Ethical and Legal Implications of Prescribing Drugs

Medical errors are among the leading causes of mortality in the United States. Professionals at John Hopkins discovered that approximately 250,000 annual deaths reported in the country resulted from the practice (Sorrell, 2017). This data may be a source of concern among various stakeholders, especially considering the resources that the government spends on prescription drugs. While negligence and incompetence may be considered as the main causes of medical errors, scholars acknowledge that other aspects, including breakdowns in processes and patient-related factors, might facilitate the issue (Sorrell, 2017). For this discussion, I have chosen a scenario of a 68-year-old individual with depression and insomnia to explain the ethical and legal implications of medical errors on physicians and patients, as well as strategies that advanced practice nurses can use to address the matter.

Ethical and Legal Implications on Stakeholders

Physicians

One of the legal consequences of the medical error in the selected case scenario would be a civil suit. Studies show that medical errors are among the top 10 reasons for lawsuits against healthcare providers (Wittich, Burkle & Lanier, 2014). Patients who suffer adversely from prescription errors, which are committed by medical practitioners may take legal measures and seek compensation. For instance, the 68-year-old client suffered from confusion, loss of coordination, and restlessness following administration of higher doses of Ambien. Hence, the patient’s condition might have been caused by the failure of a care provider to review the prescription process before recommending the dosage. The healthcare worker may be implicated of negligence and face legal charges, which may result in revocation of practicing license.

Patient

The error would result in a loss of trust in the system by the patient. Elden and Ismail (2015) state that medical errors affect clients’ confidence in healthcare services. Upon discovery of the error, the 68-year-old patient may doubt further prescriptions made by the physician. This can adversely affect the client’s state of well-being, especially in instances of skipped medication. To prevent such errors, healthcare practitioners should ensure that they disclose the matter to the patient, apologize for harm caused, and propose strategies to correct the mistake.

Laws Specific to North Carolina

Disclosure laws in the United States are formulated at the state level. They provide strategies for reporting medical errors. These laws can either be mandatory or discretionary. For instance, Rule 413 of North Carolina General Statutes, “medical actions; statements to ameliorate or mitigate adverse outcome,” protects physicians during civil lawsuits that involve medical errors (“Chapter 8C,” n.d, p. 6). Under this law, “statements by a health care provider apologizing for an adverse outcome in medical treatment, offers to undertake corrective or remedial treatment or actions and gratuitous acts to assist affected persons shall not be admissible to prove negligence or culpable conduct by the health care provider in action brought under Article 1B of Chapter 90 of the General Statutes” (“Chapter 8C,” n.d, p. 6). This law encourages healthcare providers to apologize when dealing with patients that suffer from adverse outcomes of medical errors under their care. However, the statute does not have mandatory requirements for disclosure of medical errors to patients and hospital management. Therefore, the best strategy of dealing with the selected case scenario would entail apologies directed to the affected party, and revelation of how, why, and when the error occurred.

 

 

As an Advanced Practice Nurse

As an advanced practice nurse, it is my responsibility to ensure error-free drug prescription in the institution. Given that North Carolina laws lack mandatory strategies to address disclosure, I would rely on ethical principles to guide my decision on whether to disclose the error. For example, the principle of autonomy and the right to self-determination emphasizes the need for medical practitioners to inform patients about their health care plans, and to report errors when they arise (Sorrell, 2017). This principle would guide my decision to disclose the identified error. The second strategy that would foster my decision would be a review of the organizational culture. Studies show that the culture of a facility can facilitate reporting of errors (Sorrell, 2017). In this scenario, a blame-free culture would increase the probability of reporting the matter to the management.

The Process of Writing Prescriptions

Drug prescription is among the many responsibilities of an advanced practice nurse. It is an essential patient management practice, which arises from a doctor-patient interaction (Dyasanoor & Urooge, 2016). The process involves several steps, including filling patients’ information, dosage, and dispensing instructions. Prescription errors can greatly affect a client’s well-being. Therefore, healthcare providers should ensure that such errors are minimized.

Some of the strategies that physicians may use to achieve error-free prescribing would include reviewing the patients’ history and examining the accuracy of the suggested dose. Healthcare providers should evaluate each prescription from different perspectives. For instance, it would be necessary to examine the patients’ ability to purchase and take the drug as recommended. Clinicians should enquire on concurrent medications to prevent adverse effects that may arise from polypharmacy. Overall, advanced practice nurses should make sure that the handwriting used in filling prescriptions is legible to prevent misunderstandings during drug administration.

Conclusion

Medical error is a common issue in the healthcare industry. The matter affects patients, pharmacists, and physicians. Healthcare workers should develop systematic strategies to curb the problem. If an error occurs during practice, medical practitioners should disclose the information to all stakeholders. Policymakers should also formulate statutes that would foster medical error disclosure.