Legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure
As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult.
• Review the Resources and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
• Review the scenario assigned by your Instructor above.
• Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state ( Maryland), and reflect on these as you review the scenario assigned by your Instructor above.
• Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
• Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.
Write a 3-page paper include a title page, introduction, summary, and references addresses the following:
• Explain the ethical and legal implications of the scenario ABOVE on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
• Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
• Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
• Explain the process of writing prescriptions, including strategies to minimize medication errors.
Legal and Ethical Implications of Prescribing Prescription Drugs, Disclosure, and Nondisclosure
Doctors and nurses are always perceived to be perfectionists in their work stations. This is partly because of the sensitivity of their jobs, favorably considered a matter of life or death type of sensitivity. But what most people do not understand is that doctors and nurses too, are human beings just like any other person, and they make mistakes in their profession just like people do in their different practices. If a doctor or a nurse makes a mistake while performing duties, they are met with a lot of criticism, ethical, and legal torments.
Ethical and legal implications of medical error
In HealthCare Ethics, the principle, Non-malfeasance, guides practitioners to a “Do No Harm” principle as a foundation of their practice. Day to day activities at any hospital can be overwhelming at times because of the huge numbers of patients walking in and out of the hospital every minute. This means that at one point during work hours a health care worker, nurses included, can be either fatigued, careless, or stressed out, leading to medical errors. Many of these nurses never imagine themselves having trouble administering dosages to their patients, and in rare cases, you will find these nurses checking back with the pharmacists for drug queries.
However, when errors do occur at workplaces it is the mandate of the practitioner to disclose or not disclose the error made. Ethically, it is the responsibility of the practitioner to disclose a medical error to the patient to prevent further harm (Fowler, 2015). On the contrary, some practitioners opt for non-disclosed medical errors because of legal setbacks. For instance, in the scenario above, the practitioner may choose not to disclose the wrong dosage on the fear that the family might take legal action and sue the nurse and the hospital. However, it does not do any good to the situation for the practitioner to opt for non-disclosure since the wrong dosage will lead to adverse effects on the patient, which will eventually raise concerns to the family. Therefore, it would be ethically and legally right for the practitioner to own up to the medical error and communicate the mistake to the affected family, for this way, they would have saved the legal consequences and work together with the family to address the situation and reduce further harm (Bonney, 2014). Through this approach of disclosure, the practitioner will have exercised their ethical responsibility, saved all stakeholders involved like the hospital, pharmacy, and the family from the accruing consequences of the medical error.
Disclosure and Non-Disclosure Strategies
Ethical issues surrounding medical errors call for sincere approaches towards solving these problems. Following the four ethical principles, the above scenario would be best solved using the autonomy and the right to self-determination approach or the Disclosure and Right to Knowledge approach (Kalra, Kalrz &Baniak, 2013).
Autonomy and Self Determination allows the patient to make their own decision after considering the benefits and losses of the communicated errors by the nurse (Bonney, 2014). In the above scenario, the nurse will be obligated to inform the patient and the family of the occurred errors and the most possible way to help counter and solve the issue before it escalates. The patient and the family in return will evaluate the whole scenario and decide on their best favorable plan and action, thus be a part of the solution as well.
Disclosure and Right to knowledge, on the other hand, entail limiting the health care workers to their ethical obligation of telling the truth to the patient and disclosing every information to the patient so that the patient can decide on his own, as indicated in the Patient’s Bill of Rights which calls for a fully disclosed medical error (Kalra, Kalra &Baniak, 2013). In the above scenario, therefore, the nurse owning up to her responsibility will first be an act of respect for the patient’s autonomy by fully disclosing the prescription error to the patient, and will also enable the patient and the family to act accordingly to reduce immediate harm, and build trust.
Drug Prescription Process to Minimize Medical Errors
According to Maryland State standards and regulations, as well as the World Health Organization policies of drug prescription, a practitioner is supposed to adhere to the following process so that they can minimize errors and poor-quality prescriptions (Fowler, 2015). First, a practitioner should identify and determine the patient’s problem. Second, line out the therapeutic value objective. The practitioner will then select the needed drug therapy and initiate this therapy with precise details including nonpharmacologic therapy (Ladd & Hoyt, 2016). Further, the practitioner will provide all essential information concerning the drug, instructions on how to use and store the drug, and necessary warnings. Finally, the practitioner should regularly evaluate the patients’ therapy (Ladd, & Hoyt, 2016).
To minimize prescription errors, a practitioner should use technology such as computers to conduct online prescribing and also document their work (Ladd & Hoyt, 2016). The use of computers will help the practitioner identify the correct dosages and keep records and track of every patient’s records.
Bonney, W. (2014). Medical errors: Moral and ethical considerations. Journal of Hospital Administration, 3(2), 80-88. doi:10.5430/Jha.v3n2p80
Fowler, M. D. M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association.
Kalra, J., Kalra, N., &Baniak, N. (2013). Medical error, disclosure, and patient safety: A global view of quality care. Clinical Biochemistry, 46, 1161-1169. DOI: 10.1016/j.clinbiochem.2013.03.025