How is a case of potential elder abuse different from a case of potential child abuse?
A) The aged are more vulnerable physically, socially, and emotionally.
B) Children are more likely than elders to be victims of financial exploitation.
C) People of all ages have a right to live in ways that others may judge risky.
*D) An adult, unlike a child, is always presumed mentally competent until proven otherwise.
E) None of the above
Complete cessation of sexual activity is most often a result of which of the following?
A) Marital status
B) Feelings of an older person about sexuality
*C) A decline in physical health among one or both partners
D) All of the above
E) A and B above
Which of the following is the best predictor of sexuality in old age?
A) Marital status
*B) Earlier sexual behavior
C) Feelings of an older person about sexuality
D) Physical health
E) None of the above
Which of the following are risk factors for elder abuse?
A) Psychopathology, especially alcohol and substance abuse
B) Family history of violence
C) Social isolation
D) Care giving burdens
*E) All of the above
When a person can no longer manage to prevent harm to himself or herself or others, legal intervention (i.e., “protective proceedings”) may be sought and may include which of the following processes?
A) Guardianship
B) Conservatorship
C) Civil commitment
*D) All of the above
E) A and B above
Parens patriae refers to which of the following powers?
A) The state has the authority to prohibit individuals from injuring others or harming their property.
*B) The state has the authority to protect those who cannot protect themselves.
C) That state has the authority to provide procedural safeguards to avoid wrongful imprisonment.
D) All of the above
E) A and B above
Which of the following protective functions may result when health professionals assist caregivers in recognizing the limits of their own health, identifying supportive services, and sharing caregiving responsibilities among available family members?
A) It may prevent elder abuse or neglect that might have been triggered by caregiver burden.
B) It may protect the caregiver from mistreatment or abuse.
C) It may assist professionals in balancing autonomy and beneficence.
D) All of the above
*E) A and B above
Which of the following ethical issues are most likely to arise in legal proceedings regarding elder mistreatment?
A) Promotion of autonomy
B) Least restrictive alternative
C) Guardianship concerns
D) All of the above
*E) A and B above
The “least restrictive alternative” refers to which of the following?
A) The promotion of self-governance, that is, being one’s own person, without constraint by others or by psychological or physical limitations
B) What an older adult actually does to take care of daily living needs; includes consideration of past decision-making
*C) Practitioners are ethically bound to craft individualized solutions that are least intrusive upon their client’s freedom.
D) All of the above
E) None of the above
Which of the following terms has been used to describe older patients who appear filthy and unkempt, whose homes are dirty and untidy, but who show no shame for their situation?
A) Self-Neglect Syndrome
B) Senile Breakdown Syndrome
C) Dilemma of Neglect Syndrome
*D) Diogenes Syndrome
E) None of the above
Elder abuse and self-neglect are the same phenomenon and can be addressed in the same way.
A) True
*B) False
The majority of perpetrators of elder abuse are strangers to the victims.
A) True
*B) False
Data from National Crime Victimization Surveys show that people over age 65 are more likely than other age groups to be victims of serious crimes, such as robbery, personal theft, assault, and rape.
A) True
*B) False
Advancing age is the major predictor of sexual activity in old age.
A) True
*B) False
Research has failed to find a clear relationship between age and fear of crime.
*A) True
B) False
Older people are more likely to be victims of financial exploitation than physical abuse.
*A) True
B) False
All states require mandatory reporting whenever there is evidence of elder abuse.
A) True
*B) False
Sexuality is a normal part of the human life course, including in later life.
*A) True
B) False
According to Brown, guardians and conservators often do not know or fail to heed the wishes and concerns of their wards.
*A) True
B) False
There are generally no limits to the individual’s right to exercise self-determination.
A) True
*B) False
A competent patient may refuse interventions even if a health professional confirms that the patient is being mistreated.
*A) True
B) False
Some cases of elder mistreatment occur when the burden of care giving becomes too great.
*A) True
B) False
When health professionals treat families, they always know who the primary patient is and how to balance their professional obligations among various members of the family.
A) True
*B) False
According to Heisler and Quinn, practitioners should not protect a client’s autonomy to the extent that they fail to take action to protect an elder.
*A) True
B) False
Evaluating the competency of clients necessitates working with the characteristics of the individual older adult.
*A) True
B) False
The fact that there are stereotypic or “typical” cases of self-neglect assists professionals in arriving at simplistic solutions to a variety of situations.
A) True
*B) False
Self-neglect is often attributed to older adults.
*A) True
B) False
There is a clear-cut psychopathology that explains the tendency in some individuals to neglect themselves.
A) True
*B) False
Type: E
What dilemmas do professionals face when they come across cases of suspected abuse or neglect of elders?
*A) Varies
Type: E
Describe what is meant by “guardianship.” How can guardianship be helpful or harmful to vulnerable adults?
*A) Varies
Type: E
Why is it difficult to define “quality of life” and measure well-being in old age? How is this difficulty problematic for gerontology? How does this difficulty render decisions about whether to intervene in suspected cases of abuse or neglect difficult?
*A) Varies
Type: E
Is there a difference between neglecting one’s self, and being neglected or abused by another?
*A) Varies
Type: E
Compare and contrast the exercise of police power and parens patriae power. What procedural protections are provided to safeguard individuals’ rights?
*A) Varies
Type: E
Describe the kinds of ethical dilemmas health professionals face in suspected cases of elder mistreatment.
*A) Varies
Type: E
What special considerations must be made in legal proceedings dealing with elder abuse? Which ethical issues are most likely to arise in these cases, and why?
*A) Varies
Type: E
Describe the ambiguities and contradictions that surround the problem of self-neglect among some older persons.
*A) Varies
Controversy 7
Should People Have the Choice to End Their Lives?
“Assisted suicide” is defined as:
A) A deliberate intervention to end a patient’s life
B) Not doing something, such as withdrawing life support, that results in death
*C) A doctor or family member actively provides the means or carries out the instructions required for an individual to end his or her life
D) Euthanasia
E) None of the above
Older adults make up around 13% of the U.S. population but account for what percentage of suicides?
A) About 10%
*B) Almost 16%
C) Almost 25%
D) None of the above
Which of the following are predictors of suicide?
A) Intolerable psychological pain and frustration
B) A feeling of hopelessness or helplessness
C) Expressing the intent to kill oneself
D) A and B are true
*E) All of the above
Which state was the first in the U.S. to make physician-assisted suicide legal?
A) Hawaii
B) Massachusetts
*C) Oregon
D) All of the above
E) A and B above
Among the patients studied by Pearlman and Starks, the pursuit of physician-assisted death was motivated by all of the following factors except one. Which one?
A) Illness-related experiences
B) Threat to the person’s sense of self
*C) Depression
D) Fears about the future
E) None of the above
McKhann prefers to use which of the following terms to describe the person who wishes to die and asks for help?
A) Assisted suicide
B) Active euthanasia
*C) Physician-assisted dying
D) Passive euthanasia
E) None of the above
Which of the following reflect public concerns about assisted dying?
A) The possibility of medical error
B) The potential for abuse
C) The roles played by financial interests in prolonging or shortening life
D) The possibility of a “slippery slope” down a path of moral decay
*E) All of the above
Which states in addition to Oregon have passed laws permitting physician-assisted dying?
A) Washington
B) Vermont
C) Montana
*D) All of the above
E) None of the above
According to Kass, which of the following reasons are used to support physician-assisted death?
A) The right to control one’s body and life; freedom and autonomy
B) When the patient’s life is deemed no longer worth living, usually because of great pain, a terminal condition, an irreversible coma, advanced senility, or extreme degradation
C) Once a patient is diagnosed with a terminal illness, the physician is no longer obligated to heal
D) All of the above
*E) A and B above
According to Kass, the reasons that are advanced to support physician-assisted death represent which school(s) of medical ethics?
A) The school of autonomy
B) The school of general benevolence and compassion
C) The school of professing the art of healing
D) All of the above
*E) A and B above
Among older persons, clinical depression is the most important cause of suicide.
*A) True
B) False
Most older suicide victims live alone.
A) True
*B) False
Older people who commit suicide are more likely to have recently visited their primary health care provider than to have received mental health services.
*A) True
B) False
Suicide rates rise with advancing age for women but not for men.
A) True
*B) False
The first important “right-to-die” law was passed with the Oregon Death with Dignity Act.
A) True
*B) False
U.S. common law holds that people have a right to accept or reject medical treatment.
*A) True
B) False
Termination of life-sustaining treatment is not homicide, suicide, or assisted suicide according to court decisions.
*A) True
B) False
The majority of older people do not feel sad or unhappy most of the time.
*A) True
B) False
Pearlman and Starks argue that health care providers can best serve patients by focusing on the single factor motivating them to seek physician-assisted death.
A) True
*B) False
Because of the wish to control the timing and circumstance of one’s death, some dying patients will continue to desire assisted death even if they are receiving excellent palliative end-of-life care.
*A) True
B) False
Kass argues that defining categories of “euthanizable” people is a fairly easy and straightforward task.
A) True
*B) False
Kass argues that from the health care provider’s perspective, the duty to make whole and to heal can never be compatible with intentionally killing the patient.
*A) True
B) False
Type: E
Why is depression difficult to diagnose in older adults?
*A) Varies
Type: E
What is the Patient Self-Determination Act, and how has it assisted people in making end-of-life decisions?
*A) Varies
Type: E
In your opinion, should physician-assisted suicide be legalized? Explain.
*A) Varies
Type: E
Why do some people seek physician-assisted death? How can clinicians best understand older persons’ complex experiences around serious illness, dying and death?
*A) Varies
Type: E
Explain McKhann’s arguments in favor of physician-assisted dying. Do you agree or disagree with McKhann? Explain.
*A) Varies
Type: E
In your judgment, is Woodman arguing in favor of or against physician-assisted death? Explain.
*A) Varies
Type: E
Describe how “Aunty’s” feelings about physician-assisted death changed over time. What makes these decisions complicated for patients, families, and health care providers?
*A) Varies
Type: E
How would legalized mercy killing affect the doctor-patient relationship, according to Kass? Do you agree or disagree with his position? Explain.
*A) Varies
