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? How might different state regulations affect the prescribing of this drug to this patient?
These are some of the questions you might consider when selecting a treatment plan for a patient.
Photo Credit: Getty Images/Caiaimage
As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. 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. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond. Because of your position, patients and their families will frequently place their trust in you. This trust brings with it power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is critical that you are aware of the most recent professional, legal, and ethical standards for advanced practice nurses with prescribing authority. Furthermore, it is critical to ensure that treatment plans and drug administration/prescribing are in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of specific drugs in various states may have a significant impact on your patient’s treatment plan. In this Assignment, you investigate the ethical and legal implications of scenarios and consider how to respond appropriately.
To Prepare
Review the Resources for this module 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.
By Day 7 of Week 1
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 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.
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.
—
Sample Answer:
Ethical and Legal Implications of Prescribing Drugs
Ethical and Legal Implications of Scenario 1
The ethical and legal implications of this error in scenario one base on principles of autonomy, righto determination, nonmaleficence, beneficence, disclosure, right to knowledge, and veracity (Mars, 2014). Nurses are responsible for ensuring all stakeholders involved know about medication error. The practitioner needs to disclose the steps put in place to address the matter. Autonomy and the right to self-determination, the patient has the right to take personal actions and make choices to his or her benefit. Nonmaleficence and beneficence ethics provides for the nurse practitioner, to take the necessary measures to prevent harm and ensure the patient gets proper medication.
Disclosure and knowledge require that health care practitioners to ensure the patient is aware of the error, which will be useful in making decisions on the measures to take. Furthermore, veracity provides for the medical practitioners to the best of their knowledge to provide accurate and comprehensive information that aids the patient in understanding what transpired and what led to the error. Consequently, the practitioner must ensure those involved are aware of suitable decision making. Nonmaleficence and beneficence ethics requires the nurse practitioner to take the necessary precautions to avoid harm and ensure the patient receives appropriate medication.
Disclosure and knowledge necessitate that health care practitioners ensure that the patient is aware of the error, which will be useful in deciding what steps to take. Furthermore, veracity requires medical practitioners to provide accurate and comprehensive information to the best of their ability, Helping the patient in understanding what happened and what caused the error. As a result, the practitioner must ensure that those involved are aware of appropriate decision making.
Strategies to Address Disclosure and Nondisclosure in Scenario 1
Disclosing errors is very critical in the patient administration and prevention of medication errors. Consequently, adverse effects such as death, which are likely to arise in the event of a medication error. Therefore, healthcare practitioners can address disclosure and nondisclosure of medication errors to uphold their fiduciary duties. The nurse needs to disclose the mistake and apologize to the patient and bring out the necessary measures that he or she will take to address the situation (Lerman, Scrag & Rubinson, 2020). Perhaps the nurse will be able to build trust with the patient and will show that even if there was an error, proper procedures are in place. Furthermore, the nurse can avoid liability likely to arise from the provisions of the Law of Torts on the breach of fiduciary duty to a patient.
Strategies to Guide Decision Making in Disclosing Error
Nurse practitioners need to know that it is essential to reveal and disclose the medication error within the shortest time possible. The measure will aid the hospital in taking precautionary measures urgently before the matter escalates further, affecting patient safety. I would report the error and seek further clarification with other practitioners on how to turn around the situation to improve the health of patients.
On the other hand, it would be considerate to apply confidential peer review to avoid any risk arising from the error made, for example, loss of practice certificate or adverse effects on the patients. In this case, other nurse practitioners will come together and work with me to address the issue as well as provide further guidelines that might be useful in such a situation. A confidential peer review will examine all the procedures that were taken and come up with a resolution that would help the patient improve from the medication error (Shapiro & Galowitz, 2016).
Process of Writing Prescriptions and Strategies to Minimize Medication Errors.
To ensure proper prescription, a nursing practitioner needs to enter an appropriate prescription for the patient to minimize errors (Barclay, 2017). In this case, the practitioner needs to avoid any omissions or inputting of inaccurate information. The nurse could use reliable methods to record patient information as well as seek information about the patient.
Also, the nurse practitioner must take note of drugs that look alike. Some medicines may resemble each other, yet they are for different patients or different treatments. It is critical to clarify with the prescriber before advancing any prescription to the patient. In this case, it would be possible to eliminate prescription errors in administering medication. Furthermore, this will help to understand if the prescription is complete as provided by the physician. The rate of medical errors will reduce drastically, leading to proper medication.
References
Barclay, K. M. (2017). Mistake proofing laboratory monitoring for alemtuzumab treated patients with multiple sclerosis (Doctoral dissertation, University of British Columbia).
Shapiro, J., & Galowitz, P. (2016). Peer support for clinicians: a programmatic approach. Academic Medicine, 91(9), 1200-1204.
Lerman, L. G., Schrag, P. G., & Rubinson, R. (2020). Ethical problems in the practice of law. Wolters Kluwer Law & Business.
Marrs, J. A. S. (2014). Ethics in Nursing Administration. Financial Management for Nurse Managers, 325.
