d. a commitment to upholding the code of ethics and the standards of care. ANS: C Any relationship between a health care provider and a patient is a special affiliation; all professional decisions must be unencumbered by conflicting personal interests. To treat all patients without discrimination is an example of tolerance. A mature individual works efficiently and effectively toward the goals of attaining and maintaining oral health for each patient. Honesty and integrity are exemplified by a commitment to uphold the code of ethics and the standards of care. DIF: Comprehension REF: p. 11 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 27. When a license to practice dental hygiene is granted, that person is responsible for knowing and upholding the laws established by the state dental practice act. If a portion of the code is changed subsequent to the date of licensure, that person is not responsible for practicing according to revisions in the law. a. Both statements are true. 12 OBJ: 7b. Both statements are false. c. The first statement is true, the second statement is false. d. The first statement is false, the second statement is true. ANS: C The person must practice according to the current laws. Ignorance of a portion of the law or code is not an excuse for noncompliance by a dental hygienist or any other health care provider. The ADHA Code of Ethics for Standards of Professional Responsibility (To Ourselves as Professionals) states that a dental hygienist should “enhance professional competencies through continuous learning in order to practice according to high standards of care.” It also states (To Scientific Investigation) “Be knowledgeable concerning currently accepted preventive and therapeutic methods, products, and technology and their application to our practice.” DIF: Comprehension REF: p. 12 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 28. A license to practice as a dental hygienist is granted by a. The American Dental Association b. The American Dental Hygienists’ Association c. The State Board of Dentistry d. The school of matriculation, meaning where the student graduated ANS: C Licenses are granted by the state. All state boards, as well as those in the Virgin Islands and Puerto Rico, grant a license to practice to the dental hygienist. The responsibility and power for legislative protection of the public rest with each individual state or territory. Licensure is designed to enforce practice codes, establish standards, and sanction incompetent practitioners. DIF: Comprehension REF: p. 12 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 29. Which of the following individuals is regarded as the father of dental hygiene? a. Dr. David T. Ozar b. Dr. Laurence McCullough c. Dr. A. C. Fones d. Dr. Carl Rogers ANS: C Dr. Fones is regarded as the father of dental hygiene. The scope of practice of a dental hygienist was first established by law in Connecticut in 1915 at the urging of Dr. Fones. The Connecticut dental law served as a model for the states that later adopted similar legislation. Dr. Ozar is credited with developing the three models of professionalism. Dr. McCullough stated that two virtues are required in a professional person. Dr. Rogers was a famous humanistic psychologist. DIF: Recall REF: p. 12 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.4 General 30. Most legislative changes related to dental health care are driven by individuals in 13 OBJ: 7 OBJ: 7the dental or dental hygiene profession. For the most part the public remains unaware of the intricacies of the process. a. Both statements are true. b. Both statements are false. c. The first statement is true, the second statement is false. d. The first statement is false, the second statement is true. ANS: A Some of the factors that influence legislative changes in a state include the need and demand for dental care, the distribution of dental health care providers, federal health legislation, and the goals of organized dental and dental hygiene association’s advocacy groups. DIF: Recall REF: p. 12 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.4 General 31. Which of the following is regarded as an expanded function for a dental hygienist rather than a traditional duty? a. Scaling and root planing b. Patient education c. Exposing dental radiographs d. Administration of an injection ANS: D Examples of expanded functions include administration of injectable local anesthesia or placement of restorative material. Some states have implemented an additional practice level for dental hygienists. Individuals pursuing this level of practice must complete additional training in periodontal or restorative functions and be sanctioned to perform these skills by the particular state in which they practice. DIF: Recall REF: p. 13 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 32. A dental hygienist can practice independently of a dentist in all states, because several states have adopted mechanisms to allow practice without the supervision of a dentist after gaining a special license or credential. a. Both that statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: D It is true that several states have adopted mechanisms to allow a dental hygienist to practice without the supervision of a dentist after gaining a special license or credential. But states differ in which services are permitted and the level of supervision required, and only duties or functions allowed in a particular state may be performed, even if an individual is trained and licensed in another state when the dental practice act is more expansive. DIF: Comprehension REF: p. 13 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 14 OBJ: 7Chapter 02: Ethical Theory and Philosophy MULTIPLE CHOICE 1. Ethical decision making is a behavior and can be done well or done poorly. It is inherent and is not taught or learned. a. Both statements are true. b. Both statements are false. c. The first statement is true, the second statement is false. d. The first statement is false, the second statement is true. ANS: C Ethical decision making is something that can be done well or done poorly and it is something that can be taught and learned. Many problems are situations in which we can easily determine what to do, but in other situations determining what is the ethical action takes careful reflection. An introduction to the foundation of ethical theory can guide ethical decision making and assist in understanding the process by which such decisions are made. DIF: Comprehension REF: p. 15 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 2. Moral development is thought to be a process, because moral development has been shown to typically occur in progressive steps or stages. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A Just as each individual develops physically and intellectually, moral development also has been shown to typically occur in progressive steps or stages. Some researchers have related age, maturation of components of personality, and increased experience with moral development, whereas others have stressed that moral development has a cognitive component as well. DIF: Comprehension REF: p. 15 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 3. Which of the following is thought to be one of the strongest and most consistent correlates with development of moral judgment? a. Age b. Years of formal education c. Social status d. Income 15ANS: B Years of formal education is one of the strongest and most consistent correlates with development of moral judgment. It is even stronger than chronologic age. For many people moral development continues as long as the person is in a formal environment, but then plateaus upon leaving school. DIF: Recall REF: p. 16 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 4. Moral education programs seem to be most effective among which of the following members of society? a. Infants b. Children c. Adolescents d. Adults ANS: D Adults seemed to gain more from such programs than did younger children, most likely because a wider range of life experiences typically enriches a person’s awareness of the moral aspects of situations. A review of moral education programs revealed that almost half were effective in promoting moral development, especially if the program lasted longer than a few weeks and if the program involved the participants in discussions of controversial moral dilemmas. DIF: Recall REF: p. 16 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 5. The capacity for moral judgment is rigid, because a person’s cognitive moral development and his or her ability to employ what he or she understands peaks at a certain age. a. Both that statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: E Findings suggest that the capacity for moral judgment is not as rigid as some have argued. Neither a person’s cognitive moral development nor his or her ability to employ what he or she understands in actual decisions is frozen at some specified age. Individuals can continue to learn, and research has supported the idea that adults make greater gains than children. DIF: Comprehension REF: p. 16 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 6. According to Piaget’s four-stage model of moral development, the egocentric stage is found in individuals of which of the following ages? a. 0-2 years old b. 2-7 years old 16c. 7-12 years old d. 12 years old and older ANS: B The egocentric stage is from ages 2 to 7 years old. Children in this age group are thought to bend rules and react instinctively to the environment. The amoral stage is from ages 0 to 2 years. The heteronomous stage is from ages 7 to 12 years. Children in this age group accept the moral authority of others. Persons 12 years old and older are thought to be autonomous and have a morality of self based on cooperation; rules and regulations become internalized. DIF: Recall REF: p. 17 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 7. According to Piaget, rules are tested and become internalized during which of the following stages of moral development? a. Amoral stage b. Egocentric stage c. Heteronomous stage d. Autonomous stage ANS: D Rules become internalized during the autonomous stage of moral development. The egocentric stage is characterized by bending rules and instinctive reaction to the environment. The heteronomous stage is typified by acceptance of the moral authority of others. Each stage in the process of cognitive moral development involves judgment skills that are more complex, comprehensive, and differentiated from the preceding stage. DIF: Recall REF: p. 17 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 8. Which of the following is the most basic stage of Kohlberg’s three-level model of moral development? a. Interpersonal concordance orientation b. Law and order orientation c. Punishment and obedience orientation d. Instrumental relativist orientation e. Social contract legalistic orientation ANS: C Kohlberg’s theory focuses primarily on cognitive processes. He defined six stages, of which punishment and obedience orientation is first. This stage is followed by Stage 2: instrumental relativist orientation, Stage 3: interpersonal concordance orientation, Stage 4: law and order orientation, Stage 5: social contract legalistic orientation, and Stage 6: universal ethical principle orientation. DIF: Recall REF: p. 17 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 9. Which of the following stages of Kohlberg’s three-level model of moral 17development is considered to be conventional reasoning, in which expectations of family and groups are maintained and where loyalty and conformity are considered important? a. Law and order orientation b. Instrumental relativist orientation c. Social contract legalistic orientation d. Universal ethical principle orientation e. Punishment and obedience orientation ANS: A Conventional reasoning involves interpersonal concordance orientation and law and order orientation. Preconventional reasoning involves punishment and obedience orientation and instrumental relativist orientation. Postconventional or principled reasoning involves social contract legalistic orientation and universal ethical principle orientation. DIF: Recall REF: p. 17 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 10. Which of the following theorists of cognitive moral development created the concept of the ethic of care? a. Lawrence Kohlberg b. Jean Piaget c. Carol Gilligan ANS: C Carol Gilligan worked with Lawrence Kohlberg but wrote that his model reflects a male- oriented perspective of morality. She stated that women tend to see morality in the context of a relationship that she called the ethic of care. She proposed that feminine moral reasoning is typically different from masculine moral reasoning. Gilligan believes that complete moral development occurs in the context of two moral orientations—a male justice orientation and a female ethic of care—and therefore that Kohlberg’s measurement of moral development only in a justice- oriented scoring system is biased toward the male. DIF: Recall REF: pp. 17-18 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 11. Which of the following is an example where avoiding hurt becomes the moral guide governing all moral reasoning according to Gilligan’s model of moral development? a. Orientation to individual survival b. Goodness as self-sacrifice c. Morality of nonviolence ANS: C The morality of nonviolence is the highest level of moral development according to Gilligan. The most basic level of moral development is orientation to individual survival, which is surviving by being submissive to society. The intermediate level is goodness as self-sacrifice, in which being moral is first not hurting others with no thought of hurt to self. 18DIF: Comprehension REF: p. 18 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 12. People operate on their experiences to make sense of them. The experiences, as we make sense of them, change the basic conceptual structures by which people construct meanings. a. Both statements are true. b. Both statements are false. c. The first statement is true, the second statement is false. d. The first statement is false, the second statement is true. ANS: A This is the basic tenet of cognitive theory. Researchers studying the relation between moral judgment and behavior can see that many factors determine behavior. For example, studies link moral perception with actual, real-life behavior as well as moral judgment. DIF: Recall REF: p. 18 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 13. According to Rest and his co-workers, people who love to learn; seek challenges; and are reflective, set goals, take risks, and profit from stimulating and challenging environments are those who develop in which of the following characteristics? a. Longevity b. Advanced education c. Moral judgment d. High remuneration ANS: C Studies link moral perception with actual, real-life behavior as well as moral judgment. These characteristics are frequently found in professional students who are working hard to become excellent professionals. DIF: Recall REF: p. 18 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 14. The cognitive aspects of moral development are only part of the story, because incorporating the skill of differentiating right from wrong into life is a matter of building habits. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A One of the best ways to appreciate the value of a habit is to see how it operates in someone we admire. This is the fruition of development of habits such as carefully perceiving, carefully judging, and consistently acting in accordance with one’s moral 19judgments. DIF: Comprehension REF: p. 19 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 15. In the academic world, examining the different ways in which moral thinking can be done is called a study of a. humanity. b. moral or ethical theory. c. behavior. d. operant conditioning. e. reasoning. ANS: B An ethical or moral question is a question in which a person’s well-being or rights or duties are at issue or at stake. Because the meanings of “ethical” and “moral” are not carefully distinguished in a manner that is widely and consistently used, these terms often are treated as synonyms and used interchangeably. DIF: Recall REF: p. 19 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 16. Which of the following views of moral reasoning is predicated on the idea that the rightness or wrongness of any action is determined and justified by the consequences of the act being considered? a. Consequentialism b. Nonconsequentialism c. Virtue ethics d. Deontology ANS: A This type of thinking is always comparative because it aims at maximizing good consequences. Consequentialists consider the consequences of each important alternative course of action available to them in the situation before deciding the right action. Nonconsequentialism or deontology argues that some acts are right or wrong independent of their consequences. DIF: Recall REF: p. 19 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 17. You are at a party and notice that a friend has consumed more alcohol than usual and appears inebriated. At you watch her weave to her car, you wrestle with intervening, and many questions go through your mind. You wonder if she will be angry and resent it later on if you try to stop her but fear that she will not make it home safely if you do not. You wrestle whether or not to grab her keys and call a cab. This is an example of which of the following types of ethics? a. Consequentialist ethics b. Nonconsequentialist ethics c. Virtue ethics d. None of the above 20ANS: A You are weighing the potential outcomes or consequences of your decisions. Doing moral thinking in this way means considering all relevant consequences of potential actions in the situation, identifying and evaluating them in terms of benefit and harm in order to determine the action(s) that, compared with the alternatives, yield the best outcomes, before making a choice about which action to take. DIF: Comprehension REF: pp. 19-20 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 18. John Stuart Mill was a proponent of utilitarianism, which states that an action should be judged to be moral on its capacity to provide the greatest good for the largest number of people. a. Both statements are true. b. Both statements are false. c. The first statement is true, the second statement is false. d. The first statement is false, the second statement is true. ANS: C John Stuart Mill was one of the most famous proponents of utilitarianism. Mill often is described as saying that an action should be judged to be moral on its capacity to provide the greatest good for the largest number of people. However, his teacher Jeremy Bentham said that, not Mill, and Bentham himself eventually repudiated the phrase because it misled people into thinking that, for a utilitarian, whatever benefited the majority was the right thing to do. Both men did teach that the moral action is the one that maximizes good and minimizes harm when the consequences for every affected person are considered. DIF: Comprehension REF: p. 20 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 19. Who was a proponent of utilitarianism? a. Immanuel Kant b. Plato c. John Stuart Mill d. Aristotle ANS: C John Stuart Mill was a proponent of utilitarianism, a version of the consequentialist approach to moral decision making who stressed that, in consequentialist reasoning, every person affected by an action should be considered. Immanuel Kant is credited for establishing one of the most detailed nonconsequentialist or deontological theories of ethical thinking. Plato and Aristotle articulated the Greek tradition of virtue ethics and emphasized that the cultivation of virtuous traits of character is the primary function of morality. DIF: Recall REF: p. 20 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 20. Adding fluoride to a community water system is a good example of the application 21of which of the following types of ethical reasoning? a. Consequentialism or utilitarian ethics b. Deontology or nonconsequentialism c. Virtue ethics d. None of the above ANS: A This is one of the best examples of utilitarianism in dentistry. The consequence is a benefit to society through caries reduction, provided at a relatively low cost and available to all members of a community regardless of social status or income, and with almost no possibility of causing harm. Nonconsequentialism would say that an action is right or wrong regardless of the consequences. DIF: Recall REF: p. 20 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 21. Which of the following ethical theories regards an action as right when it conforms to a principle or rule of conduct that meets a requirement of some overriding duty? a. Consequentialism b. Nonconsequentialism c. Virtue ethics d. Deontology ANS: B Deontologists or nonconsequentialists state that some actions are required by the rightness or wrongness of the action, regardless of the consequences of the action. Whereas consequentialists focus on the consequences of an act, deontologists argue that some acts are right or wrong independent of their consequences. DIF: Recall REF: p. 20 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 22. Immanuel Kant is associated with which of the following theories of ethical thinking? a. Virtue ethics b. Consequentialism c. Nonconsequentialism d. None of the above ANS: C Immanuel Kant is credited for establishing one of the most detailed nonconsequentialist or deontological theories of ethical thinking. Plato and Aristotle are associated with virtue ethics. John Stuart Mill is associated with consequentialism. DIF: Recall REF: p. 21 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 23. Which of the following ethical types of reasoning would be most likely to say that a physician should be honest in telling a cancer patient that he or she only has a short time to live, even if he or she knew the patient would live longer if he or she did not 22know the truth? a. Consequentialist ethics b. Nonconsequentialist ethics c. Virtue ethics ANS: B With this view, a professional’s duty to tell the truth to a patient is not founded on the consequences of telling the patient the truth, but on the belief either that an absolute duty exists never to lie or that the patient is entitled by reason of a fundamental right to receive the truth. DIF: Comprehension REF: p. 21 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 24. According to Immanuel Kant, the test for a universal law is whether an action is related to (a/an) a. overriding duty. b. moral compass. c. desirable outcome. d. benefit for the majority. ANS: A Kant held that the test of any rule of conduct is whether it can be a duty for all human beings to act on. That test is what tells us whether an action is directly related to an overriding duty. This school of thought has had a significant effect on biomedical ethics. DIF: Recall REF: p. 21 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 25. Immanuel Kant’s test for correct moral reasoning is called the categorical imperative, which means a a. designation of the reasoning according to four criteria. b. stable pattern of perceiving, thinking, and acting rightly. c. rule or standard of conduct that is binding for all human beings. d. consequence of an alternative course of action in a given situation. ANS: C This rule or standard of conduct is absolutely binding for all human beings under all circumstances in which the rule or standard applies. Sometimes Kant’s Categoric Imperative is compared with the golden rule. Kant did not develop the categorical imperative according to four criteria. Stable patterns of perceiving, thinking, and acting rightly are definitions of character, or virtue. Analysis of consequences is associated with consequentialist ethics, whereas Kant and his philosophies are associated with nonconsequentialism. DIF: Comprehension REF: p. 21 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 26. According to Kant, helping an elderly person cross the street is (a/an) a. categorical imperative. 23b. perfect duty. c. imperfect duty. d. moral obligation. e. universal law. ANS: C An imperfect duty is an obligation to help another person in need or to be compassionate. It is a matter of moral judgment that a person must carefully make to determine for whom and in which situations to fulfill this duty. A categorical imperative is a rule or standard of conduct that is absolutely binding for all human beings under all circumstances in which the rule or standard applies. DIF: Comprehension REF: p. 21 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 27. Some moral philosophers have advocated that correct moral thinking should be like solving a simple mathematical equation. Theories of moral development have been offered to help understand how easy making good moral decisions can be. a. Both statements are true. b. Both statements are false. c. The first statement is true, the second statement is false.