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#Solved: Ethical and Legal Implications of Prescribing Drugs
What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient?
These are some of the questions you might consider when selecting a treatment plan for a patient. As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives on a daily basis. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. In this Discussion, you explore ethical and legal implications of scenarios and consider how to appropriately respond.
Scenario 1:
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.
Scenario 2:
A friend calls and asks you to prescribe a medication for her. You have this autonomy, but you don’t have your friend’s medical history. You write the prescription anyway.
Scenario 3:
You see another nurse practitioner writing a prescription for her husband who is not a patient of the nurse practitioner. The prescription is for a narcotic. You can’t decide whether or not to report the incident.
Scenario 4:
During your lunch break at the hospital, you read a journal article on pharmacoeconomics. You think of a couple of patients who have recently mentioned their financial difficulties. You wonder if some of the expensive drugs you have prescribed are sufficiently managing the patients’ health conditions and improving their quality of life.
To prepare:
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Review Chapter 1 of the Arcangelo and Peterson text, as well as articles from the American Nurses Association, Anderson and Townsend, the Drug Enforcement Administration, and Philipsend and Soeken.
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Select one of the four scenarios listed above.
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Consider the ethical and legal implications of the scenario for all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family.
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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.
With these thoughts in mind:
Write an explanation of the ethical and legal implications of the scenario you selected on all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family.
Describe two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario.
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Ethical and Legal Implications of Prescribing Drugs
Ethics are the unlegislated rules of any profession. They derive from the belief that persons should do no harm deliberately to themselves and to others. This essay discusses a medical error scenario in the context of healthcare professional practice. It presents the ethical and legal implication of the scenario as well as the necessary strategies to mitigate the medical error.
Ethical and legal implications
The scenario in question involved a nurse practitioner prescribing the wrong dosage of medication to a five-year old. Instead of administering the right does, the nurse prescribed a dose suitable for an adult. Arcangelo, Peterson, Wilbur and Reinhold (2017) advice that nurses should always ensure they know the nature of therapy that patients need before administering prescription. They point out that weight is the most important factor to consider when determining dosage for children. Specifically, there must be clear indications of the dosage for every kilogram of a child’s body weight (Arcangelo et al., 2017). The prescriber, namely the Nurse Practitioner, has the responsibility for interpreting medication information from the physician and implementing the information by prescribing the appropriate drug. In the above scenario, the nurse failed in his duty and is subject to punitive measures, including dismissal from work, withdrawal of practice license or even prosecution. One possible implication for the error is the child developing complications due to overdose. Such a result could spiral into further outcomes, such as lawsuits, loss of jobs for the nurse and pharmacist and loss of reputation for the hospital. According to Brown (2013) reports that most of the claims against doctors result from medication errors.
Strategies to guide decision making
As a practice nurse, the first strategy would be to immediately stop administering the wrong dosage. I would then disclose and explain the error to the parents or guardians of the child and apologize for the mistake. Guilod (2013) posits that a failure to disclose medication errors could precipitate financial losses in form of lawsuits and claims by patients or their families who suffer the consequences of adverse effects. Thereafter, I would report my error to the pharmacist and ask for a correct dosage following the right prescription procedures for paediatric cases. Ultimately, I would show remorse and render myself subject to any punitive decisions taken against me for my mistake.
The second strategy is to conduct a root-cause analysis, identify lasting corrective and preventing measures for such an error. The likelihood is that the hospital management will immediately appoint a team or a person to investigate the error. I would cooperate with the investigators in explaining the possible reasons for my mistake. This cooperation will help everyone to trace the first cause of the error. According to Crigger and Holcomb (2008), the pressure of work could drive nurses to make mistakes when prescribing drugs. In such situation, the lasting solution is to hire more nurses to reduce workload. The hospital can also increase verification points between the prescribing nurses to ensure the patient receives the right dosage.
Conclusion
In the healthcare scenario, it is not uncommon for nurse practitioners to make mistakes. While some of these mistakes carry dire consequences on the practitioners’ professional practice and patients’ health, some may not be so harmful to patients. This paper has shown that medication errors in paediatrics can engender many consequences on the patient, the patient’s family, the hospital and the practitioners alike. The most ethical thing to do in the event of such errors is to disclose the mistake and try to deal with the possible consequences. It is also important to identify and eradicate the root causes of prescription errors so as to prevent them altogether.
References
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds) (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Crigger, N., & Holcomb, L. (2008). Improving nurse practitioner practice through rational prescribing. The Journal for Nurse Practitioners, 4(2), 120-125.
Guilod, O. (2013). Medical Error Disclosure and Patient Safety: Legal Aspects. J Public Health Res., 2(3), e31.
Brown, S. (2013, August 8). The medical law and ethics that pertain to safe prescribing. Medical Protection. Retrieved February 26, 2018 from http://www.medicalprotection.org/uk/about-mps/media-centre/media-gallery/mps-blogs/blogs/prescribing/prescribing-blog-posts/prescribing/2013/08/08/the-medical-law-and-ethics-that-pertain-to-safe-prescribing
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Tags: ethical and legal implications of prescribing drugs for nurse practitioners, ethical and legal implications of prescribing drugs
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