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Louise Penny’s recent novel, The Madness of Crowds, is set post-COVID.  However, COVID has left its mark, including significant strains on the solvency of the Canadian government.  The old normal cannot be restored because of the cultural and economic aftershocks catalyzed by the pandemic. To address those issues, the fictional Canadian government has commissioned a renowned statistician, Abigail Robinson, to delete emotion and politics from the recovery equation and analyze what, exactly, must be done to rebuild national solvency and stability, and prevent the same disaster from ever happening again.  According to Robinson’s analysis, the sick and elderly used too many of the country’s resources during the pandemic. In other words, people who were the most vulnerable to the novel coronavirus, who would die soon anyway, were putting a strain on the country’s finances, medical supplies and personnel.  It is, she says, “a crisis heightened but not created by the pandemic.”  Based on her analysis, Robinson concludes that the solution is a program of “mercy killing,” as she calls it – of the ill, the handicapped and the aged.  Abigail Robinson promises that, if they follow her recommendations, “ça va bien aller” (all will be well).

Part II: Legal & Ethical Analysis, and Strategic Implications (Total – 60 points) For these scenarios:    First, identify a key legal issue and legal concepts that relate to the first and second scenarios, and the ethical concerns / tradeoffs that relate to the third scenario.  Key legal concepts include key requirements for a relevant legal issue (such as the multiple choice answer options covered in Part I).  Also, for each of these legal concepts, identify a key fact or facts that is / are relevant for analyzing that concept.  Likewise for the ethical concerns / tradeoffs, identify stakeholders and key fact/s that are relevant to the ethical concern.  It is recommended you use a table/s such as these: Legal Issue Legal Concept Key Fact Key Legal Issue for 1st scenario LC 1 F1 “” LC 2 F2 “” LC 3 F3 “” LC 4 F4 For example, if Negligence were a key issue, you would have a table like this (note – duty & damages are normally straightforward, so they are not included) Legal Issue Legal Concept Key Fact Negligence Breach Fact about breach “” Causation Fact about causation   Ethical Concern / Tradeoff Relevant Stakeholder Key Fact ECT RS 1 F5 “” RS 2 F6 “” RS 3 F7     Then, offer and explain your strategic recommendations.  

A laboratory company offered and paid remuneration to physicians to induce the ordering of pharmacogenetic tests, in exchange for laboratory referrals for pharmacogenetic testing and for furnishing and billing for tests paid for, in part, by Federal health programs, that were not medically necessary, purportedly in return for their participation in a clinical trial.

REQUIRED ACADEMIC INTEGRITY AGREEMENT: UST Academic Integrity Policy Honesty and trust among students and between students and faculty are essential for a strong, functioning academic community.  Consequently, students are expected to do their own work on all academic assignments, tests, projects and research/term papers.  Academic dishonesty, whether cheating, plagiarism or some other form of dishonest conduct related to academic coursework and listed in the Student Policy Book under “Discipline: Rules of Conduct” will automatically result in failure for the work involved. This open textbook (Perry & Thompson) / open note / open Canvas exam, but no outside research (including no use of Google / ChatGPT, other AI or search engine etc) is allowed.  By clicking below you are agreeing to the terms and conditions of this exam.  You are further agreeing that you will not talk with anyone else about the exam, either during or after the exam and that you will not copy of any part of this exam at any time.   This specifically includes not taking pictures of your screen with any device. YOU MUST AGREE TO COMPLY WITH THIS POLICY IN ORDER TO TAKE THIS EXAM.  INDICATE YOUR AGREEMENT BY CLICKING “I AGREE” BELOW.

PART 1:  Multiple-Answer Choice (Total – 34 points) For the given scenarios, identify the health care legal issues and/or overarching ethical considerations (covered in 2nd part of the course) that may require significant attention by the relevant health care organizations or provider/s. The first three questions are worth 3 points each (choose best answer for these), the next five are worth 5 points each (there may be multiple answers for these).

Which hematologic complication is associated with chronic kidney disease (CKD) due to decreased erythropoietin production?

Select the statement that best describes the pathophysiology of acute appendicitis?

The executive director of a food bank seeks out the data of how many pounds of food were distributed in the last year. This is an example of: 

Select the statement that best describes the underlying pathophysiology of Genitourinary Syndrome of Menopause (GSM)?

A 65-year-old woman presents to the emergency department with progressive dysphagia. Initially she had trouble with ingestion of bulky food, later with soft food, and now with difficulty on thin liquids and excessive salivation. What must be included in the differential diagnosis?