ETHICAL AND LEGAL IMPLICATIONS OF PRESCRIBING DRUGS NURS 6521

ETHICAL AND LEGAL IMPLICATIONS OF PRESCRIBING DRUGS NURS 6521

ETHICAL AND LEGAL IMPLICATIONS OF PRESCRIBING DRUGS NURS 6521

In the case scenario, a friend calls and requests me to prescribe her medication. Although I have the autonomy, I do not have the friend’s medical history. However, I still write the prescription. This paper explores the ethical and legal implications of this scenario, approaches to address disclosure and nondisclosure, and the procedure of writing prescriptions.

Ethical and Legal Implications Of The Scenario On All Stakeholders Involved

Prescribing or giving medications to family members and friends, except for an emergency is regarded as unprofessional conduct and can call for disciplinary measures. The ethical problem surrounds the fact that the relationship with a friend or relative can cloud a practitioner’s judgment (Sorrell, 2017). Based on the state, the prescriber in this scenario can face legal consequences for prescribing to their friend. Writing a drug prescription for friends in a social setting can prompt legal action. Since the prescriber has the autonomy to prescribe, the ethical and legal consequences would center on what is best for the person prescribed and whether local ethic boards have an outlook on the matter (Sorrell, 2017). The prescribed medication may result in an adverse drug event since no assessment was conducted, which fails to uphold ethical principles of beneficence and nonmaleficence.

The ethical and legal implications of the act would not only fall on the prescriber but also the dispensing pharmacist. Ethical implications for the pharmacists would include the failure to uphold beneficence and nonmaleficence. The pharmacist ought to have reviewed the diagnosis for the patient before dispensing to ensure the medication is appropriate for the patient’s medical condition (Sorrell, 2017). Failing to review the medical information puts the patient at risk of adverse drug effects if the drug is not appropriate for the patient.  Furthermore, the patient may face legal implications for getting a prescription without being assessed and diagnosed by a healthcare provider.

Strategies to Address Disclosure and Nondisclosure As Identified In the Scenario

Disclosure of medical error refers to the communication between a health provider and a client, family member, or a client’s proxy whereby the provider admits that a medical error occurred. North Carolina has a statute that protects reports made by a health provider making an apology for an adverse treatment outcome. The statute on disclosure, states that health providers should offer to implement remedial or corrective treatment interventions, as well as voluntary acts to assist the affected patient (North Carolina Medical Board, 2017). However, the North Carolina statute does not protect any confessions of fault or a provider’s acknowledgment of responsibility. In the case that the medication has an adverse event on the prescriber’s friend or the prescriber realizes they prescribed the wrong medication, the prescribing clinician should inform the patient (Eniola & Gambino, 2019). The clinician should explain how the error occurred and the actions to be taken to correct the error and its effects.

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Strategies That You, As an Advanced Practice Nurse, Would Use To Guide Your Decision Making In This Scenario

In this scenario, my decisions would be based on the North Carolina laws and ethical principles. I would reveal the medication error to the patient by explaining how it occurred as stated by the state law to avoid legal action and implications such as having my APN license revoked (Eniola & Gambino, 2019). In addition, I would employ beneficence and nonmaleficence in making decisions to promote ethical practice. Beneficence is the moral duty to promote good, while nonmaleficence is the duty to cause no harm. In this regard, I would take the duty to do good and prevent harm on the patient by informing them of the error and taking prompt interventions to mitigate potential harm from the medication error (Sorrell, 2017). Besides, I would explain to the patient the steps that the provider and the hospital are implementing to prevent errors in the future. This would help maintain the client’s trust in the clinician and the hospital.

Process of Writing Prescriptions and Strategies to Minimize Medication Errors

The prescribing clinician should first fill in the patient’s data, including name, age, sex, and medical diagnosis. The next step is to write the prescribed medication, including the name, dose, frequency, and route of administration (de Araújo et al., 2019). Besides, the clinician should indicate the frequency of refills, particularly for patients with chronic illness. The last step should be to write the clinician’s name, address, National Provider Identifier number, and DEA number. Medication errors can be reduced by taking a detailed history of the patient’s drug allergies and current medications (de Araújo et al., 2019). Organizations can adopt technology systems such as the E-prescribing software, which generates prescriptions electronically and send them directly to the pharmacy. The software minimizes errors cause by illegible paper prescriptions.   Drug interaction checkers can also be used to help evaluate potential drug interactions, thus reducing adverse drug outcomes.

Conclusion

The prescribing clinician and dispensing pharmacist face ethical implications for not upholding beneficence and nonmaleficence by prescribing medication without a patient assessment and medical diagnosis.  The North Carolina statute states that the clinician should inform the client of the medical error and the corrective treatments to be implemented. Medication errors can be avoided by taking a patient history of drug allergies, current treatments, and using IT systems.

 

References

de Araújo, B. C., de Melo, R. C., de Bortoli, M. C., Bonfim, J. R. D. A., & Toma, T. S. (2019). How to prevent or reduce prescribing errors: an evidence brief for policy. Frontiers in pharmacology10, 439. https://doi.org/10.3389/fphar.2019.00439

Eniola, K., & Gambino, C. (2019). Taking the Fear Out of Error Disclosure. Family practice management26(6), 36-36.

North Carolina Medical Board. (2017). Position Statements North Carolina Medical Board. https://www.ncmedboard.org/images/uploads/other

Sorrell, J. M. (2017). Ethics: Ethical issues with medical errors: Shaping a culture of safety in healthcare. OJIN: The Online Journal of Issues in Nursing22(2). de Araújo, B. C., de Melo, R. C., de Bortoli, M. C., Bonfim, J. R. D. A., & Toma, T. S. (2019). How to prevent or reduce prescribing errors: an evidence brief for policy. Frontiers in pharmacology10, 439. https://doi.org/10.3389/fphar.2019.00439

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