1. A poll is published.

The results are that after the age of 80, no one should access to
intensive care. Identify the correct response to this information.
a. This data demonstrates that the public never know what is morally right
b. This data is useful to know when completing the descriptive analysis
c. A strong conceptual analysis has been given
d. This data demonstrates that the public always knows what is morally right
2. Reasons for telling the truth include:
a. Not telling the truth implies that the health care professional knows what is best
for the patient
b. It guarantees patients agree with their caregivers
c. It maintains trust
d. Telling the truth implies that the health care professional
3. In the Mr. Boucher case, telling the truth is complicated because it requires considering
whether:
a. Whether delayed disclosure is justified
b. All options
c. The priority is respect for Mr. Boucher’s autonomy or acting in what his family
think is in his best interest
d. Deciding whether the fears of his family are valid
4. Virtues for health care professionals
Beauchamp and children (2013) have identified ‘care’ as “a fundamental virtue for
traditional health care relationship” (p.33). They then list five ‘focal’ virtues which
“support and promote caring and caregiving” (p.33). All of these virtues are integral to
the character of a virtuous health care professional except:
a. Discernment - the ability to understand what is needed in a situation (e.g., how
best to provide for a patients needs)
b. Conscientiousness - being guided by your superiors
c. Compassion - regard for another's welfare, emotional response to another’s
suffering and the attempt to alleviate it (p.37)
d. Trustworthiness - being reliable so that others (patients, colleagues) know that
you will do your best for them and be honest with them
5. The Internet Encyclopedia of Philosophy defines ethics as the field of ethics (or moral
philosophy) that:
a. The accumulation of information and once informed, following rules and laws
b. Involves systematizing, defending, and recommending concepts of lawful and
unlawful behavior
c. Involves systematizing, defending, and recommending concepts of right and
wrong behavior
d. Responding to ethical challenges in order to avoid conflicts with colleagues
6. Patient privacy is protected by:
a. Canadian Charter of Rights and Freedoms Section 7 which allows deception in
accordance with principles of fundamental justice
b. Canadian Charter of Rights and Freedoms Section 11 which guarantees
everyone the right not to be discriminated health care
 c. Canadian Charter of Rights and Freedoms Section 7 which grants the right to
life, liberty and security of the person
d. Canadian Charter of Rights and Freedom Section 10 which allows everyone to
retain and instruct counsel without delay and to be informed of that right
7. Tobacco use, sales and advertising is controlled in Canada. This law is justified by the
following ethical argument:
a. Tobacco use is associated with death from heart disease and cancer
b. People with weak characters use his substance
c. Government can make more taxes by limiting lifestyle choices
d. Majority of Canadians support this law
8. In chapter three, the ancient and modern accounts of autonomy are discussed. Using
the concept of autonomy as intended by Kant what would you say to someone who
decides to quit their employment, live on welfare and drink alcohol to excess.
a. Live and let live. As long as nurses are not hurting anyone, their actions are
ethical
b. We only have duties to self
c. Rationality will show them what they ought to do
d. It is ethical for nurses to choose to waste their potential
9. One benefit of rule-utilitarianism (RU) is:
a. Helps decide what is the pe\referred end in each situation
b. Provides rules and laws that are followed universally
c. Puts emphasis on duties and not outcomes
d. Encourages critical thinking about rules and laws
10. Case about Doctors without Borders. The nurse is ask to give the families sterile
equipment when the children have female cutting also called female genital mutilation.
Using act utilitarian reasoning the nurse should reason as follows:
a. The practice will happen in any event so I might as well give them sterile
equipment
b. The end is to gain the trust of the families, therefore I will give them the sterile
equipment
c. Giving the mothers sterile equipment will benefit the children
d. I strive to help each child be healthy and will not cooperate with this harmful
practice
11. Using deontological reasoning, the reason that the World Health Organization states the
following about FC or FGM is the following:
a. There is a duty never to harm another
b. The consequences for the child are exaggerated
c. Wishes of parents must be respected
d. It is a tradition that should be respected
12. Kant’ theory is studied despite its limits because:
a. Focuses attention on benefits and harms of possible outcomes
b. Respect for all persons is a duty
c. Supports medical aid in dying (Euthanasia and assisted death)
d. Gives the formula: the end justify the means
13. Philosophy requires studying theories about our world and how we perceive ourselves in
it. Moral philosophy, also known as ethics, is a branch of philosophy that asks questions
such as:
a. What makes something ‘right’?
b. What is the most efficient action to take?
c. How do we know how to get ahead in our profession?
d. What does it mean to be a successful person?
14. Two nurses who made medication errors are afraid to report the incidents to their
manager who has a history of retaliation against nurses who make errors. The nurses
prepare for the meeting with the manager. They study research about the benefits of the
new approach to improving patient safety. According to the reading Ethical talk, the
nurses are demonstrating the following strategy for promoting constructive dialogue:
a. Getting ready to dominate the discussion to prevent the manager responding
b. Being informed in order that they can engage with the manager in a discussion of
the issue
c. Overwhelming the manager with all the research they have done
d. Being expects wanting to shame the manager into admitting he or she was
wrong
15. An order is written that a patient must be sedated and have a feeding tube inserted.
Patient says, no I refuse to have a feeding. The best ethical response would be to say:
a. You have no choice. Make it easier for yourself and agree to the orders
b. Please agree or I will be in trouble
c. I have no choice. I have an order to sedate you. Please cooperate
d. I cannot proceed without your consent
16. Family member says “I am going to ask CBC and CTV to make a documentary about
how you are letting our mother die.” Before they contact the media the first person or
department who must give consent is:
a. The patient
b. Her care givers
c. The manager of health records
d. Press and media officer
17. Your professor asks what you think about the legalization of medical assistance in dying
(MAiD). You say it is approved by the law and therefore it is difficult. You are
demonstrating what type of moral response?
a. Reflective - judgments based on principles, rules, values, which are consciously
accepted, can be defended
b. Pre-reflective - justification uses values, principles, rules which are accepted
uncritically, e.g., my parent/teacher/religion/the law told me to think/behave this
way
c. Pre-expressive - what my friends think is right
d. Expressive - feelings used to “justify” rightness or wrongness of something
18. Your text discusses the history of utilitarianism and contrasts the version of Bentham, its
originator, with John Stuart Mill, who ‘refined’ the theory. The theory tells us that when
we undertake any action that we think may have significant ethical consequences, we
 should use this following 4-step process. From this list, what step should not be
followed?
a. Identify only possible courses of action that will benefit you
b. Predict the consequence of each course of action
c. Select the course of action that produces the greatest net happiness
d. Evaluate the happiness and unhappiness produced as a result of the
consequences of each course of action, subtracting the unhappiness produced
from the amount of happiness produced
19. Case: Mr. Boucher
Mr. Boucher is 88 years old. He retired after working for many years as a school
principal. He is a world war II veteran. Last week, he fell down his basement steps and
lost consciousness for a few minutes. In the past week he has been dizzy. His family
physician insisted he have diagnostic work. He went to the local hospital and had
several tests. While he was getting dressed, the clinical team told his wife Margaret and
son James that he had an inoperable liver cancer. He would be asymptomatic for
probably three months. They did not recommend surgery because of the location of the
tumor. Mr. Boucher did not hear because he was not wearing his hearing aids. His son
and wife asked to speak to the clinical team privately. His wife told the clinical group that
he must not be told now. She explained that he has a long history of clinical depression.
Their son James, the chief of medicine at the same hospital, agrees with his mother. He
said his father suffers from post-traumatic stress syndrome (PTSD). His psychiatrist
recommended that a trip to Normandy with his war “buddies” sponsored by the
Canadian Veterans Affairs department would help him cope better. His son and wife
request he is told after they have made the trip to Normandy to see the Candian
Cemeteries. His wife and son will go with him. Mr. Boucher landed on D Day and he
agrees with his psychiatrist that he will benefit from returning to the beaches and visiting
the cemeteries where many of his friends died. The trip is planned for next month, June,
when there are major celebrations on the D-Day beaches. Their trip will last one week.
James and his mother predict that when he finds out he has liver cancer; he will become
depressed, cancel the trip and return to his old habit of blaming everyone for his
problems. When they return from France, they think he should be told. His wife and son
predict that he would cancel the trip once he learns his diagnosis. Later that day, Mr.
Smith asks the staff what they found out. He says he doesn't feel like himself and says,
“I think the trip to Normandy with my family and the guys that can still make the trip will
help me have some inner peace.”.

When Mr. Boucher and his family came to the hospital, they trusted the health care
professionals. In turn they had a duty to:
a. Be sensitive to the power they have to help and harm patients
b. Tell his family to stop being paternalistic
c. Avoid answering questions about ethical concerns
d. Thank his family for being paternalistic
20. A care provider says: “When i read about Mr. Boucher, I felt that it is best to go with my
first reaction.” An appropriate response would be:
a. You are right. We are not accountable for what happens, so it is okay
b. What do you mean? I do not think there is a moral problem
c. You are right. We have no other choice because we are so busy
d. You are wrong. We need to think about the options and outcomes
21. Rule utilitarianism requires that the caregiver should:
a. Always conform to hospital policies and rules: no exceptions allowed
b. Support critical reflection of laws and policies
c. Consider each case on its own merits
d. Look for power-imbalances between patients, families, and care givers
22. A care provider says, “If that was me, given the expected suffering and death, I would
want to die quickly and with little suffering. I would even consider medical aid in dying.”
This statement is an example of which theory about morality?
a. Deontological
b. Feminism
c. Act utilitarianism
d. Rule utilitarianism
23. His psychiatrist provided information that his Post traumatic stress syndrome, unless
there was some improvement, would interfere with him coping with a terminal illness.
This information would be important at what stage of the ethical decision-making
process?
a. Conceptual analysis, middle, when ethical values and theories are considered
b. Normative or conclusion, when a decision reached
c. Descriptive analysis, beginning, when clinical information is gathered
24. Months later, Mr. Boucher is admitted to a palliative care unit. There are orders to use
physical restraints when he is agitated. You think using physical restraints is unethical
and contradicts your values about patient care. Select the theory of morality that
explains your response.
a. Deontology
b. Utilitarianism
c. Virtue ethics
d. Paternalism
25. According to the Ethical-Decision-Making Framework for Individuals (2009) as
Presented by MacDonald, the first step in ethical decision-making is:
a. Make your choice
b. Collect information and identify problems
c. Learn what your employer expects you to do
d. Consult an ethics committee
26. Regarding this case, Kant’s deontological theory would support the following statement:
a. His son knows him best and we should respect his request
b. The team must think about the most efficient use of health care resources
c. Giving Mr. Boucher to benefit from his therapeutic trip is the best outcome
d. There is a duty to be honest with him, now
27. Mr. Boucher’s care givers think about their opinions. They consider the pro’s and con’s
of telling him the bad news now or later. The care givers are at what at the following
stage stage of ethical decision making:
a. Checking professional expectations
b. Conceptual analysis, middle, when ethical values and theories are considered
c. Descriptive analysis, beginning, when clinical information is gathered
d. Normative or conclusion, when a decision is reached
28. Identify a valid act utilitarian argument to support delayed disclosure of the diagnosis
until his return.
a. If it was my father, I would want him to be protected from bad news for as long as
possible
b. My goal is to get along with his son in order to improve my career opportunities
c. Our goal is to help him die with more inner peace and to do so. He needs to take
a therapeutic trip and then receive the bad news
d. We must follow the orders given by the chief of medicine
29. Which statement indicates you are prepared to think critically about the case.
a. He will die in palliative care and the sooner the better
b. The family is unreasonable
c. It is our duty to provide care without any bias
30. In palliative care, Mr. Boucher wants to go home to die and he is told he must stay in the
palliative care unit. He says, ‘I feel so powerless. I am fighting my caregivers and the
powerful hospital system.’ The following theory will help you understand his situation.
a. Duty-based
b. Feminism
c. Virtue
d. Efficiency
31. The following statement is an example of act utilitarian reasoning
a. Given he is a Veteran, we must ensure his intrinsic worth is respected and give
him the bad news immediately
b. Given he has terminal cancer, let him be inblissful ignorance until he dies. Best
not to tell him he has cancer now or in the future
c. The best outcome for the taff is to avoid conflict with his son; follow his instruction
to delay disclosure
d. The best outcome is that he be better prepared for his imminent death, delayed
disclosure
32. Kant suggests that for a principle (or “maxim” as he calls it) to be seen one we should
act on; it must satisfy the test of what he refers to as ‘The Categorical Imperative’. The
Categorical Imperative, he says is a maxim that all rational people can figure out for
themselves. Your text gives an account of Kant’s Categorical Imperative including its
‘formulations.’
a. Test each maxim in terms of the expected outcomes
b. Consider what maxim, if any, will either justify or reject each course of action
c. Identify the best possible courses of action
d. Act on the maxim that prevents harm to others
 33. Identify the statement or statements about ethics made by the authors of your text
a. Ethics is a rational activity
b. All of these options
c. Religion and ethics are distinct
d. Ethics is a matter of religious faith
34. Anne frank and her family are hiding in home during the Nazi Occupation of the
Netherlands. A person comes to the door and asks if they are hiding Anne Frank and her
jewish family. You have a conflict between the duties to tell the truth and not to harm
others according to what theory?
a. Deontology
b. Act utilitarianism
c. Rue-utilitarianism
d. Teleology
35. Case: Stephen questions (next 5 questions)
Stephen is a young man aged 22, with schizophrenia. He asked for admission to the
hospital because he wanted help with his illness. Stephen is a voluntary patient (can leave when
he wants) and is capable to make treatment decisions. He does research and learns that the
adverse side effects of his medication are weight gain, erectile dysfunction (ED) and diabetes.
He has already gained weight and has ED. He is afraid of getting diabetes. His care givers tell
him that unless he resumes taking his medications, his status will be changed to involuntary
(cannot leave the hospital). Also, his care givers tell Stephen that he is exaggerating side
effects. They take away his computer and I-phone and tell him to stop doing research. The care
givers tell him that the side effects are worth dealing with and “you will get used to the
medications”. Stephen disagrees. He decides to take his medications in order to get his
computer and I-phone back. After taking his medications for one week he is discharged. He
then stops his medications.

As you, a student, work through the conceptual analysis during this stage, you realize
that:
a. Stephen should accept that the staff know what is best for him.
b. Care givers have the dilemma of choosing to respecting Stephen’s autonomy or
acting in what they think is in his best interests
c. All you have to do is follow hospital policies to resolve the case
d. Because Stephen has schizophrenia, he will never be able to deliberate
effectively

36. You are a student caring for Stephen and you decided to use an ethical decision-making
process to think through the situation. At the start of the process you should:
a. Ask for an ethics consultation
b. Ask yourself what would be a perfect answer
c. Ask Stephan what he wishes to happen
d. Ask Stephan whether he as an Apple I-phone
37. Stephans Caregivers say their actions were justified because they had to make sure he
took his medications. Their reasoning is an example of:
a. Act-utilitarianism and paternalism
b. Rule utilitarianism and paternalism
c. Rule utilitarianism and virtue theory
d. Feminisms and paternalism
38. It is justified to limit Stephen autonomy and keep him in the hospital against his will
(involuntary patient) when:
a. He puts other patients at serious risk of harm
b. He complains about his lack of privacy
c. He tells the care givers they are deceiving him
d. He refuses to get out of bed until noon
39. Stephen is capable of making his own treatment decisions. The team say unless you
take these medications, we will find a way to keep you in the hospital. They are
demonstrating:
a. Caring and weak paternalism
b. Act utilitarianism thinking and strong paternalism
c. Rule-utilitarianism thinking and weak paternalism
d. Deontology and feminism
40. A patient's neighbour is a director of nursing in the hospital. She comes to the unit and
sees her neighbour. She is about to open her chart. The ethical response is:
a. You cannot see the chart because you are not directly involved in her care
b. Maybe you can convince her to take her meals
c. Did Mr. and Mrs.Harper have a happy relationship?
d. Good to see she has a caring friend
41. Your professor asks you what you think about the legalization of medical assistance in
dying. You say it is approved by the law but i have thought through the question and
think MAiD is unethical. You are demonstrating what type of moral response?
a. Expressive - feelings used to “justify” rightness or wrongness of something
b. Pre-reflective - justification uses values, principles, rules which are accepted
uncritically, e.g, my parent/teacher/religion/the law told me to think/behave this
way
c. Reflective - judgments based on principles, rules, values which are consciously
accepted, can be defended
d. Pre-expressive: what my friends think is right
42. How do you know when a person is virtuous? Identify the correct statement.
a. It is also important to note that an outsider often can judge whether a person is
truly virtuous, even if he or she habitually performs apparently virtuous actions
b. To become a virtuous person entails constant striving to become a more
influential person
c. It is also important to note that an outsider often cannot judge whether a person
is truly virtuous, even if he or she habitually performs apparently virtuous actions.
d. A person is virtuous when they are honest because he or she is afraid to be
caught stealing.
 43. Case 7, page 122
Case Seven page 122. Question 21, 22 and 23 refer to this case. Women with advanced
dementia has pneumonia. Unless treated, she could die from pneumonia. In the descriptive
analysis stage, you would identify the following:

a. According to deontological reasoning her life must not be shortened

b. According to rule utilitarian thinking, consent laws must be followed
c. Ending her suffering is virtuous
d. One child values sanctity of life over quality of life

44. Same case. Her daughter says she promised her mother she would take care of her and
letting her die under these circumstances would mean she broke her promise. Her
daughter is demonstrating what type of reasoning?
a. Paternalism
b. Feminist theory
c. Utilitarian theory
d. Deontological theory
45. Same case. Her son tells his sister that sometimes promises can be broken. He is
demonstrating what type of reasoning?
a. Deontological theory
b. Paternalism
c. Feminist theory
d. Utilitarian theory
46. Your professor say you are too young to understand how to respond to complex ethical
problems facing Mr. Boucher.The professor says: “Listen to me who has more education
and experience than you.” In the article by Weston, this action is an example of:
a. Going for the “quick kill”
b. Using fake or false information to score points
c. Separating and polarizing
d. Taking all the room you can in a discussion
47. During a class debate, both debate teams do not listen or try to understand what the
other team is arguing. In the article by weston, this action is an example of:
a. Demonstrating the depth of their convictions
b. Going for the quick kill
c. Taking up all the space they can in a discussion
d. Successfully making their points
48. In the video, Dr. Beauchamp makes this point about the truth-telling and keeping
patients informed:
a. Keeping patients informed hs been a value for centuries
b. No exceptions permitted. Always tell the whole truth right away
c. There are occasions when delayed disclosure is justified
d. Follow hospital policies about giving bad news
49. Feminist scholars made the following comments about obtaining informed consent:
 a. Competency is connected with rationality but the rationality of oppressed groups
is denied
b. The exercise of asking for informed consent can be a mask for the old-style
medical paternalism
c. All of these options
d. None of these options
e. Asking for informed consent can be a mechanism for getting compliance frome
docile patients
50. Identify the correct statement about virtuous persons
a. Virtuous persons must avoid social events at bars and clubs where they may be
attracted to vice
b. Virtuous persons know how to act in the right way, at the right time because the
follow rules and laws
c. Virtuous persons know how to act in the right way, at the right time because they
are guided by their character
d. Virtuous persons are dull and boring because they avoid new experiences

CASE: Andrew, a Ryerson Student (next 4 questions)

On a Monday, Alex stole $25.00 from Mary’s backpack. It was a Monday and he would get paid
until Wednesday. On Wednesday, he replaced the cash in Mary’s backpack without her
knowing. She thought she had mis-placed the cash when she found it. Security services saw
the theft on their cameras. He was charged with the crime of theft. The police asked Alex why
he stole the money. Alex stated the he regretted his actions but he needed the money to buy
groceries for his family (true). Despite returning the money, he went to court.

51. The judge says I understand you were motivated by caring for your family. What you did
was against the law but I understand you were committed to helping your family.
Therefore, you will be found not guilty. This reasoning demonstrates:
a. Virtue theory and feminist theory
b. Virtue theory and weak paternalism
c. Virtue theory and rule-utilitarianism
d. Virtue theory and application of first categorical imperative
52. The judge says: you broke the law. You know stealing is never justified. This decision is
an example of:
a. Act-Utilitarianism
b. Rule-utilitarianism
c. Kantian reasoning
53. The judge says that given the specific circumstances, he will find him innocent. This
decision is an example of:
a. Rule-utilitarianism
b. Kanitan reasoning
c. Act-utilitarianism
 54. The judge says you were in a difficult situation. Laws and rules about stealing must be
respected. However, I can make an exception to the law in this case. This decision is an
example of:
a. Kantian reasoning
b. Act-utilitarianism
c. Rule-utilitarianism

CASE:Jill Costa (next 4 questions)

Jill aged fourteen goes to a walk-in clinic and is seen by a Nurse Practitioner (NP). Jill says she
is sexually active and wants oral contraception “the pill”. The NP discusses the health concerns
associated with being sexually active and using birth control pills. Jill understands the risks. Jill
says it is against her faith to be sexually active before marriage. The NP gives her prescription
and told how to obtain contraception without charge. The following week, her mother came to
see the NP. She says the pharmacist called and told her that her daughter had filled a
prescription for the pill. Jill’s mother says she wants to know when and why her daughter had
started taking the pill saing: “She is a child and I should have been here when she talked to you.
Then she would never have got the prescription. She went behind my back. She is too young to
know what she is doing.”

55. The NP reflects, studying ethics in university was valuable because I learned that
a. Following my gut feeling is always an ethically justified response
b. Ethical issues are black and white, there is no grey
c. Standards and codes tell me what I ought to do
d. You need a systematic way to think through ethical problems

56. The NP can justify giving Jill the prescription because:

a. She acted in Jill’s best interests
b. She disagrees with Jill’s family values
c. Jill is her favourite young patient
d. Jill was persistent

57. Mrs. Costa and NP have a discussion. Mrs. Costa says the NP did not have the right to give
her daughter any health care without the consent of her (mother). Np replies using terms of age
of consent, paternalism, lesser of two evils, and consent laws. Mrs. Silva says I do not know
what you are talking about. The NP demonstrates the following technique identified in ethical
talk.
a. Giving facts and evidence to prove you are correct
b. Listening and seeking common ground
c. Educating the patients and their family
d. Going for the Quick Kill by talking in slogans and soundbites

58. Identify the most appropriate response the NP can give:

a. I thought she was much older, she looks like she is seventeen
 b. You need to accept she is not a child anymore
c. It would be worse if she got pregnant
d. Her health information is confidential

59. Privacy and confidentiality are distinct. Mary, aged 17 is admitted to hospital because of an
overdose. Her mother comes to her nurse and asks why her daughter is in hospital. Identify the
correct statement about privacy.
a. Privacy laws allow custodians to share information with the mother because she is
worried about her daughter
b. Privacy laws protect health information being given to her mother without Mary’s consent
c. Privacy laws never allow disclosure of private health information
d. Patients have confidentiality rights and health care professionals have privacy rights

60. One limit of act-utilitarianism (AU) is:

a. Encourages blind following of laws
b. Can justify an unjust act that brings happiness to a few
c. Provides a clear direction for the person experiencing a moral dilemma
d. Promotes utility and welfare