倫理：Mid year exam対策

E1. The following are true of informed consent:

a. A voluntary uncoerced decision
b. The cornerstone of patient autonomy
c. Patients have the right to accept/reject suggested options
d. Only a and b
e. All
Explanation: インフォームドコンセントは、患者が自由意志で情報に基づいた決定を行う権利を示します。

A2. Informed consent involves all of the following except:

a. Providing a potential subject with inadequate information to allow for an informed consent decision about participation in the clinical investigation
b. Facilitating the potential subject’s comprehension of the information
c. Obtaining the potential subject’s voluntary agreement to participate
d. Providing adequate opportunity for the potential subject to ask questions and consider whether to participate
e. Continuing to provide information as the clinical investigation progresses or as the subject or situation requires
Explanation: 十分な情報提供はインフォームドコンセントの基本要素です。

D3. Not a basic element of informed consent:

a. Voluntary participation
b. Contacts
c. Description of clinical investigation
d. Number of participation
e. None
Explanation: 参加者の人数はインフォームドコンセントにおいて基本的な要素ではありません。

D4. When a patient lacks decision-making capacity:

a. Identify an appropriate surrogate
b. Assist the surrogate to make decisions
c. The surrogate is entitled to a lesser respect compared to the patient
d. Only a and b
e. All
Explanation: 患者の意思決定能力がない場合、代理人の支援が必要です。

B5. The following are true on withholding information from a patient except:

a. Withholding information without the patient’s knowledge is ethically unacceptable except in emergency situations
b. The obligation to communicate means that the physician must give information immediately
c. Once the emergency situation has been resolved, the physician should convey the information
d. A and C
e. None
Explanation: 情報の即時提供は必須ではなく、状況に応じた判断が重要です。

B6. It is used to decide whether a child is able to consent to contraceptive or sexual health advice and treatment:

a. Heimlich maneuver
b. Fraser guidelines
c. Health Care for minors
d. Gillick Competence
e. Childress guidelines
Explanation: フレイザーガイドラインは未成年の意思決定能力を評価する基準です。

Contents

1 A7. The following is/are true of abortion in the Philippines:
2 E8. In deciding for a critically ill newborn, which of the following should be considered?
3 B9. The following are true of genetic testing, except:
4 C2. A 25-year-old male dies with organ donation directives. The most likely recipient of his organ will be:
5 D43. The basic principles of the Belmont Report, except:
6 E56. In deciding for a critically ill newborn, which of the following should be considered?
7 A57. The following is/are true of abortion in the Philippines:
8 B58. The following are true of genetic testing except:
9 E59. In deciding for a critically ill newborn, which of the following should be considered?
10 _A_16. True of abortion in the Philippines:
11 _B_17. It is used to decide whether a child is able to consent to contraceptive or sexual health advice and treatment.
12 1. Marquis was in a car accident and is now in a coma. There was a written order on his medical chart that indicates that he is not to be revived should his heart stop. What is the name for this medical order?
13 3. When dealing with hostile patients/relatives, why is it important to look beyond their anger?
14 5. A living will sets out which of the following?
15 7. When do people deal with death the best?
16 11. When one dies, the pattern of grieving depends on all EXCEPT which of the following?
17 12. What is the function of funeral practices and rituals?
18 13. Studies that compare older and younger people find that older people express more concern about which aspect of death?
19 14. The effects of advance care planning on end-of-life care include the following, EXCEPT?
20 15. The following situations allow patients to make meaningful decisions for future care crises, EXCEPT?
21 16. Which of the following is an example of an ethical conflict that doctors face when they treat dying patients?
22 18. What is one of the main problems with advance directives?

A7. The following is/are true of abortion in the Philippines:

a. Revised Penal Code Act 3815
b. Legally advocated
c. Sometimes criminalized
d. The criminal provisions may contain exceptions to save the life of the pregnant woman
e. None
Explanation: フィリピンでは、人工妊娠中絶は改正刑法に基づいて取り扱われています。

E8. In deciding for a critically ill newborn, which of the following should be considered?

a. The needs
b. Interest
c. Family resources
d. Availability of treatment options
e. All
Explanation: 重篤な新生児の治療において、すべての選択肢を考慮する必要があります。

B9. The following are true of genetic testing, except:

a. Genetic diagnosis can carry both benefits and risks for the patient
b. The decision to test should only consider the potential benefit
c. If parents unreasonably request or refuse testing for the child, the physician may use legal means to override the parents’ choice
d. The physician should seek the informed consent of the minor patient’s parents
e. None
Explanation: 遺伝子検査の決定は、潜在的なリスクも考慮する必要があります。

B10. Requires that subjects be informed they may decline participation or stop at any time without penalty or loss of benefits to which they are entitled:

a. Benefits
b. Voluntary participation
c. Alternative procedures or treatment
d. Confidentiality
e. Informed consent
Explanation: 自由意志による参加は、倫理的研究の基本原則の一つです。

D11. How is Gillick Competency defined?

a. Children under the age of 16 years old can consent to the provision of contraception if necessary
b. Children under the age of 16 can consent to an abortion if necessary
c. Children between the ages of 16-18 years can consent to medical treatment
d. Children under the age of 16 years have the capacity to consent if they have sufficient maturity and understanding
e. Children between the ages of 16-18 years can consent to both contraception and abortion if necessary
Explanation: ギリック能力は、未成年者が十分な成熟度と理解力を持つ場合に意思決定可能であると定義されます。

C12. A doctor is protected from litigation for carrying out treatment unlawfully in a minor if:

a. Consent has been obtained from a minor over the age of 16 years
b. Consent has been obtained from a “Gillick” competent child
c. Either statement could apply
d. Neither statement applies
Explanation: 未成年に対する治療では、適切な同意が得られた場合、医師は法的保護を受けます。

B13. In the context of information disclosure, which of the following statements is correct?

a. The doctrine of informed consent requires that patients are provided with full information
b. The amount of information required is measured against the reasonable patient
c. A claim that a doctor was negligent for insufficient disclosure must be brought in negligence
d. Valid consent is sufficient to legitimize procedures
e. None
Explanation: 患者への情報提供は「合理的な患者」の基準に基づいて測定されます。

C14. The factors to be considered when determining an incompetent adult’s best interests include:

a. The age of the patient
b. The patient’s diagnosis
c. The need to use the least restrictive principle
d. Whether the patient can sign a consent form
e. None
Explanation: 制約を最小限に抑えることが、無能力な成人の最善の利益を決定する上で重要です。

C15. A person lacks capacity in relation to a decision if:

a. The person is under 18 years old
b. The person makes an unwise decision
c. The person is unable to make a decision due to an impairment or disturbance in mind function
d. The person has dementia
e. None
Explanation: 意思決定能力の欠如は、心の機能障害による場合が多いです。

D1. It refers to the privacy of information and its protection against unauthorized disclosure:

a. Privacy
b. Top secret
c. Data privacy
d. Confidentiality
e. Competency
Explanation: 「機密性」は、情報が無断で開示されないよう保護する倫理的および法的義務を指します。

E2. The rule of the confidentiality of physician-patient communication and patient record is not absolute under the following circumstances, except:

a. For insurance compensation
b. Upon patient consent
c. In the interest of public order and safety
d. For research purposes
e. None
Explanation: 医師と患者の機密保持には例外があり、法的要件や公共の安全が求められる場合に制限されることがあります。

B3. It provides that every person shall respect the dignity, personality, privacy, and peace of mind of another person:

a. RA 3185
b. RA 386
c. RA 9262
d. RA 8505
Explanation: RA 386（フィリピン民法）は、個人の尊厳やプライバシーを保護する基本法です。

C4. This can be applied when a person who is not authorized by parties to a private communication records or communicates its contents:

a. RA 8505
b. RA 9262
c. RA 4200
d. RA 3185
Explanation: RA 4200（反盗聴法）は、私的通信の記録や開示を防止するための法律です。

B5. Individuals availing of insurance coverage sign waivers allowing health maintenance organizations to access their medical records in exchange for benefits or claims:

a. RA 3185
b. RA 7875
c. RA 8505
d. RA 386
Explanation: RA 7875（フィリピン健康保険法）は、医療記録へのアクセスを保険の条件として規定しています。

C6. The following are true of confidentiality, except:

a. A legal obligation
b. Points to the duty that rests on those to whom the private information is entrusted
c. The individual’s right to be free from unwanted external scrutiny
d. Privileged communications are not unnecessarily disclosed
e. None
Explanation: 「機密性」は情報を預かる者の義務であり、個人の外部監視からの自由とは異なります。

E7. True of Electronic Medical Records except:

a. Transcends the physical limitations of paper files
b. Improves the quality and accuracy of data
c. Facilitates access and sharing of health information among HCPs
d. Tends to redefine the scope of privacy and confidentiality
e. None
Explanation: 電子カルテは、従来の紙記録の限界を克服しつつ、機密性とプライバシーの再定義を促します。

B8. The privacy of communication and correspondences shall be inviolable except upon lawful court order or when public safety requires:

a. RA 7875
b. Philippine Constitution, Sec. 3
c. RA 8505
d. RA 3185
Explanation: フィリピン憲法第3条は、通信のプライバシーを保護しますが、公共の安全が必要な場合には制限されることがあります。

C9. Which of the following statement/s is/are true?

a. The patients are the bearers of the duty of confidentiality
b. The healthcare providers are the holders of privacy
c. Revelation of secrets is now criminalized
d. Any injury that the patient may incur as a direct result of violation of the duty to maintain confidentiality will not make a physician liable
e. None
Explanation: 秘密の開示が刑事罰の対象となるケースが増加しています。

E10. The following is/are true of legal and ethical provisions:

a. The right to privacy is a basic human right
b. There is no legislation that directly addresses the privacy issue specific to health information
c. The right to privacy is guaranteed by the constitution
d. A and B
e. All
Explanation: プライバシーの権利は人権として認められており、医療に関連する法律もそれを保護します。

Matching Type: RA Numbers

RA Number	Description
I RA 3753	Law on Registry of Civil Status
F RA 3573	Reporting of Communicable Diseases
H RA 7875	National Health Insurance Act of 1995
G RA 4200	Anti Wire-Tapping Law
E RA 9165	Patients on Drug Rehabilitation
J RA 9262	Violence Against Women and Children
D RA 8504	Identity and Status of HIV Patients
B RA 8505	Rape Victim Assistance and Protection
C RA 3185	Revelation of Secrets
A RA 10173	Data Privacy Act

A1. John, a 38-year-old male athlete diagnosed with end-stage osteosarcoma with a living will refusing aggressive treatments. His physician insists on all treatments. The physician is exercising:

a. Act of Paternalism
b. Ideal beneficence
c. Obligatory beneficence
d. Specific beneficence
e. Surrogate decision-making
Explanation: 「パターナリズム」とは、患者の意思に反して行動する医療者のアプローチを指します。

C2. A 25-year-old male dies with organ donation directives. The most likely recipient of his organ will be:

a. A 45-year-old alcoholic with irreversible liver failure
b. A 75-year-old female with dementia and end-stage renal failure
c. A 35-year-old entrepreneur with acute renal failure
d. A 10-year-old male with multi-organ failure and brain death
e. A 40-year-old female with heart failure and HIV-positive
Explanation: 臓器移植では、受益者の健康状態や予後が優先されます。

C3. The principle of ethics described as “doing no harm” is:

a. Beneficence
b. Justice
c. Nonmaleficence
d. Respect for autonomy
e. Veracity
Explanation: 「無害性の原則」は患者に害を及ぼさないことを強調します。

B4. A public hospital in the Southern Isle is having a large number of unreported incidents of needlestick injuries and no reporting system or compensation for healthcare providers is in place for such incidents. As contrast, patients are well-protected against harassment and the spread of Hepatitis B and C infections. Victims of maleficence here are:

a. Communities
b. Employees
c. Families
d. Patients
e. Stakeholders
Explanation: 従業員（医療提供者）がリスクにさらされ、適切な保護や補償が提供されていない場合、彼らは害を被る犠牲者とみなされます。

C5. When may confidentiality be breached?

a. When the patient does not listen to the doctor
b. When financial resources are scarce and the patient is non-compliant
c. When a patient authorizes it
d. For a patient who requires invasive treatment
e. In the case of foreign nationals in a country
Explanation: 患者が明示的に承認した場合のみ、医師は法的および倫理的に機密保持を解除できます。

D6. A 62-year-old man who just had a tumor biopsy of the thalamus showing Glioblastoma. As you went out of the OR you saw his son in the hall, and he begs you not to tell his father because the knowledge would kill him even faster. A family conference to discuss the prognosis is already scheduled for later that afternoon. What is the best way for the doctor to handle this situation?

a. The doctor should honor the request of the family member who is protecting his beloved brother from the bad news
b. The doctor should tell the son that withholding information is not permitted under any circumstances
c. The patient should withhold informing the patient about the seriousness of the Glioblastoma because of the grave diagnosis
d. The doctor should ask the patient how he wants to handle the information in front of the rest of the family, and allow for some family discussion time
e. Doctor may understand the patient has the right to know all the details and worst scenario and inform him
Explanation: 患者本人の意向を確認し、家族と共に情報を共有する方法が最善とされています。

D7. You operated on a 46-year-old patient for removal of large ICH. The patient remained in a coma. Three days later the patient arrested and died in ICU, you were there. As you are going out of the ICU, the patient’s wife rushed to you in the hospital corridor, asking about her husband. What should you do?

a. Inform her that her husband just passed away
b. Ask her to bring members of her family and meet you later
c. Refer her to the ICU staff to ask them
d. Calm her and ask a nurse or other female doctor to join you to a private room to inform her about the death of her husband
e. Calm her and inform her immediately and take her to the ICU to see the body of her husband
Explanation: 患者家族の感情を尊重し、適切なプライバシーを確保して情報を伝えることが重要です。

B8. The classification of patients as intellectually subnormal or confused may put ethical consideration on:

a. They can never be guilty of negligence
b. Their ability to give informed consent
c. Their autonomy
d. Healthcare workers are sometimes cruel
e. They can never give informed consent
Explanation: 知的障害や混乱した状態にある患者は、同意能力に制限が生じるため、特別な配慮が必要です。

E9. You were on duty at the ER and received a family involved in a road accident. The husband was in a coma, GCS 5, suffers large right frontoparietal epidural hematoma. The son, 18 years old, suffers moderate head injury, GCS is 12, no neurological deficit but confused. The wife has pneumothorax, in agony and short breath, fully conscious and neurologically intact. You decided to send the patient to the Operating room, who should sign the consent?

a. The son
b. The wife
c. Both son and wife together
d. Two consultants and the medical directors
e. Two consultants and medical directors after informing the wife and son
Explanation: 家族が意思決定できない場合、医師が緊急時の介入について決定します。

E10. A 75 years old male patient suffering from metastatic cancer of prostate is admitted in hospice for palliative comfort care. He requests doctor to increase the dose of narcotics analgesics to relieve his pain and suffering. Physician is reluctant to increase the dose as the patient already had maximum possible dose of analgesics and further increase in dose will only hasten patient’s death. Under the rule of double effect (RDE), to maximize comfort and to decrease pain and suffering, analgesics’ dose could be increased. Physician can take decisions only if it satisfies the following:

a. Proportionality between good effect and the bad effect
b. The nature of the act
c. The agent’s intention
d. The distinction between means and effects
e. All of the choices must be fulfilled to justify that benefits outweigh the harm
Explanation: 二重効果の原則では、すべての条件が満たされている場合にのみ行動が許容されます。

E11. The principles of medical ethics are all, except:

a. Non-Maleficence
b. Beneficence
c. Autonomy
d. Justice
e. Confidentiality
Explanation: 医療倫理の基本原則には「守秘義務（Confidentiality）」は含まれませんが、これは重要な倫理的責務です。

B12. An adult, fully conscious and oriented patient with advanced renal cancer, expressed clearly his wish verbally to his treating doctor, not to receive any chemotherapy or resuscitation and preferred to die in peace. A few days later that patient became unconscious. The patient’s family requested to give the patient chemotherapy. What should you do if you recognize a conflict between the known verbal wishes of a patient and the decision of his family?

a. Follow the family’s request and give chemotherapy
b. Refer the patient to another team for a second opinion
c. Don’t listen to the family
d. Be ready to seek court intervention
e. Give trial of chemotherapy and allow only one attempt of resuscitation in case of arrest
Explanation: 患者の意思を最優先にするために、別のチームによる意見を求めるのが適切です。

C13. Granted informed consent ethically means:

a. The physician/surgeon should do what is medically indicated and ought to be for the good of the patient and cause no harm
b. Patient consents to accept any complication
c. Patient and family signed to accept any complication including death as an outcome of treatment or surgery
d. It is a routine procedure in the hospital
e. This term is used only for serious clinical conditions
Explanation: インフォームドコンセントは、患者と家族が治療や手術の結果を十分に理解した上で同意することを指します。

C14. Medical Ethics is very much concerning about the importance of patients understanding the consequences of their consent. Which of the following is often left out, but may be just as important to the patient?

a. Understanding the legal consequences (it might get them into trouble)
b. Understanding the harm it might cause physicians (it might increase hospital costs)
c. Understanding the expense (there may be hidden costs)
d. Understanding the nature of their consent (it may involve lying, breaking a promise, etc.)
e. Nothing is left out; only consequences matter to rational people
Explanation: 隠れた費用を含めた治療の全コストを患者が理解することが重要ですが、しばしば見落とされがちです。

A15. The most important consideration regarding the information in informed consent is:

a. It be understood by the patient
b. It must be communicated free of emotion
c. It must be technically accurate
d. It must be delivered in writing
e. It must be strictly medical
Explanation: インフォームドコンセントの主な目的は、患者が情報を理解し、意思決定を下せるようにすることです。

A16. The principle of Double Effect ethically means:

a. It is acceptable to knowingly cause harm in pursuit of some good
b. It is not acceptable to knowingly cause harm in pursuit of some good
c. It is a principle of diminishing returns
d. It is the Principle of Utility
e. The principle is ethically rejected
Explanation: 二重効果の原則では、害が避けられなくても利益がそれを上回る場合には行為が正当化されます。

C17. The ethical principles don’t approve restrictions put or guide what information must be shared in obtaining informed consent because:

a. Physicians may not favor an expensive treatment
b. Physicians are always changing their customs
c. Patients have the right to know all the details of their illnesses, management, and possible outcomes
d. Patients are too likely to simply agree without thinking
e. Patients mistrust physicians, creating a conflict
Explanation: 倫理的には、患者が病気や治療の詳細を知る権利を持つことが強調されています。

B18. You evaluated a 65-year-old man with a 3-month history of chest pain and fainting spells that you feel merit cardiac catheterization. After informing him fully of the benefits, consequences, and risks, he was able to demonstrate that he understands all of these and refuses the intervention. What should you do?

a. Respect his choice
b. Explore reasons for his decision and try to convince him again
c. Consider the discussion ended
d. Continue with the procedure nevertheless
e. Refer him to another Doctor you previously had a conflict with
Explanation: 患者の意思決定を尊重しつつ、再度の説明でリスクとベネフィットを明確に伝えることが重要です。

B19. A 60-year-old patient has complaints of abdominal pain that is persistent but not extreme. Workup shows hepatoma. He just retired from a busy professional career and he and his wife are about to leave for a round-the-world cruise. What should you do?

a. Inform his wife first
b. Inform him of his condition now
c. Exercise the therapeutic privilege and inform him later when he returns
d. Inform him when his condition worsens
e. Ask his best friend to call and tell him while he is cruising
Explanation: 医師の義務として、患者の意思決定に必要な情報を速やかに提供することが重要です。

B20. Sai is an 18-year-old, married male still living with and dependent on his parents, was diagnosed with Ruptured Acute appendicitis. Who should give the consent for surgery?

a. Parents
b. Sai
c. His wife
d. His doctor
e. Grandparents
Explanation: 成人として法的に認められた18歳の患者が同意を与える権利を持っています。

D21. When is patient’s consent necessary?

a. In an emergency, patient needs tracheostomy
b. In a woman diagnosed with ectopic pregnancy, it turns out to be a case of acute appendicitis and the surgeon decides to remove the appendix
c. During an appendectomy, the surgeon discovers an abnormal-looking ovary and decided to remove it
d. The colon was perforated during sigmoidoscopy and the surgeon decides to do a laparotomy to undertake repair
e. During laparotomy when an artery was bleeding and the surgeon decided to ligate it
Explanation: 緊急ではないが予定外の治療を行う場合には、患者の同意が必要です。

D22. A physician may perform a diagnostic or therapeutic procedure without the consent of the patient or his relatives:

a. When the physician believes the procedure is necessary
b. When the patient is merely being stubborn
c. When the patient is unconscious
d. In an acute emergency when there is no time to discuss the situation in order to seek consent
e. When the patient and relatives can afford expensive procedures
Explanation: 緊急時には、患者や家族の同意を得る時間がない場合、医師が必要と判断すれば治療を進めることが許されます。

E23. All of these are true of confidentiality, except:

a. Based on trust
b. Always should be maintained of all medical, legal, and personal information
c. Applied to conversation between doctor and patient
d. Sometimes keeping it would cause harm
e. May be transmitted to a friend as long as it is kept confidential
Explanation: 守秘義務は患者のプライバシー保護に限定され、友人への情報共有は許されません。

D24. One of these is not true of the principle of justice:

a. Requires that people be treated fairly
b. Requires that people be treated equally
c. Actions are consistent, accountable, and transparent
d. Ordered by the court
e. Respect of the law
Explanation: 正義の原則は、公平性や透明性を求めるものですが、法的命令を含むわけではありません。

C25. In some cases, there are good reasons for overriding truth-telling:

a. All patients with cancer and AIDS
b. If the patients are from China
c. Patients do not want the truth if the news is bad
d. If the patients are ignorant
e. All of the above
Explanation: 真実を告げることが患者に悪影響を与える場合、告知しない選択も倫理的に許容されることがあります。

D26. All of these are principles of medical ethics, except:

a. Autonomy
b. Beneficence
c. Justice
d. Honesty
e. None
Explanation: 医療倫理の基本原則に「正直さ」は含まれませんが、重要な道徳的要素です。

E27. All of the following are medical ethics theories, except:

a. Deontological Theory
b. Teleontological Theory
c. Virtue Theory
d. Autonomy Theory
e. None
Explanation: 医療倫理理論には「自律性理論」というものは存在しません。

B28. One of the following is not part of the components of Medical Ethics:

a. Physician-patient relationship
b. Physician-physician relationship
c. The relationship of the physician to the Society
d. The relationship of the physician to the department of health
e. None
Explanation: 医療倫理は医師と患者、社会、政策立案者との関係に重点を置いています。

D29. Informed consent includes all of the following, except:

a. Understanding
b. Voluntary
c. Agreement
d. Debates
e. None
Explanation: インフォームドコンセントには、議論を含める必要はありません。

B30. Stopping a medication that is shown to be harmful is an example of:

a. Beneficence
b. Nonmaleficence
c. Autonomy
d. Justice
e. Respect
Explanation: 「害を与えない」という原則に基づく行為です。

B31. All of these are true of Nonmaleficence principle, except:

a. Includes an obligation not to inflict harm intentionally
b. Includes informed consent and truth-telling
c. Physicians must refrain from providing ineffective treatments or acting with malice towards patients
d. Offers little useful guidance to physicians because many beneficial therapies also have serious risks
e. None
Explanation: 「害を与えない」の原則はインフォームドコンセントや真実告知を直接含みません。

B32. The capacity to think, decide, and act on the bases of thought and decision freely and independently best describes:

a. Confidentiality
b. Autonomy
c. Privacy
d. Competency
e. Justice
Explanation: 自律性は、患者が自由に意思決定する能力を指します。

D33. Double effect in medical ethics usually regarded as the combined effect of:

a. Nonmalpractice and confidentiality
b. Autonomy and justice
c. Beneficence and autonomy
d. Beneficence and nonmalpractice
e. Beneficence and justice
Explanation: 二重効果の原則は、「利益を与える」ことと「害を避ける」ことを組み合わせたものです。

D34. Patient-physician privilege is best described as:

a. Autonomy
b. Justice
c. Truth-telling
d. Confidentiality
e. Privacy
Explanation: 医師と患者の特権は、患者の秘密を守る守秘義務に基づいています。

C35. The four medical ethics principles which shared between Values-Based Medicine and the principles of ethics, explained by Beauchamp and Childress are:

a. Autonomy, privacy, respect, and confidentiality
b. Veracity, privacy, beneficence, and nonmaleficence
c. Autonomy, nonmaleficence, beneficence, and justice
d. Veracity, privacy, confidentiality, and fidelity
e. Autonomy, veracity, nonmaleficence, and beneficence
Explanation: 医療倫理の4つの原則は、自己決定、害を避けること、利益を与えること、そして正義です。

A36. Which of the following ethical issues form the foremost part of the Hippocratic Oath?

a. Confidentiality
b. Sexual boundaries
c. Advertising
d. Bribery
e. Doctor’s rights
Explanation: ヒポクラテスの誓いでは、守秘義務が重要な要素として言及されています。

B37. The concept of justice in ethics is:

a. An obligation of the patient to the society
b. That the health resources must be distributed according to the principles of equity
c. Taken as patients’ right to choose or refuse treatment
d. For all medical Professionals to do good for all patients under circumstances
e. The obligation to do no harm to the patients
Explanation: 公平性に基づいて医療リソースを配分することが、正義の原則の中核です。

A38. Primum Non Nocere means:

a. First, do no harm
b. First, do not listen
c. Never be the first
d. The higher, the fewer
e. Give nothing to the first
Explanation: ラテン語の「Primum Non Nocere」は、医療倫理の基本原則として「まず害を与えないこと」を意味します。

E39. The principles of medical ethics are all, except:

a. Non-Maleficence
b. Beneficence
c. Autonomy
d. Justice
e. Confidentiality
Explanation: 守秘義務は重要な要素ですが、医療倫理の主要な4原則には含まれていません。

E40. The relationship between clinical research and clinical medical practice is ethically considered. Which of the following best describes it?

a. Research is tightly regulated because a particular research may put a patient at risk for the benefit of others.
b. Medical practice focuses on the patient’s own best interests and relies on benefit/risk ratio, so it is not very tightly regulated.
c. There is distinction between research and medical practice.
d. Patients have to consent for any surgical or medical step of management or for accepting to be enrolled in research.
e. All of the above
Explanation: 医療研究と臨床実践は異なる目的と規制の下で行われます。全ての選択肢がこれを説明しています。

E41. The following are true of Principle, except:

a. A general law or doctrine
b. A guide to action or behavior
c. Basis of reasoning
d. More abstract
e. The guidance it provides is more specific
Explanation: 原則は一般的で抽象的な指針であり、具体的なガイダンスを提供するものではありません。

D42. The following statements are true, except:

a. Not every human being is capable of self-determination
b. The capacity for self-determination matures during an individual’s life
c. Some persons are in need of extensive protection
d. The extent of protection afforded should depend upon the likelihood of benefit and risk of harm
e. None
Explanation: 保護の程度は利益と害の可能性のバランスではなく、倫理的必要性によって決定されるべきです。

D43. The basic principles of the Belmont Report, except:

a. Respect for persons
b. Beneficence
c. Justice
d. Nonmaleficence
e. None
Explanation: ベルモント報告書の基本原則は、「人への尊重」「善行」「正義」の3つです。「害を与えないこと」は直接含まれません。

E44. The core principles of biomedical ethics, except:

a. Beneficence
b. Nonmaleficence
c. Justice
d. Respect for persons
e. None
Explanation: 生物医学倫理のコア原則には、善行、害を避けること、正義、自律性が含まれます。

E45. The following statements are true of competency, except:

a. One’s ability to make a particular decision
b. One has an understanding of the situation
c. The decision is based upon rational reasons
d. One is allowed to make a decision under the circumstances that prevail
e. No exception
Explanation: 意思決定能力は状況や理性的な理解に依存しますが、例外もあり得ます。

A46. In order to be an autonomous choice, the following must be complied except:

a. It should be involuntary
b. The choice must be adequately informed
c. The patient should have a decision-making capacity
d. The patient is competent
e. No exception
Explanation: 自律的な選択には、自発性が必要です。「非自発的」は適用されません。

E47. The Greek mythology-based idiom “Caught between Scylla and Charybdis” is simplified by which of the following?

a. Torn between two lovers
b. Choosing between the one you love and the one who loves you
c. Choose the one who means more to you
d. May the best man win
e. Choose the lesser evil
Explanation: この表現は、困難な二者択一を迫られる状況を示し、悪の中で「より害が少ない方を選ぶ」という意味を持ちます。

D48. This holds that justice requires that equals be treated equally and unequals be treated unequally but in proportion to their relevant inequalities:

a. Utilitarian Theory of justice
b. Egalitarian Theory of Justice
c. Distributive Justice
d. Principle of Formal Justice
e. Libertarian Theory of Justice
Explanation: 形式的正義の原則は、不平等を適切に考慮して公正に扱うことを求めます。

B49. It refers to the process whereby a person comes to believe in something through the merit of reasons another person advances:

a. Manipulation
b. Persuasion
c. Coercion
d. Autonomy
e. Competence
Explanation: 説得は、他者の合理的な理由に基づいて信念を持つプロセスを指します。

E50. The following are true of informed consent:

a. A voluntary, uncoerced decision
b. The cornerstone of patient autonomy
c. Patients have the right to accept/reject suggested options
d. Only a and b
e. All
Explanation: インフォームドコンセントには、患者の自発的かつ情報に基づいた意思決定が求められます。

D51. Not a basic element of informed consent:

a. Voluntary participation
b. Contacts
c. Description of clinical investigation
d. Number of participation
e. None
Explanation: 参加者数はインフォームドコンセントの基本要素ではありません。

A52. Informed consent involves all of the following except:

a. Providing a potential subject with inadequate information to allow for an informed consent decision about participation in the clinical investigation
b. Facilitating the potential subject’s comprehension of the information
c. Obtaining the potential subject’s voluntary agreement to participate
d. Providing adequate opportunity for the potential subject to ask questions and consider whether to participate
e. Continuing to provide information as the clinical investigation progresses or as the subject or situation requires
Explanation: 不適切な情報提供はインフォームドコンセントの本質に反するため、選択肢 a は該当しません。

D53. When a patient lacks decision-making capacity:

a. Identify an appropriate surrogate
b. Assist the surrogate to make decisions
c. The surrogate is entitled to lesser respect compared to the patient
d. Only a and b
e. All
Explanation: 患者が判断能力を欠く場合でも、代理人は患者と同様に尊重されるべきです。

B54. The following are true on withholding information from a patient except:

a. Withholding information without the patient’s knowledge is ethically unacceptable except in emergency situations
b. The obligation to communicate means that the physician must give information immediately
c. Once the emergency situation has been resolved, the physician should convey the information
d. A and C
e. None
Explanation: 情報伝達の義務は迅速さだけでなく、患者が理解できる適切なタイミングに基づきます。

B55. It is used to decide whether a child is able to consent to contraceptive or sexual health advice and treatment:

a. Heimlich maneuver
b. Fraser guidelines
c. Health Care for minors
d. Gillick Competence
e. Childress guidelines
Explanation: Fraser ガイドラインは、未成年者が特定の治療に同意する能力を評価する際に使用されます。

E56. In deciding for a critically ill newborn, which of the following should be considered?

a. The needs
b. Interest
c. Family resources
d. Availability of treatment options
e. All
Explanation: 重篤な新生児の治療決定には、多様な要因を包括的に検討する必要があります。

A57. The following is/are true of abortion in the Philippines:

a. Revised Penal Code Act 3815
b. Legally advocated
c. Sometimes criminalized
d. The criminal provisions may contain exceptions as to save the life of the pregnant woman
e. None
Explanation: フィリピンでは、刑法第 3815 条で中絶は厳しく規制されています。

B58. The following are true of genetic testing except:

a. Genetic diagnosis can carry both benefits and risks for the patient
b. The decision to test should only consider the potential benefit
c. If parents unreasonably request or refuse testing for the child, the physician may use legal means to override the parents’ choice
d. The physician should seek the informed consent of the minor patient’s parents
e. None
Explanation: 遺伝子検査の決定は、利益だけでなくリスクも慎重に考慮する必要があります。

E59. In deciding for a critically ill newborn, which of the following should be considered?

a. The needs
b. Interest
c. Family resources
d. Availability of treatment options
e. All
Explanation: 繰り返しですが、新生児の治療判断には全ての要因が重要です。

B60. Requires that subjects be informed they may decline to take part in the clinical investigation or may stop participation at any time without penalty or loss of benefits to which subjects are entitled:

a. Benefits
b. Voluntary participation
c. Alternative procedures or treatment
d. Confidentiality
e. Informed consent
Explanation: ボランティア参加は、臨床研究の重要な原則です。

D61. How is Gillick competency defined?

a. Children under the age of 16 years old can consent to the provision of contraception if necessary
b. Children under the age of 16 can consent to an abortion if necessary
c. Children between the ages of 16-18 years can consent to medical treatment
d. Children under the age of 16 years have the capacity to consent if they have sufficient maturity and understanding
e. Children between the ages of 16-18 years can consent to both contraception and abortion if necessary
Explanation: Gillick の能力は、子供が十分な成熟度と理解を持つ場合に同意する能力を持つとする概念です。

C62. A doctor is protected from litigation claim of carrying out treatment unlawfully in a minor if:

a. Consent has been obtained from a minor over the age of 16 years
b. Consent has been obtained from a “Gillick” competent child
c. Either statement could apply
d. Neither statement applies
Explanation: 16 歳以上の未成年者や Gillick 能力を持つ子供からの同意は、法的保護を提供します。

B63. In the context of information disclosure, which of the following statements is correct?

a. The doctrine of informed consent requires that patients are provided with information to make a fully informed decision
b. The amount of information required is measured against the reasonable patient
c. A claim that a doctor was negligent for failing to disclose sufficient information must be brought in negligence
d. Valid consent is sufficient to legitimize procedures
e. None
Explanation: 「合理的な患者」の基準が情報開示の範囲を決定します。

C64. The factors to be considered when determining an incompetent adult’s best interests include:

a. The age of the patient
b. The patient’s diagnosis
c. The need to use the least restrictive principle
d. Ascertaining whether the patient is able to sign a consent form
e. None
Explanation: 最小制限の原則は、無能力な成人の最善の利益を評価する際の重要な要素です。

C65. A person lacks capacity in relation to a decision that must be taken if:

a. The person is under the age of eighteen years
b. That person makes an unwise decision
c. At the material time, the person is unable to make a decision in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind
d. The person has dementia
e. None
Explanation: 能力欠如は、特定の判断を下すために必要な精神的な機能が損なわれている場合に該当します。

E66. The following is/are true of legal and ethical provisions:

a. The right to privacy is a basic human right
b. There is no legislation that directly addresses the privacy issue specific to health information
c. The right to privacy is guaranteed by the constitution
d. A and B
e. All
Explanation: 法律と倫理の規定は、個人のプライバシーを基本的人権として保護することを強調しています。

C67. Which of the following statement/s is/are true?

a. The patients are the bearers of the duty of confidentiality
b. The healthcare providers are the holders of privacy
c. Revelation of secrets is now criminalized
d. Any injury that the patient may incur as a direct result of violation of the duty to maintain confidentiality will not make a physician liable
e. None
Explanation: 秘密保持の違反が刑事罰の対象となるケースが増えています。

B68. The privacy of communication and correspondences shall be inviolable except upon lawful order of the court or when public safety requires:

a. RA 7875
b. Philippine Constitution, Sec. 3
c. RA 8505
d. RA 3185
Explanation: フィリピン憲法第3条では、通信のプライバシーが法律または公共の安全が必要な場合を除いて保護されています。

E69. True of Electronic Medical Records except:

a. Transcends the physical limitation of paper files
b. Improves the quality and accuracy of data
c. Facilitates access and sharing of health information among HCPs
d. Tends to redefine the scope of privacy and confidentiality
e. None
Explanation: 電子医療記録は従来の紙媒体を超えるが、その導入にはプライバシーの再定義が必要となる場合があります。

C70. The following are true of confidentiality except:

a. A legal obligation
b. Points to the duty that rests on those to whom the private information is entrusted
c. The individual’s right to be free from unwanted external scrutiny
d. Privileged communication is not unnecessarily disclosed
e. None
Explanation: プライバシーに関連する権利は守られるべきですが、秘密保持の本質とは異なります。

B71. Individuals availing of insurance coverage sign waivers allowing health maintenance organizations to access their medical records in exchange for benefits or claims:

a. RA 3185
b. RA 7875
c. RA 8505
d. RA 386
Explanation: RA 7875（フィリピン国民健康保険法）は、保険請求のために医療記録へのアクセスを許可します。

C72. This can be applied when a person who is not authorized by parties to a private communication records or communicates its contents:

a. RA 8505
b. RA 4200
c. RA 9262
d. RA 3185
Explanation: RA 4200（アンチワイヤータッピング法）は、無許可の通信内容の記録や共有を防ぎます。

B73. It provides that every person shall respect the dignity, personality, privacy, and peace of mind of another person:

a. RA 3185
b. RA 386
c. RA 9262
d. RA 8505
Explanation: RA 386（民法）は個人の尊厳やプライバシーを尊重する義務を明記しています。

E74. The rule of the confidentiality of physician-patient communication and patient record is not absolute under the following circumstances except:

a. For insurance compensation
b. Upon patient consent
c. In the interest of public order and safety
d. For research purposes
e. None
Explanation: 秘密保持の原則は特定の条件下で制限されますが、これは例外規定のリスト全体に当てはまります。

D75. It refers to the privacy of information and its protection against unauthorized disclosure:

a. Privacy
b. Top secret
c. Data privacy
d. Confidentiality
e. Competency
Explanation: 秘密保持（Confidentiality）は情報のプライバシーを守るための重要な概念です。

76-85 Matching Type

Column O	Answer	Column P	Explanation
RA 10173	A	Data Privacy Act	プライバシー保護に関する法律で、特に個人情報の取り扱いに焦点を当てています。
RA 3185	C	Revelation of Secrets	情報の漏洩や秘密の暴露に関する規定を含む法律です。
RA 8505	B	Rape Victim Assistance and Protection	性暴力被害者の保護と支援に関する法律です。
RA 8504	D	Identity and Status of HIV Patients	HIV感染者の身分と状況に関する法律で、患者のプライバシーと権利を保護します。
RA 9262	J	Violence Against Women and Children	女性や子供に対する暴力を防止し、支援を提供する法律です。
RA 9165	E	Patients on Drug Rehabilitation	薬物リハビリプログラムの患者に関する規定を扱う法律です。
RA 4200	G	Anti-Wire-Tapping Law	通信の盗聴を防ぐ法律です。
RA 7875	H	National Health Insurance Act of 1995	健康保険の全国的な枠組みを提供する法律で、国民の健康を保証します。
RA 3573	F	Reporting of Communicable Diseases	感染症の報告と管理を定めた法律です。
RA 3753	I	Law on Registry of Civil Status	戸籍登録に関する法律で、家族の法的地位を保護します。

E86. Practical obstacles to the practice of confidentiality include:

a. Modern medical treatment involves a small number of medical professionals
b. Approved research
c. Patient information is increasingly stored on large electronic databases which may not be secured absolutely
d. A and b
e. All
Explanation: 秘密保持の障害は、現代医療の複雑さや電子情報の利用拡大に伴い、多岐にわたります。

B87. Treatment refusal is on:

a. External constraints of beneficence
b. Practitioner-driven constraints on autonomy
c. Patient-driven constraints on beneficence
d. Medical responsibility constraints
e. Practitioner-driven constraints on beneficence
Explanation: 治療拒否は、医療従事者による自律性への制限と関係しています。

E88. Virtues are habits formed by all of the following except:

a. One’s personality
b. Interacting with people in work environment
c. Parental training
d. Social training
e. Professional and other standards to one’s choice and roles in society
Explanation: 美徳は個人の選択や社会的役割に基づくものではなく、習慣や経験から形成されます。

C89. One of the following is not true on access to patient’s data:

a. The data belongs to the patient
b. The medical record belongs to the hospital
c. Third-party information
d. Accuracy reduced by sharing
e. Layman unable to cope with data
Explanation: 第三者情報の取り扱いは、患者データへのアクセスに含まれるとは限りません。

E90. Doctors do have an obligation to:

a. Prevent harm
b. Help individuals with disability
c. Rescue those who are in danger
d. Remove harm
e. All
Explanation: 医師の義務は、多岐にわたり包括的です。

91-95 Matching Type

Column X	Answer	Column Y	Explanation
Justice	B	Benefits and burden	公平性は、利益と負担を公平に分配することを重視します。
Coercion	E	Intentional threat	強制とは、意図的な脅迫行為を指します。
Respect for Autonomy	D	Self-rule	自律の尊重は、個人が自らの意思で決定する権利を指します。
Nonmaleficence	A	Primum non nocere	「まず害を与えない」という倫理原則を表します。
Beneficence	C	Bring benefit	善行は患者に利益をもたらすことを意味します。

D96. It refers to the privacy of information and its protection against unauthorized disclosure:

a. Privacy
b. Top secret
c. Data privacy
d. Confidentiality
e. Competency
Explanation: Confidentialityは、情報の保護を通じてプライバシーを維持することを意味します。

E97. The following are true of informed consent:

a. A voluntary uncoerced decision
b. The cornerstone of patient autonomy
c. Patients have the right to accept/reject suggested options
d. Only a and b
e. All
Explanation: インフォームドコンセントは患者の自律性を尊重する上で重要です。

B98. Harinath’s act is an example of:

a. Persuasion
b. Manipulation
c. Competency
d. Coercion
e. Autonomy
Explanation: Manipulationは、他者の意思に影響を与える行為の一つです。

B99. Maheesh’s choice is best described as an example of:

a. Respect
b. Autonomy
c. Competency
d. Honesty
e. Sincerity
Explanation: 自律性とは、自らの判断に基づいて選択を行うことを指します。

C100. Paul, a 25-year-old computer technician, posts a list of COVID-19 Persons under investigation on Facebook. This activity depicts breach of:

a. Autonomy
b. Privacy
c. Confidentiality
d. Justice
e. Friendship
Explanation: Confidentialityの侵害は、医療情報の不適切な共有によって発生します。

_D_1. This holds that justice requires that equals be treated equally and unequals be treated unequally but in proportion to their relevant inequalities.

a. Utilitarian Theory of Justice
b. Egalitarian Theory of Justice
c. Distributive Justice
d. Principle of Formal Justice
e. Libertarian Theory of Justice

Explanation:
原則として、Formal Justice（形式的正義）は、人々を平等に扱い、関連する不平等に応じて不平等に対応することを主張します。

_B_2. It refers to the process whereby a person comes to believe in something through the merit of reasons another person advances.

a. Manipulation
b. Persuasion
c. Coercion
d. Autonomy
e. Competence

Explanation:
説得（Persuasion）は、相手に合理的な理由を提示することで信念を形成させるプロセスを指します。

_E_3. The Greek mythology-based idiom “Caught between Scylla and Charybdis” is simplified by which of the following?

a. Torn between two lovers
b. Choosing between the one you love and the one who loves you
c. Choose the one who means more to you
d. May the best man win
e. Choose the lesser evil

Explanation:
この慣用句は、ギリシャ神話から派生しており、「二つの悪のうち、より小さい方を選ぶ」という状況を表します。

_E_4. The following statements are true of competency except:

a. One’s ability to make a particular decision
b. One has an understanding of the situation
c. The decision is based upon rational reasons
d. One is allowed to make a decision under the circumstances that prevail
e. No exception

Explanation:
全ての選択肢はコンピテンス（Competency）の定義に該当するため、例外はありません。

_A_5. In order to be an autonomous choice, the following must be complied except:

a. It should be involuntary
b. The choice must be adequately informed
c. The patient should have a decision-making capacity
d. The patient is competent
e. No exception

Explanation:
自律的な選択（Autonomy）には、選択が自発的であることが不可欠であるため、非自発的（Involuntary）は除外されます。

_E_6. The core principles of biomedical ethics except:

a. Beneficence
b. Nonmaleficence
c. Justice
d. Respect for autonomy
e. None

Explanation:
バイオメディカル倫理の主要原則は、すべて選択肢に挙げられているものに含まれています。

_D_7. The basic principles of the Belmont Report except:

a. Respect for persons
b. Beneficence
c. Justice
d. Nonmaleficence
e. None

Explanation:
ベルモント報告では、「非悪性（Nonmaleficence）」は含まれず、他の三つが基本原則です。

_E_8. The following statements are true except:

a. Not every human being is capable of self-determination
b. The capacity for self-determination matures during an individual’s life
c. Some persons are in need of extensive protection
d. The extent of protection afforded should depend upon the likelihood of harm and risk of benefit
e. None

Explanation:
全ての選択肢が自己決定能力に関する正しい陳述であり、例外はありません。

_E_9. The following are true of Principle except:

a. A general law or doctrine
b. A guide to action or behavior
c. Basis of reasoning
d. More abstract
e. The guidance it provides is more specific

Explanation:
原則（Principle）は一般的で抽象的なものであり、具体性はありません。

_E_10. When a patient lacks decision-making capacity:

a. Identify an appropriate surrogate
b. Assist the surrogate to make decisions
c. The surrogate is entitled to the same respect
d. The surrogate can be someone not related by blood
e. None

Explanation:
選択肢すべてが意思決定能力を欠いた患者に対して正当な取り扱いとして考えられるため、例外はありません。

_A_11. Informed consent involves all of the following except:

a. Providing a potential subject with inadequate information to allow for a fully informed consent decision about participation in the clinical investigation
b. Facilitating the potential subject’s comprehension of the information
c. Obtaining the potential subject’s voluntary agreement to participate
d. Providing adequate opportunity for the potential subject to ask questions and consider whether to participate
e. Continuing to provide information as the clinical investigation progresses or as the subject or situation requires

Explanation:
インフォームドコンセントには十分な情報を提供することが求められるため、「不十分な情報提供」は例外となります。

_D_12. Not a basic element of informed consent:

a. Voluntary participation
b. Contacts
c. Description of clinical investigation
d. Number of participation
e. None

Explanation:
インフォームドコンセントの基本要素に参加者の「数」は含まれません。

_D_13. The following are true of informed consent except:

a. A voluntary uncoerced decision
b. The cornerstone of patient autonomy
c. Patients have the right to accept suggested options
d. Patients cannot reject suggested options
e. None

Explanation:
患者は提案された選択肢を拒否する権利があるため、「拒否できない」は誤りです。

_B_14. The following are true of genetic testing except:

a. Genetic diagnosis can carry both benefits and risks for the patient
b. The decision to test should only consider the potential benefit
c. If parents unreasonably request or refuse testing of the child, the physician may use legal means to override the parents’ choice
d. The physician should seek the informed consent of the minor patient’s parents
e. None

Explanation:
遺伝子検査は潜在的リスクも考慮すべきであり、利益だけに焦点を当てるべきではありません。

_E_15. In deciding for a critically ill newborn, which of the following should be considered?

a. The needs
b. Interest
c. Family resources
d. Availability of treatment options
e. All

Explanation:
重病の新生児の場合、全ての要因を考慮する必要があります。

_A_16. True of abortion in the Philippines:

a. Revised Penal Code Act 3815
b. Legally advocated
c. Sometimes criminalized
d. The criminal provisions may contain exceptions as to save the life of the pregnant woman
e. None

Explanation:
フィリピンの堕胎に関する法律は改正刑法3815条に基づいています。

_B_17. It is used to decide whether a child is able to consent to contraceptive or sexual health advice and treatment.

a. Heimlich maneuver
b. Fraser guidelines
c. Health Care for minors
d. Gillick Competence
e. Childress guidelines

解説:
フレーザーガイドライン（Fraser Guidelines）は、子どもが避妊や性健康に関する治療に同意できるかどうかを判断するための指針です。

_D_18. The following are true on withholding information from patients except:

a. Withholding information without the patient’s knowledge is ethically unacceptable except in emergency situations.
b. The obligation to communicate means that the physician must give information immediately.
c. Once the emergency situation has been resolved, the physician should convey the information.
d. In some cases, the obligation to communicate can be postponed.
e. None

解説:
医師には情報を遅らせず伝える義務があり、「義務の延期」は通常、倫理的に許容されません。

_B_19. Requires that subjects be informed they may decline to take part in the clinical investigation or may stop participation at any time without penalty or loss of benefits to which subjects are entitled.

a. Benefits
b. Voluntary participation
c. Alternative procedures or treatment
d. Confidentiality
e. Informed consent

解説:
ボランタリー参加（Voluntary Participation）は、参加者がペナルティなしで調査を辞退または中止できる権利を指します。

_C_20. In the context of information disclosure, which of the following statements is correct?

a. The doctrine of informed consent requires that patients are provided with information to make a fully informed decision.
b. The amount of information required to discharge the duty of care is measured against the reasonable patient.
c. A claim that a doctor was negligent for failing to disclose sufficient information to enable them to make a proper decision must be brought in negligence.
d. Valid consent is sufficient to legitimize medical and surgical procedures.
e. None

解説:
情報開示義務違反による医師の過失責任は、過失（negligence）の主張として扱われます。

_D_21. How is Gillick competency defined?

a. Children under the age of 16 years old can consent to the provision of contraception if necessary.
b. Children under the age of 16 can consent to an abortion if necessary.
c. Children between the ages of 16-18 years can consent to medical treatment.
d. Children under the age of 16 years have the capacity to consent if they have sufficient maturity and understanding.
e. Children between the ages of 16-18 years can consent to both contraception and abortion if necessary.

解説:
Gillick Competenceは、16歳未満の子どもが十分な成熟度と理解力を持つ場合、同意能力を有することを意味します。

_C_22. A person lacks capacity in relation to a decision that must be taken if:

a. The person is under the age of eighteen years.
b. That person makes an unwise decision.
c. At the material time, the person is unable to make a decision in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind.
d. The person has dementia.
e. None

解説:
意思決定能力を欠く理由は、心の機能の障害や機能不全に起因することが主です。

_C_23. A doctor is protected from litigation claim of carrying out treatment unlawfully in a minor if:

a. Consent has been obtained from a minor over the age of 16 years.
b. Consent has been obtained from a “Gillick” competent child.
c. Either statement could apply.
d. Neither statement applies.

解説:
16歳以上の未成年やGillick Competenceを有する子どもの同意が得られている場合、医師は法的責任から保護されます。

_B_24. It provides that every person shall respect the dignity, personality, privacy, and peace of mind of another person.

a. RA 3185
b. RA 386
c. RA 9262
d. RA 8505

解説:
RA 386（Civil Code of the Philippines）は、個人の尊厳やプライバシーを尊重することを規定しています。

_D_25. It refers to the privacy of information and its protection against unauthorized disclosure.

a. Privacy
b. Top secret
c. Data privacy
d. Confidentiality
e. Competency

解説:
Confidentiality（守秘義務）は、情報を無断で開示しないことを指します。

_E_26. True of Electronic Medical Records except:

a. Transcends the physical limitation of paper files.
b. Improves the quality and accuracy of data.
c. Facilitates access and sharing of health information among HCPs.
d. Tends to redefine the scope of privacy and confidentiality.
e. None

解説:
電子医療記録（EMR）に関するすべての記述は正しいため、例外はありません。

_B_27. Individuals availing of insurance coverage sign waivers allowing health maintenance organizations to access to their medical records in exchange for benefits or claims.

a. RA 3185
b. RA 7875
c. RA 8505
d. RA 386

解説:
RA 7875は、国民健康保険法（National Health Insurance Act of 1995）を指します。

_C_28. Which of the following statement/s is/are true?

a. The patients are the bearers of the duty of confidentiality.
b. The healthcare providers are the holders of privacy.
c. Revelation of secrets is now criminalized.
d. Any injury that the patient may incur as a direct result of violation of the duty to maintain confidentiality will not make a physician liable.
e. None

解説:
守秘義務の違反は、現在では刑事罰の対象となります。

_E_29. The following is/are true of legal and ethical provisions:

a. The right to privacy is a basic human right.
b. There is no legislation that directly addresses the privacy issue specific to health information.
c. The right to privacy is guaranteed by the constitution.
d. The right to privacy is protected by the constitution.
e. All

解説:
全ての選択肢は、プライバシーに関する法的および倫理的規定について正しい内容です。

_C_30. This can be applied when a person who is not authorized by parties to a private communication records or communicates its contents.

a. RA 8505
c. RA 4200
b. RA 9262
d. RA 3185

解説:
RA 4200は、反盗聴法（Anti Wire-Tapping Law）であり、プライバシー侵害を防止します。

_A_31. John, a 38-year-old male athlete, was admitted for pain in his right knee. Investigations revealed end-stage osteosarcoma. His primary physician insists on all possible treatments, despite John’s living will refusing aggressive treatments. The physician is exercising:

a. Act of Paternalism
b. Ideal beneficence
c. Obligatory beneficence
d. Specific beneficence
e. Surrogate decision maker

解説:
父権主義（Act of Paternalism）とは、医師が患者の意思に反して「患者の利益のため」として行動することを指します。

_C_32. A 25-year-old healthy male dies in a fatal accident. He has advanced directives for organ donation. The most likely recipient will be:

a. A 45 years alcoholic with irreversible liver failure
b. A 75-year-old female with extreme dementia and end-stage renal failure
c. A 35-year-old entrepreneur with acute renal failure
d. A 10-year-old male with multi-organ failure and brain death
e. A 40-year-old female with heart failure and HIV-positive

解説:
臓器移植では、寿命、回復見込み、健康状態などを考慮し、適切な候補者が選ばれます。ここでは、35歳の腎不全患者が選ばれる可能性が最も高いです。

_C_33. On the first day of duty, Dr. T teaches the clerks about the principle of “doing no harm.” The principle described is:

a. Beneficence
b. Justice
c. Nonmaleficence
d. Respect for autonomy
e. Competency

解説:
Nonmaleficence（無害原則）は、「害を与えないこと」を意味し、医療倫理の基本原則の一つです。

_B_34. A public hospital has unreported needlestick injuries. The victims of maleficence here are:

a. Communities
b. Employees
c. Families
d. Patients
e. Stakeholders

解説:
未報告の針刺し事故により、従業員（医療従事者）が直接的な被害を受けています。

_D_35. After a patient dies in the ICU, his wife approaches the physician in the corridor. The best course of action is:

a. Inform her in the corridor immediately.
b. Ask her to bring family members and meet later.
c. Refer her to ICU staff.
d. Calm her and invite her to a private room with a nurse to inform her of the death.
e. Take her to see her husband’s body immediately.

解説:
プライバシーと感情の配慮を重視し、プライベートな空間で丁寧に説明するのが最善です。

_B_36. The classification of patients as “intellectually subnormal” raises ethical concerns about:

a. They can never be guilty of negligence.
b. Their ability to give informed consent.
c. Their autonomy.
d. Healthcare workers’ cruelty.
e. They can never give informed consent.

解説:
知的障害がある患者は、インフォームドコンセントを与える能力が十分かどうかが主要な倫理的関心事です。

_E_37. A 75-year-old hospice patient requests higher doses of narcotics. Under the rule of double effect, the physician can proceed if:

a. Proportionality between good and bad effects is maintained.
b. The nature of the act is ethical.
c. The agent’s intention is ethical.
d. The distinction between means and effects is ethical.
e. All of the above.

解説:
「二重効果の原則」では、全ての条件を満たした場合にのみ、治療が倫理的に正当化されます。

_A_38. Granted informed consent ethically means:

a. The physician/surgeon should do what is medically indicated, and ought to be for the good of the patient and cause no harm.
b. Patient consents to accept any complication.
c. Patient and family signed to accept any complication, including death.
d. It is a routine procedure in the hospital.
e. This term is used only for serious clinical conditions.

解説:
インフォームドコンセントは、医師が患者にとって最善の治療を行う責任を持ち、患者への害を最小限にする原則を含みます。

_C_39. Patients often overlook certain aspects of informed consent. Which is commonly left out but may be as important?

a. Understanding the legal consequences.
b. Understanding the harm it might cause physicians.
c. Understanding the expense (there may be hidden costs).
d. Understanding the nature of their consent.
e. Nothing is left out.

解説:
患者が隠れた費用や経済的負担を十分に理解していない場合があり、これは重要な要素です。

_A_40. The most important consideration regarding the information in informed consent is:

a. It be understood by the patient.
b. It must be communicated free of emotion.
c. It must be technically accurate.
d. It must be delivered in writing.
e. It must be strictly medical.

解説:
インフォームドコンセントにおいて最も重要なのは、患者が情報を正しく理解できることです。

_A_41. The principle of Double Effect ethically means:

a. It is acceptable to knowingly cause harm in pursuit of some good.
b. It is not acceptable to knowingly cause harm in pursuit of some good.
c. It is a principle of diminishing returns.
d. It is the Principle of Utility.
e. The principle is ethically rejected.

解説:
「二重効果の原則」は、善意の行為が副次的に害を引き起こす場合、それが受け入れられる条件を提供します。

_C_42. The ethical principles don’t approve restrictions put on sharing information in obtaining informed consent because:

a. Physicians may not favor an expensive treatment.
b. Physicians are always changing their customs.
c. Patients have the right to know all the details of their illnesses, management, and possible outcomes.
d. Patients are too likely to simply agree without thinking.
e. Patients mistrust physicians, creating a conflict.

解説:
患者には、自身の病状や治療について詳細を知る権利があり、情報の制限は倫理的に認められません。

_A_43. You evaluated a 65-year-old man who refuses cardiac catheterization. What should you do?

a. Respect his choice.
b. Explore reasons for his decision and try to convince him again.
c. Consider the discussion ended.
d. Continue with the procedure nevertheless.
e. Refer him to another doctor.

解説:
患者の意思決定の尊重は、倫理的医療実践の重要な要素です。

_B_44. A 60-year-old patient plans a cruise after being diagnosed with hepatoma. What should you do?

a. Inform his wife first.
b. Inform him of his condition now.
c. Exercise therapeutic privilege and inform him later.
d. Inform him when his condition worsens.
e. Ask his best friend to tell him.

解説:
診断結果は、患者自身に直接、早期に伝えることが倫理的に望ましいです。

_B_45. Thirdy, an 18-year-old married male diagnosed with appendicitis, needs surgery. Who should give consent?

a. Parents
b. Thirdy
c. His wife
d. His doctor
e. Grandparents

解説:
18歳の既婚者であれば、自己同意の能力を有しているとみなされます。

_C_46. When is patient consent necessary?

a. In an emergency, patient needs tracheostomy.
b. In a woman diagnosed with ectopic pregnancy.
c. During an appendectomy, the surgeon discovers an abnormal-looking ovary and decides to remove it.
d. The colon was perforated during sigmoidoscopy, requiring laparotomy.
e. During laparotomy, an artery was bleeding and the surgeon decided to ligate it.

解説:
緊急でない場合、追加の処置には患者の同意が必要です。

_D_47. A physician may perform a diagnostic or therapeutic procedure without the consent of the patient or relatives in:

a. When the physician believes the procedure is necessary
b. When the patient is merely being stubborn
c. When the patient is unconscious
d. In an acute emergency when there is no time to discuss the situation to seek consent
e. When the patient and relatives can afford expensive procedures

解説:
急性の緊急事態では、迅速な対応が必要であるため、同意を得る時間がない場合には、医師が直ちに行動することが許されます。

_D_48. One of these is not true of the principle of justice:

a. Requires that people be treated fairly
b. Requires that people be treated equally
c. Actions are consistent, accountable, and transparent
d. Ordered by the court
e. Respect of the law

解説:
正義の原則は、法廷の命令ではなく、倫理的な公平性に基づいています。

_C_49. In some cases, there are good reasons for overriding truth-telling:

a. All patients with cancer and AIDS
b. If the patients are from China
c. Patients do not want the truth if the news is bad
d. If the patients are ignorant
e. All of the above

解説:
患者が悪い知らせを知ることを望まない場合、真実を伝えることを控える倫理的な理由があります。

_D_50. One of the following is not part of the components of Medical Ethics:

a. Physician-patient relationship
b. Physician-physician relationship
c. The relationship of the physician to society
d. The relationship of the physician to the department of health
e. None

解説:
医療倫理の基本構成要素には、医師と社会や患者との関係は含まれますが、特定の組織との関係は含まれません。

_D_51. Informed consent includes all of the following except:

a. Understanding
b. Voluntary
c. Agreement
d. Debates
e. None

解説:
インフォームドコンセントには、患者が意思決定を理解し、自主的に同意することが含まれますが、議論自体は必須ではありません。

_B_52. Stopping a medication that is shown to be harmful is an example of:

a. Beneficence
b. Nonmaleficence
c. Autonomy
d. Justice
e. Respect

解説:
有害な治療を中止することは、害を避ける（Nonmaleficence）の原則に従っています。

_B_53. All of these are true of the Nonmaleficence principle except:

a. Includes an obligation not to inflict harm intentionally
b. Includes informed consent and truth-telling
c. Physicians must refrain from providing ineffective treatments or acting with malice towards patients
d. Offers little useful guidance to physicians because many beneficial therapies also have serious risks
e. None

解説:
Nonmaleficenceは害を与えない義務を指しますが、インフォームドコンセントや真実を伝えることは必ずしも含まれません。

_B_54. The capacity to think, decide, and act on the bases of thought and decision freely and independently best describes:

a. Confidentiality
b. Autonomy
c. Privacy
d. Competency
e. Justice

解説:
自律性（Autonomy）は、自由かつ独立して決定する能力を表します。

_D_55. Patient-physician privilege is best described as:

a. Autonomy
b. Justice
c. Truth-telling
d. Confidentiality
e. Privacy

解説:
患者-医師特権は、機密性（Confidentiality）を保つことを中心とした概念です。

_C_56. The four medical ethics principles shared between Values-Based Medicine and Beauchamp and Childress’s principles are:

a. Autonomy, privacy, respect, and confidentiality
b. Veracity, privacy, beneficence, and nonmaleficence
c. Autonomy, nonmaleficence, beneficence, and justice
d. Veracity, privacy, confidentiality, and fidelity
e. Autonomy, veracity, nonmaleficence, and beneficence

解説:
これらの4つの原則（自律性、無害原則、慈善、正義）は、現代の医療倫理の基本となるものです。

_A_57. The concept of justice in ethics is:

a. An obligation of the patient to the society
b. That the health resources must be distributed according to the principles of equity
c. Taken as a patient’s right to choose or refuse treatment
d. For all medical professionals to do good for all patients under circumstances
e. The obligation to do no harm to the patients

解説:
正義の概念は、公平性の原則に基づいて医療資源を分配することを重視します。

_A_58. Primum Non Nocere means:

a. First, do no harm
b. First, do not listen
c. Never be the first
d. The higher, the fewer
e. Give nothing to the first

解説:
ラテン語の「Primum Non Nocere」は、医療倫理の基本原則「まず害を与えないこと」を意味します。

_E_59. The relationship between clinical research and clinical medical practice is ethically considered. Which of the following best describes it?

a. Research has been tightly regulated because a particular research may put a patient at risk for the benefit of others.
b. Medical practice is focusing on the patient’s own best interests and relies and considers the benefit/risk ratio, so it is not very tightly regulated.
c. There is a distinction between research and medical practice.
d. Patient has to consent for any surgical or medical step of management or for accepting to be enrolled in research.
e. All of the above.

解説:
臨床研究と医療実践は倫理的に明確に区別され、両者に固有の規制と基準があります。

_E_60. Virtues are habits formed by all of the following except:

a. One’s personality
b. Interacting with people in the work environment
c. Parental training
d. Social training
e. Professional and other standards to one’s choice and roles in society

解説:
徳（Virtues）は、主に人格や社会的訓練により育まれますが、職業基準そのものではありません。

_C_61. One of the following is not true on access to patient’s data:

a. The data belongs to the patient
b. The medical record belongs to the hospital
c. Third-party information
d. Accuracy reduced by sharing
e. Layman unable to cope with data

解説:
患者のデータへのアクセスには規制がありますが、「第三者情報」という選択肢は明確ではありません。

_E_62. Doctors do have an obligation to:

a. Prevent harm
b. Help individuals with disability
c. Rescue those who are in danger
d. Remove harm
e. All

解説:
医師には、害を防ぎ、障害のある人を助け、危険にさらされている人を救う義務があります。

_B_63. Manuel courted the girl by sending her flowers and letters and fetching her in school every day. Manuel’s moves show an example of:

a. Manipulation
b. Persuasion
c. Coercion
d. Autonomy
e. Competency

解説:
説得（Persuasion）は、論理や感情に訴えかけて他人を納得させる行為です。マニュエルの行動は、彼女の感情に訴える誠実なアプローチとして説明できます。

_B_64. Raffy forcibly pulled the girl into his car after repeated refusals. This is an example of:

a. Persuasion
b. Coercion
c. Autonomy
d. Competency
e. Manipulation

解説:
強制（Coercion）は、相手の自由な意思決定を脅迫や力で妨げる行為です。ラフィーの行為は明らかに倫理的に問題があります。

_D_65. “Do not deprive of freedom” is an interpretation of the principle of:

a. Beneficence
b. Maleficence
c. Nonmaleficence
d. Respect for autonomy
e. Justice

解説:
自律性の尊重（Respect for autonomy）は、個人の自由な意思決定を認め、介入を最小限に抑えることを指します。

_D_66. One of the following is true of the Hippocratic Oath:

a. Is not part of the important events in the development of medical ethics
b. It is widely believed to have been written by Aristotle
c. It first appeared in 300 BCE
d. An oath historically taken by doctors swearing to practice medicine ethically
e. None

解説:
ヒポクラテスの誓いは、医師が倫理的に医療を実践することを誓う歴史的な誓約です。

_C_67. True of coercion, except:

a. Occurs if one person intentionally uses a severe threat of harm
b. Renders a well-informed behavior non-autonomous
c. Influence by appeal to reason
d. Voids an act of autonomy
e. None

解説:
理性に訴える影響力は、説得であり、強制（Coercion）ではありません。

_B_68. It underlies the medical maxim “Primum Non Nocere”:

a. Beneficence
b. Nonmaleficence
c. Scylla and Charybdis
d. Maleficence
e. Justice

解説:
「Primum Non Nocere」（まず害を与えない）は、無害原則（Nonmaleficence）の基本理念を表しています。

_B_69. According to the rule of double effect, the permissible effect may be pursued even though the harmful effect may follow, in the following conditions except:

a. The agent intends only the good effect
b. The bad effect must be a means to the good effect
c. The good effect must outweigh the bad effect
d. The act must be good
e. No exception

解説:
悪い結果が良い結果を達成する手段である場合、この行動は二重効果の原則に反します。

_B_70. This is the principle chosen by persons behind the metaphor “veil of ignorance”:

a. Utilitarian Theory of Justice
b. Egalitarian Theories of Justice of Rawls
c. Libertarian Theory of Justice of Nozick
d. Principle of Formal Justice
e. Distributive Justice

解説:
「無知のヴェール」の比喩は、ジョン・ロールズの平等主義的正義論を基礎としています。

_A_71. Its material principle purports to answer the question “When is inequality a relevant inequality?”

a. Principle of Formal Justice
b. Theory of Distributive Justice
c. Egalitarian Theory of Justice
d. Utilitarian Theory of Justice
e. Libertarian Theory of Justice

解説:
形式的正義の原則は、不平等が正当化される場合の条件を扱います。

_D_72. A family conference to discuss the prognosis of a patient with glioblastoma is scheduled. The doctor should:

a. Honor the request of the family member who is protecting his beloved brother from the bad news
b. Tell the son that withholding information is not permitted under any circumstances
c. Patient should withhold informing the patient about the seriousness of the Glioblastoma because of the grave diagnosis
d. The doctor should ask the patient how he wants to handle the information in front of the rest of the family and allow for some family discussion time
e. Doctor may understand the patient has the right to know all the details and worst scenario and inform him

解説:
患者の自律性を尊重し、家族全体で情報共有の方法を話し合うことが最善です。

_B_73. A family involved in a road traffic accident includes a husband in a coma (GCS 5), a son (GCS 12) who is confused, and a wife who is conscious but in pain. Who should sign the consent for surgery?

a. The son
b. The wife
c. Both son and wife together
d. Two consultants and the medical directors
e. Two consultants and medical directors after informing the wife and son

解説:
意識があり意思決定能力を有する妻が署名するのが適切です。

_B_74. An adult patient expressed verbally not to receive any chemotherapy. Later unconscious, the family requests chemotherapy. The doctor should:

a. Follow the family’s request, and give chemotherapy
b. Refer the patient to another team for a second opinion
c. Don’t listen to the family
d. Be ready to seek court intervention
e. Give a trial of chemotherapy and allow only one attempt of resuscitation

解説:
患者の意思を尊重するため、別のチームに相談するのが妥当です。

_E_75. All of the following are medical ethics theories except:

a. Deontological Theory
b. Teleontological Theory
c. Virtue Theory
d. Autonomy Theory
e. None

解説:
自律性理論は独立した倫理理論ではなく、他の倫理理論に組み込まれる概念です。

_D_76. All of these are principles of medical ethics except:

a. Autonomy
b. Beneficence
c. Justice
d. Maleficence
e. Nonmaleficence

解説:
害を与える（Maleficence）は医療倫理の原則に反します。

_A_77. Taking oral antihypertensive medication to control elevated blood pressure is an example of:

a. Beneficence
b. Nonmaleficence
c. Autonomy
d. Justice
e. All

解説:
高血圧治療は、患者の利益（Beneficence）を促進する行動の一例です。

_D_78. This holds that justice requires that equals be treated equally and unequals be treated unequally but in proportion to their relevant inequalities:

a. Utilitarian Theory of Justice
b. Egalitarian Theory of Justice
c. Distributive Justice
d. Principle of Formal Justice
e. Libertarian Theory of Justice

解説:
形式的正義の原則（Principle of Formal Justice）は、平等と不平等の区別を基準に基づいて行う必要性を強調しています。

_B_79. It refers to the process whereby a person comes to believe in something through the merit of reasons another person advances:

a. Manipulation
b. Persuasion
c. Coercion
d. Autonomy
e. Competence

解説:
説得（Persuasion）は、合理的または感情的な理由に基づいて他人を納得させる行為です。

_D_80. Not a basic element of informed consent:

a. Voluntary participation
b. Contacts
c. Description of clinical investigation
d. Number of participation
e. None

解説:
インフォームド・コンセントの基本要素には、参加者数は含まれません。それは研究の運営要素であり、倫理的意思決定に直接関係しません。

_E_81. Practical obstacles to the practice of confidentiality include:

a. Modern medical treatment involves a small number of medical professionals
b. Approved research
c. Patient information is increasingly stored on large electronic databases which may not be secured absolutely
d. Health insurance
e. All

解説:
情報機密性の実践には、電子データベースのセキュリティや複数の関係者間の情報共有など、現代の医療に固有の多くの課題が存在します。

1. Marquis was in a car accident and is now in a coma. There was a written order on his medical chart that indicates that he is not to be revived should his heart stop. What is the name for this medical order?

a. Advance directive
b. Health care proxy
c. Living will
d. Do-not-resuscitate (DNR) order

解説:
DNRオーダー（Do-not-resuscitate order）は、患者が心停止した場合でも心肺蘇生を行わないよう指示する医療指示書です。

2. A patient presents at the clinic and demands to view his medical record. It is the midst of dengue season. Consequently, the office is short-staffed and experiencing a high volume of patients. What is the best response?

a. Refuse the request and ask the patient to come back next month
b. Apologize to the patient and explain the office’s situation. Make an appointment for the patient to return on a less busy day
c. Allow the patient immediate access to the records without supervision
d. Inform the patient they can only access digital versions of the record

解説:
患者の要望を尊重しつつ、合理的な解決策を提供することが最善です。忙しい状況を説明し、別の日に対応するよう提案します。

3. When dealing with hostile patients/relatives, why is it important to look beyond their anger?

a. To understand their cultural background
b. To assess their financial resources
c. To recognize fears or anxiety related to unsuccessful or lack of treatment
d. To ensure hospital policies are followed

解説:
怒りは患者や家族の恐怖や不安から来ている場合があります。これを理解することで、適切な対処や共感を示すことができます。

4. Professionalism can be defined as exhibiting courteous and businesslike behavior in the workplace. Which of the following is an example of professionalism?

a. Avoiding conflict by staying silent
b. Reporting a colleague’s error to a supervisor appropriately
c. Communicating effectively and respectfully with patients and colleagues
d. Prioritizing personal opinions over professional guidelines

解説:
プロフェッショナリズムには、敬意と透明性を持って患者や同僚と効果的にコミュニケーションすることが含まれます。

5. A living will sets out which of the following?

a. A patient’s right to informed consent
b. Instructions for financial decisions
c. The ill person’s right to express their wishes for end-of-life care
d. The choice of a healthcare proxy

解説:
リビングウィルは、患者が終末期の医療についての希望を事前に明確にするための文書です。

6. You are on your community placement, which offers bereavement counseling. In one session, the placement worker, who you are shadowing, deals harshly with a crying client. This has never happened before. What should you do?

a. Report the worker immediately to higher management
b. Confront the placement worker afterward in private
c. Ignore the incident
d. Discuss the matter directly with the client

解説:
プライベートで状況を冷静に話し合うことで、問題の解決や再発防止につながります。

7. When do people deal with death the best?

a. When they have access to professional counseling
b. When they have family support
c. When they have strong religious beliefs or no beliefs at all
d. When they are financially secure

解説:
信念体系は、死に対処する際の心理的な支えになることが多いとされています。

8. A nurse on duty brings personal problems to work on a daily basis, discussing her divorce with you and patients. What should you do?

a. Ignore the behavior
b. Attempt to resolve the situation yourself by addressing it directly with the nurse. If this does not work, inform your supervisor
c. Report her immediately
d. Advise her to leave work

解説:
まず直接的に対応し、それでも解決しない場合は上司に報告するのが適切です。

9. A patient calls to schedule an appointment and is hearing impaired. She asks that you speak louder so she can hear you better. What is the most appropriate response?

a. Continue speaking as you were
b. Move to a private location to ensure privacy and speak louder
c. Ask her to have someone else call for her
d. Refuse the request

解説:
プライバシーを保ちながら、患者の要望に応えることで、医療倫理を尊重します。

10. Your mother has asked you and your sibling to sign a document stating that she has chosen the two of you to make decisions on her behalf, should she lose her mental capacity. What is the name of this document?

a. Advance directive
b. Living will
c. Do-not-resuscitate order
d. Proxy directive

解説:
プロキシディレクティブは、患者が意思決定能力を失った場合に代わりに決定を下す人を指定する文書です。

11. When one dies, the pattern of grieving depends on all EXCEPT which of the following?

a. Cultural background
b. Support system
c. Personality of the bereaved
d. The gender of the bereaved person

解説:
死別の悲しみに対する反応は文化的背景やサポート体制などに影響されますが、性別は直接的な決定要因ではありません。

12. What is the function of funeral practices and rituals?

a. To ensure proper legal documentation
b. To help the bereaved family cope with grief and re-establish community bonds
c. To emphasize the importance of the deceased’s wealth
d. To facilitate inheritance distribution

解説:
葬儀や儀式は、家族が悲しみに対処し、コミュニティの支援を再構築するための重要な機能を果たします。

13. Studies that compare older and younger people find that older people express more concern about which aspect of death?

a. Financial implications
b. Impact on their family
c. The process of dying
d. Spiritual fulfillment

解説:
高齢者は、死の過程や苦痛についてより多くの不安を表明する傾向があります。

14. The effects of advance care planning on end-of-life care include the following, EXCEPT?

a. Increased clarity about patient wishes
b. Reduced unnecessary medical interventions
c. Improved family satisfaction
d. Decreased hope on the part of the family

解説:
事前ケア計画は家族や患者の希望を明確にし、満足度を高めるものですが、希望を失わせることが目的ではありません。

15. The following situations allow patients to make meaningful decisions for future care crises, EXCEPT?

a. Living wills
b. Advance care planning discussions
c. Patient’s choice not to make decisions
d. Proxy directives

解説:
患者が意思決定を放棄する場合、それは将来のケアについて有意義な決定を下す機会を減少させます。

16. Which of the following is an example of an ethical conflict that doctors face when they treat dying patients?

a. Deciding whether to disclose terminal diagnoses
b. Balancing pain relief with potential addiction risk
c. Ongoing court battles over the legal status of euthanasia
d. Determining when to involve palliative care specialists

解説:
医師は、安楽死や生命終末期ケアに関連する法的・倫理的なジレンマに直面することがあります。

17. It will not be helpful for the primary care physician to give false reassurance to patients even though family members might persuade him/her to do so. False reassurance will only result in more anxiety. The reasons are:

a. It undermines trust between the patient and physician
b. It creates unrealistic expectations for treatment outcomes
c. It breaks the ethical duty of honesty
d. All of the above

解説:
偽りの安心感を与えることは、信頼関係を損ない、不安を増幅させる可能性があります。

18. What is one of the main problems with advance directives?

a. The dying patient and his family cannot agree on the living will
b. They are legally unenforceable in some jurisdictions
c. They often conflict with physician recommendations
d. They are only applicable in certain medical conditions

解説:
事前指示は家族や患者間で意見が合わないことがあり、その実施が難しい場合があります。

19. A parent of an adult patient is calling to inquire about test results for the patient. The patient has no release of information forms on file. What should you do?

a. Share the information, assuming the parent has the patient’s consent
b. Refuse to provide any assistance
c. Politely explain that privacy standards prevent sharing information but encourage future consent
d. Contact the patient directly for verbal permission

解説:
患者情報の共有はプライバシー基準に従い、正式な同意がない限り行うべきではありません。

20. Which of the following statements can be made regarding doctors and directives?

a. Doctors should prioritize their judgment over advance directives
b. Advance directives are optional for physicians to follow
c. Doctors are encouraged to discuss directives with patients and their families
d. Directives are binding only in life-threatening conditions

解説:
医師は患者とその家族と指示書について話し合い、彼らの意思を尊重することが求められます。