Ethical And Legal Implications Of Prescribing Drugs paper
Ethical And Legal Implications Of Prescribing Drugs paper
AC is a 72-year-old male who is admitted to your ICU after suffering a massive stroke that has left him unresponsive and unable to communicate. He is currently on a ventilator. His wife of 48 years is available along with their one adult daughter. The wife informs you that they don’t have any advanced directives, but she is “pretty sure her husband would not want to live like this.” However, their daughter is adamant her dad would want to be kept alive in case there is any chance to come out of this. 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. 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. Ethical And Legal Implications Of Prescribing Drugs paper
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A 72-year-old patient is in ICU after suffering a massive stroke that has left him unable to communicate. He is currently on a ventilator. His wife suggests that her husband doesn’t want to live like this for the rest of his life. His daughter is adamant about the situation and wants him kept alive, hoping for a chance to get out of this situation. The two decisions regarding the patient’s treatment are controversial. As the nurse, I will provide quality care, for example, two-hourly bed turning to avoid pressure sores, feeding the patient via nasogastric tube to prevent regurgitation and vomiting, and give prophylactic medication to prevent venous thrombosis. Prophylactic medication is either heparin or aspirin. This essay describes the ethical dilemma in the scenario explaining the strategies for closure and non-disclosure, the decision-making process, the procedure for writing prescriptions, and minimizing medication errors.
Ethical And Legal Implications In This Scenario
Ethics are the principles or values that govern behavior and may include fairness, honesty, and respect for human rights. Ethical issues are decisions or practices conflicting with society’s moral principles (Morley, et al, 2018). The ethical issue in this case scenario is the disregard for human rights to life because the patient’s wife suggests that he wouldn’t want to live in that state. According to the universal declaration for human rights, all persons have a right to life and protection from cruel, inhumane, and degrading treatment. The violation of these rights subjects the perpetrator to prosecution. Ending a human life or euthanasia is established as criminal legislation. Euthanasia is ending a life to alleviate suffering. According to the law, only the patient and the physician can consent to or authorize euthanasia (Sanz, et al, 2021). This patient does not have an indication for euthanasia because he is not in pain. Therefore, the patient’s scenario is against the law, ethics of society, and the nursing ethical principles of beneficence, non-maleficence, and justice. The nurse should treat the patient by providing the expected care and services. The nurse should offer rehabilitative services like physiotherapy to prevent long-term complications. Additionally, protect him from harm.
Strategies For Disclosure And Non-Disclosure
Disclosure is announcing a patient’s medical information, giving an apology, and an explanation to the family members without apportioning blame. Disclosure should be timely, open, and honest (Russell, D. 2018). In this case, the disclosure team involves the clinical nurse, physician, palliative care, psychotherapist, and family members. The clinical nurse explains the course of the illness and its outcome. The multidisciplinary team helps the family in understanding the medical decisions made. The nurse apologizes to the family for acting against their wish. The family should agree or collaborate on the clinical decision in the interest of the patient. Non-disclosure is keeping information from relatives. The causes of non-disclosure are fear of rejection or harm of the information given, anger from the recipient, and loss of control of the matter. In this scenario, non-disclosure will be a breach of respect for autonomy and consent. Additionally, it could exclude confidential treatment. According to Russell, D. (2018), disclosure enables the nurse to do his best to protect the patient’s interests. Ethical And Legal Implications Of Prescribing Drugs paper
Decision-Making Process
A decision is a resolution made after concluding. The process of decision making involves identifying the decision to the problem, gathering the necessary information, identifying alternatives, weighing the evidence, selecting from other alternatives, and taking the necessary action to implement (Nibbelink, C. W., & Brewer, B. B. 2018). As a nurse, I will make this decision out on my clinical experience and knowledge. Ending a patient’s life against their wish, is against nursing ethical principles and universal human rights. I will decide to refer the family for psychotherapy and palliative care counseling to enable them to give their patients dignified end-of-life care and prepare for death.
The Process Of Writing A Prescription
A prescription is a detailed document in which a patient’s medicine is written for dispensing. A prescription should have the patient’s particulars which are, the name, age, weight, gender, diagnosis, and the drugs. The drugs should be indicated as generic or original with their calculated dosage, route of administration, frequency, and the numbers to be dispensed. There should be an indication of the maximum refills a patent can have with the same prescription to avoid drug abuse.
Strategies To Minimize Medication Errors
Medication errors are avoidable circumstances in which a patient gets the wrong drug, or prescription, or develops side effects in the presence of the care provider. To minimize medication errors, an organization should give a directive on who should prescribe. There should be a counter-check of the diagnosis, drugs dispensed, and what is prescribed. The care provider should warn the patient of the possible side effects of the drug.
Conclusion
Ethical behavior is characterized by fairness, honesty, and respect for human rights. Ethical issues occur when the decisions made conflict with society’s moral principles. Disclosure is announcing a patient’s medical information to the family members without apportioning blame by being timely, open, and honest. Disclosure enables the nurse to do his best to protect the patient’s interests. A prescription is a detailed document in which a patient’s medicine is written for dispensing. Correct prescription prevents the occurrence of medication errors. Ethical And Legal Implications Of Prescribing Drugs paper
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632).
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 1, “Prescriptive Authority” (pp. 1–3)
Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)
American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767
American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.
This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.
Drug Enforcement Administration. (2021). CFR – Code of Federal Regulations Title 21. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=1300
This website outlines the code of federal regulations for prescription drugs. Ethical And Legal Implications Of Prescribing Drugs paper
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Drug Enforcement Administration. (n.d.-a). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html
This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.
Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manual090506.pdf
This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs. Ethical And Legal Implications Of Prescribing Drugs paper
Drug Enforcement Administration. (n.d.-b). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html
This website details key aspects of drug registration.
Fowler, M. D. M., & American Nurses Association. (2015). Guide to the code of ethics for nurses with interpretive statements: Development, interpretation, and application (2nd ed.). American Nurses Association.
This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.
Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list
This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.
Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17
This article provides NPs with information regarding state-based laws for NP prescribing.
Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association of Nurse Practitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446
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