Advanced Pharmacology Assignment: Ethical and Legal Implications of Prescribing Drugs
The case scenario depicts a situation where I make an error as an NP when prescribing medication to a 5-year-old male patient. Instead of dosing the patient appropriately, I prescribe a dose suitable for an adult. This paper seeks to explore the ethical and legal implications in this scenario, approaches to address disclosure and nondisclosure, and the procedure of writing prescriptions.
Ethical and Legal Implications of the Scenario You Selected On All Stakeholders
Several ethical issues may surface due to medication errors such as harm to patients, dilemma to disclose the error, erosion of trust, and impact on quality care. The case scenario has ethical and legal implications for the NP and the pharmacist. In this case, ethical implications that face the NP include failing to uphold ethical principles of nonmaleficence and beneficence (Sorrell, 2017). Prescribing an adult dose to a child puts him at risk of toxicity due to overdose and adverse drug effects. The NP fails to uphold nonmaleficence and beneficence since the dose is likely to harm the patient failing to promote the best outcome for the child (Sorrell, 2017). Furthermore, the NP is at risk of legal implications and faces legal charges or consequences such as license revocation because of overdosing the patient.
The pharmacist’s role was to evaluate the prescribed drug’s correctness, effectiveness, and safety based on the diagnosis and age. Consequently, the pharmacist can face legal implications for failing to double-check the prescribed dose and ensure it is correct and safe for the child (Sorrell, 2017). This can result in legal charges as well as revocation of the practicing license. Similar to the NP, the pharmacist may face ethical consequences for failing to uphold nonmaleficence and beneficence since he did not ensure that the dose was safe for the patient before dispensing (Sorrell, 2017). Furthermore, the healthcare facility may face legal charges if the child develops adverse side effects or drug reactions due to inappropriate dosing.
Strategies to Address Disclosure and Nondisclosure
NPs face a dilemma on whether to disclose a medication error or not due to the legal consequences involved. In 2004, the NJ Legislature enacted the Patient Safety Act (PSA). The legislation instituted a legal duty to immediately disclose medical errors to patients affected by them (NJDHSS, 2017). Under the legislation, a patient must be notified of the error no later than the end of the episode of care. If the error is discovered after the end of the episode of care, the patient should be informed promptly when they are victims of a life-threatening preventable adverse event (NJDHSS, 2017). In addition to compelling providers to report adverse events to the victims of medical malpractice, the PSA also requires the health providers to report the medical errors to the Department of Health and Human Services.
Strategies I Would Use To Guide Decision Making In This Scenario
As an APN, I would decide whether to disclose the error guided by the state laws and ethical principles. I would go through the state laws on disclosure and follow the legislation that states that the provider must immediately disclose to the patient. According to ethical principles, medication safety is crucial, and if an error occurs, the nurse should take the necessary measures (Sorrell, 2017). Failing to disclose and report an error is considered illegal and unethical since it can cause harm to the patient. In this scenario, I would arrange a meeting with the patient and the parent and notify them of the prescription error and how it happened. I would apologize to the patient professionally to maintain a healthy relationship and trust. In addition, I would explain to the parent the potential effects of the error and how it will be managed to prevent adverse effects.
Process of Writing Prescriptions and Strategies to Minimize Medication Errors
When writing a prescription, the prescriber should indicate their name and address, date of prescription, and the drug’s name and dose. In addition, the prescriber should indicate the name, age, and address of the patient (de Araújo et al., 2019). Medication errors can be reduced by having the clinician take a detailed patient history, including current medications and known drug allergies, to prevent drug interactions and adverse drug reactions (de Araújo et al., 2019). Besides, facilities should adopt the use of E-prescribing software, which allows clinicians to electronically generate and directly send a prescription to a pharmacy (McLeod et al., 2019). Using the softwar
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