As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient
Assignment: 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.
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.
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.
You will also evaluate and analyze ethical and legal implications and practices related to prescribing drugs. As advanced practice nurses, almost every clinical decision you make will have ethical or legal implications. Your ethical and legal knowledge is fundamental to your ability to resolve the multitude of challenging issues encountered in practice. This week you have an assignment to write a paper – you will explore the ethical and legal implications of the following scenario, and consider how to appropriately respond:
Scenario options
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.
Expert Answer and Explanation
Legal and Ethical Implication in Prescription
Legal and ethical implications manifest in the scenario in which an Advanced Practicing Nurse (APN) has to decide between observing codes of ethics on prescription, and prescribing medicion to their friend who has no known health history. Nursing professionals are expected to practice within the boundaries of the codes of the American Nurses Association (ANA). One of these codes’ provisions require APNs to promote and protect patients’ health as well as safety. Reflecting on this provision, prescribing the medication to the patient without getting details of their health condition constitutes a breach of this provision.
Accordingly, such a decision can cause harm on the patient considering that some medications such as aspirin can exacerbate the ulcers (Kadivar et al., 2017). When the patient gets harmed because of taking the wrong medication, the patient’s family trust of the health care system becomes eroded. Consequently, this may negate the quality of care which a prescriber provides, and adversely affect the pharmacists reputation. Fundamentally, an element of malpractice also manifests in this scenario.
Considering that prescribing medications without following due prescription guidelines can cause medical errors, it is imperative that an APN address the disclosure and non-disclosure issues. Arizona’s Revised Statutes 36-664, provide conditions under which disclosure as well as non-disclosure can happen. An appropriate strategy for disclosure that reflects these statutes include communicating with the patient to help them be aware of the details of the medical condition, and being empathetic to the plight of the patient. Where the patient is unable to consent because of their limited ability to make independent decisions, the care professional attending to the patient can disclose.
As an APN, I would use some key approaches to make an ethically relevant decision, so that I don’t compromise the safety and the health of the patient. I would particularly rely on the theoretical models to guide the decisions I make with respect to the ethical issue which present in the scenario. Consequentialism, as a theory, reflects on the moral impact a decision is likely to have. Based on the scenario, in any case I prescribe medication to the patient without following the due guidelines for prescription, I would risk the patient’s health and life (Kadivar et al., 2017).
Consequently, this will result to the erosion of the trust the public has towards the health system. Conversely, encouraging the patient to go through the right assessment and intervention procedures can result to reduced harm. Thus, the use of this theory can guide the decision-making in this scenario.
Another strategy that is core to managing this type of issue is to rely on the Kantian theory. Under this theory, individuals have moral obligations act morally. Based on this theoretical approach, and reflecting on the case, I am obliged as APN to provide the best possible care which in this case entails adhering to the codes of conduct. Under this law, still, I have a moral duty to disclose any error to protect the reputation of the nursing profession.
The prescription process entails a number of chronologically organized procedures focused on minimizing medical errors. Prior to determining the therapy objective to which the drug is intended, it is important to first determine the manifesting clinical issue. The next step entails the selection of a medication that is appropriate for the medical issue, and explaining to the patient the dosage details as well as the side effects (Bonnie et al., 2017).
References
(2005 Arizona Revised Statutes- Revised Statutes Confidentiality; exceptions). Retrieved from https://law.justia.com/codes/arizona/2005/title36/00664.html.
Bonnie, R. J., Ford, M. A., Phillips, J., National Academies of Sciences, Engineering, and Medicine (U.S.)., National Academies of Sciences, Engineering, and Medicine (U.S.)., & National Academies of Sciences, Engineering, and Medicine (U.S.). (2017). Pain management and the opioid epidemic: Balancing societal and individual benefits and risks of prescription opioid use. Washington, DC : The National Academies Press.
Kadivar, M., Manookian, A., Asghari, F., Niknafs, N., Okazi, A., & Zarvani, A. (2017). Ethical and legal aspects of patient’s safety: a clinical case report. Journal of medical ethics and history of medicine, 10, 15.
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