Euthanasia and informed consent MCQs With Answer

Euthanasia and informed consent MCQs With Answer

This quiz collection is designed for M.Pharm students studying Research Methodology & Biostatistics, focusing on the ethical, legal and methodological aspects of euthanasia and informed consent. It covers definitions, classifications, regulatory frameworks, capacity assessment, surrogate decision-making, advanced directives, and consent-related issues in clinical research and practice. Questions include scenarios that highlight implications for study design, documentation, bias, and protection of vulnerable populations. Each item tests conceptual understanding and practical application in healthcare research and pharmacy practice, helping students prepare for exams and ethical decision-making in clinical trials, patient care, and policy interpretation.

Q1. What best defines ‘voluntary euthanasia’ in clinical ethics?

• Ending a patient’s life without consent to relieve suffering
• Withholding life-sustaining treatment because of community norms
• Intentionally ending life at the competent patient’s request to relieve suffering
• Providing high-dose analgesia that may hasten death without patient knowledge

Correct Answer: Intentionally ending life at the competent patient’s request to relieve suffering

Q2. Which of the following is the most accurate distinction between active and passive euthanasia?

• Active euthanasia involves withdrawing treatment; passive involves administering lethal drugs
• Active euthanasia is legal everywhere; passive euthanasia is never legal
• Active euthanasia entails an act to cause death; passive euthanasia entails omission or withholding treatment
• Active euthanasia occurs only in research; passive occurs only in clinical care

Correct Answer: Active euthanasia entails an act to cause death; passive euthanasia entails omission or withholding treatment

Q3. Which element is NOT a core component of valid informed consent?

• Disclosure of relevant information
• Patient’s capacity to decide
• Voluntariness free from coercion
• Physician’s assurance of successful outcome

Correct Answer: Physician’s assurance of successful outcome

Q4. In research involving incapacitated patients, which mechanism commonly permits participation when direct consent cannot be obtained?

• Therapeutic coercion
• Surrogate or legally authorized representative consent
• Unilateral investigator consent
• Mandatory inclusion by institutional policy

Correct Answer: Surrogate or legally authorized representative consent

Q5. What is the ‘therapeutic misconception’ in clinical trials?

• Participants mistakenly believe the trial will definitely cure them rather than test a hypothesis
• Investigators assume all subjects will benefit from the experimental intervention
• Ethics committees confuse therapy with research oversight
• Regulators treat compassionate use as equivalent to randomized trials

Correct Answer: Participants mistakenly believe the trial will definitely cure them rather than test a hypothesis

Q6. When can an Institutional Ethics Committee (IEC) approve a waiver of informed consent in research?

• Whenever the investigator asks for faster recruitment
• Only when the research involves more than minimal risk
• When obtaining consent is impracticable and the research involves minimal risk or significant public health benefit
• When the participant population is healthy volunteers

Correct Answer: When obtaining consent is impracticable and the research involves minimal risk or significant public health benefit

Q7. Which statement best describes ‘advance directives’ related to end-of-life decisions?

• They are legally binding orders written by a physician for all patients
• They are documents by which an individual expresses future treatment preferences should they lose decision-making capacity
• They allow family members to override a competent patient’s choices
• They are the same as a do-not-resuscitate order in all jurisdictions

Correct Answer: They are documents by which an individual expresses future treatment preferences should they lose decision-making capacity

Q8. In a randomized controlled trial evaluating palliative interventions, what consent-related bias is most likely to threaten validity?

• Survivor bias due to long-term follow-up
• Selection bias introduced by differential refusal rates related to treatment preference
• Measurement bias from unblinded outcome assessors only
• Confounding because subjects are randomized

Correct Answer: Selection bias introduced by differential refusal rates related to treatment preference

Q9. What legal/ethical distinction applies to ‘non-voluntary euthanasia’?

• Performed with explicit informed consent of the patient
• Performed when the patient cannot express consent and no prior directive exists
• Performed against a competent patient’s wishes
• Performed only after court approval in all countries

Correct Answer: Performed when the patient cannot express consent and no prior directive exists

Q10. Which approach is appropriate for assessing decision-making capacity in a clinical research subject?

• Assume capacity unless a family member objects
• Evaluate understanding, appreciation, reasoning and expressing a choice specific to the decision
• Use a standardized IQ test as the sole determinant
• Rely only on the treating physician’s general impression without structured assessment

Correct Answer: Evaluate understanding, appreciation, reasoning and expressing a choice specific to the decision

Q11. Which of the following is an ethical justification sometimes used for allowing physician-assisted death where legal?

• Maximizing researcher autonomy
• Respecting patient autonomy and relieving intractable suffering
• Promoting uniform national policy without case-by-case assessment
• Reducing healthcare costs irrespective of patient wishes

Correct Answer: Respecting patient autonomy and relieving intractable suffering

Q12. In biobanking for future research, what consent model permits broad, unspecified future use while maintaining ethical oversight?

• Specific consent for each future study only
• Blanket consent without any oversight
• Broad consent combined with governance mechanisms and option to withdraw
• Implied consent based on sample submission

Correct Answer: Broad consent combined with governance mechanisms and option to withdraw

Q13. Which scenario most clearly represents ‘involuntary euthanasia’?

• Administering medication to relieve pain that may hasten death with informed consent
• Honoring a living will that refuses life-sustaining treatment
• Terminating life against a competent patient’s explicit wishes
• Withholding CPR per patient’s advance directive

Correct Answer: Terminating life against a competent patient’s explicit wishes

Q14. Which document typically must be reviewed and approved before a study involving end-of-life decisions proceeds?

• Manufacturing batch record
• Clinical trial protocol and informed consent form by the Institutional Ethics Committee
• Payment schedule for study staff only
• Researcher’s personal opinion letter

Correct Answer: Clinical trial protocol and informed consent form by the Institutional Ethics Committee

Q15. What is the ethical significance of ‘voluntariness’ in consent for research near end-of-life?

• Voluntariness ensures subjects receive financial incentives
• Voluntariness protects subjects from coercion or undue influence, especially when vulnerable
• Voluntariness allows clinicians to enroll patients without information if beneficial
• Voluntariness is irrelevant if family members approve

Correct Answer: Voluntariness protects subjects from coercion or undue influence, especially when vulnerable

Q16. Which regulatory provision often governs emergency research where prospective informed consent is not practicable?

• Requirement for surrogate consent in all emergencies
• Procedures for exception from informed consent with specific ethical safeguards and community consultation
• Ban on any research in emergency settings
• Automatic approval by the treating physician without oversight

Correct Answer: Procedures for exception from informed consent with specific ethical safeguards and community consultation

Q17. In assessing risk-benefit for a study involving decisions about euthanasia-related attitudes, which methodological issue is most relevant?

• Ensuring randomization of clinical treatments
• Minimizing psychological distress through careful questionnaire design and support
• Guaranteeing that all participants receive a palliative intervention
• Requiring all participants to complete a capacity test regardless of context

Correct Answer: Minimizing psychological distress through careful questionnaire design and support

Q18. Which practice helps prevent coercion when offering research participation to terminally ill patients?

• Presenting only the potential benefits and downplaying risks
• Separating the clinical care team from those obtaining consent and clearly explaining voluntary nature
• Conditioning clinical treatment on trial enrollment
• Using large monetary payments as the primary recruitment tool

Correct Answer: Separating the clinical care team from those obtaining consent and clearly explaining voluntary nature

Q19. Which statement about withdrawal of consent is correct?

• Once consent is given it cannot be withdrawn under any circumstances
• Participants have the right to withdraw from research at any time without penalty or loss of standard care
• Withdrawal is only permitted with approval from the ethics committee
• Withdrawal mandates immediate euthanasia per protocol

Correct Answer: Participants have the right to withdraw from research at any time without penalty or loss of standard care

Q20. For studies that involve documenting end-of-life choices, which data protection practice is essential?

• Publishing identifiable data to promote transparency
• De-identifying personal data, securing storage, and limiting access according to consent
• Sharing data freely with commercial partners without consent
• Retaining all data indefinitely in unsecured formats

Correct Answer: De-identifying personal data, securing storage, and limiting access according to consent

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