Assignment: Ethical and Legal Implications of Prescribing Drugs

Assignment: Ethical and Legal Implications of Prescribing Drugs

 

Ethical and Legal Implications of Prescribing Drugs

In the United States, advanced practice nurse practitioners have varying degrees of prescriptive authority, over certain medications and medical devices. They must thus display a comprehensive understanding of the legal implications associated with prescribing drugs, in addition to their ethical obligations (Billstein-Leber et al., 2018). Clinical practice ethical guidelines recommend all clinicians with prescriptive privileges, ensure that their patients are protected from harm. The provided case study however demonstrates a situation where a nurse practitioner prescribed an adult dose of a drug to a 5-year-old. The purpose of this discussion is to elaborate on the ethical and legal implications associated with this scenario, and effective mitigating strategies to prevent such occurrences in the future.

Ethical and Legal Implications

            In this scenario, the medication error displayed poses substantial ethical implications for the prescriber, pharmacist, patients, and the patient’s family. The nurse practitioner as the prescriber is required to uphold ethical principles governing patient safety. It was thus an act of unprofessionalism to make such a mistake of giving a child an adult dose, knowing very well the harm that the drug could cause. Ethically, the nurse is required to ensure beneficence in the process of care provision, which was violated by the incidence of medication error (Tigard, 2019). Consequently, clinicians are required to uphold justice in practice, which required the nurse to follow the necessary process required to address the medication error, rather than neglecting the patient. With this act, the nurse exposes the patient to the possibility of a legal lawsuit.

The pharmacist on the other hand is required to counter-check the prescription once received. In case of a medical error, the pharmacist must contact the prescriber and discuss the identified error before taking the necessary actions required to address the issue (Robertson & Long, 2018). However, if the pharmacist fails to identify the medical error, then he or she will also bear the ethical and legal burden associated with posing harm to the patient due to the medication error made by the nurse practitioner.

The patient, on the other hand, is a minor, who will suffer substantial harm from a drug overdose. The parents, who bear the legal responsibility of taking part in making healthcare decisions for their child can sue both the prescriber and the pharmacist for the medication error (Varkey, 2021). Consequently, the patient’s parents have a legal right to information concerning the medication prescribed to their child, and how to take it, which should have been provided by the pharmacist.

Strategies to Address Disclosure and Nondisclosure

Disclosing medication error is an ethical act thus must be exhibited by all authorized prescribers in case they are faced with such as situation. In South Carolina, provisions for medication error reporting are organized according to the South Carolina Code of Regulations. Medication errors are recognized in this state as one of the most crucial treatment-caused risks to the patient. As such, the South Carolina Department of Disabilities and Special Needs demands clinicians to report every medication error that may occur in the course of care provision as outlined under the 2012 South Carolina Code of Laws, Section 44-7-315 – on “Disclosure of information regarding facility or home” (Nicolette, 2018). The S.C. Code § 15-79-125 also elaborates on medical malpractices, such as failing to disclose medication errors, which will end up affecting the patient. As such, clinicians must apply appropriate decision-making skills concerning disclosure and non-disclosure of medication errors such as assessing the severity level of the error and conducting both reactive and proactive analysis to reduce the medication errors.

Strategies for Appropriate Decision Making

When faced with such a situation as an advanced practice nurse, I will always decide on disclosing the information to the patient. Medication safety is a crucial aspect in safeguarding patients from harm during the care delivery process. As such, in case of an error, the nurse needs to come forward to avoid legal penalties associated with non-disclosure (Varkey, 2021). I will utilize two main strategies to decide on how to disclose the matter to the patient. First, I will explain to the patient how the medication error occurred to regain trust essential for a healthy patient-provider relationship. I will then expound on how the harmful impact of the error can be ameliorated and provide appropriate steps which will be taken to ensure that such an error will never happen again. This will help regain the patient’s confidence in the care plan hence promoting positive care outcomes.

Writing Prescriptions to Minimize Medication Errors

The process of writing a prescription mainly involves six steps. First, the prescriber must evaluate the patient’s problem, then specify the therapeutic objective (Mullen et al., 2018). After which the prescriber will select the most effective drug therapy, and initiate the therapy, with appropriate consideration of the dosage, frequency, and duration of drug use. The prescriber will then give information and instructions to the patient and evaluate therapy regularly. To minimize incidences of medication errors, the prescriber must consider several factors before prescribing any medication. Such factors include whether the medication is the best choice in the management of the patient’s condition, whether there are any contraindications, whether the dosage is correct, whether the patient is allergic to any of the drug components, and appropriate storage for the drug among others.

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Conclusion

Several ethical considerations have been outlined to promote appropriate prescriptive practices upholding patient safety and preventing harm. As such, in case of medication error like in the provided case study, the nurse is required to disclose the matter to the patient and implement appropriate strategies to address the issue.

Referencing

Billstein-Leber, M., Carrillo, C. J. D., Cassano, A. T., Moline, K., & Robertson, J. J. (2018). ASHP guidelines on preventing medication errors in hospitals. American Journal of Health-System Pharmacy, 75(19), 1493-1517. DOI 10.2146/ajhp170811

Mullen, R. J., Duhig, J., Russell, A., Scarazzini, L., Lievano, F., & Wolf, M. S. (2018). Best practices for the design and development of prescription medication information: A systematic review. Patient education and counseling, 101(8), 1351-1367. https://doi.org/10.1016/j.pec.2018.03.012

Nicolette, T. (2018). Williams v. Quest: The South Carolina Supreme Court’s Misdiagnosis of Quest Diagnostics as a Health Care Provider and the Poor Prognosis for Plaintiffs in Medical Malpractice. Charleston L. Rev., 13, 393. https://law.justia.com/cases/south-carolina/supreme-court/2018/27818.html

Robertson, J. J., & Long, B. (2018). Suffering in silence: medical error and its impact on health care providers. The Journal of emergency medicine, 54(4), 402-409. https://doi.org/10.1016/j.jemermed.2017.12.001

Tigard, D. W. (2019). Taking the blame: appropriate responses to medical error. Journal of Medical Ethics, 45(2), 101-105. http://dx.doi.org/10.1136/medethics-2017-104687

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28. https://doi.org/10.1159/000509119

Assignment: Ethical and Legal Implications of Prescribing Drugs
Scenario: 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.

To Prepare
• Review the Resources for Basic Pharmacotherapeutic Concepts/Ethical and Legal Aspects of Prescribing (How patient factors may influence the pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics), and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
• Review the scenario assigned by your Instructor for this Assignment.
• Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region and reflect on these as you review the scenario assigned by your Instructor.
• 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 2- to 3-page paper that addresses the following:
• Explain the ethical and legal implications of the scenario you selected 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 the state of South Carolina.
• 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.