Case Study Assignment 2: Ethical and Legal Implications of Prescribing DrugsMA is an 85-year-old female living in a long-term care facility. She has significant cognitive decline, and her physician has even said that death is near with her other health issues, including renal failure and CHF. She was on blood thinners for years due to […]
A major ethical issue in the case involves administering a treatment strategy that exposes a hospice patient to extreme pain. The patient has terminal renal failure and chronic heart failure, from which her physician has concluded that her time of death is approaching. She cries in agony and cannot tolerate the pain when the clinician makes lab draws to check her INR. Since the patient has a terminal illness, her care should be focused on the appellation of her pain and meeting her emotional and spiritual needs at the end of life (Rudzka et al., 2019, p. 30). Therefore, it is unethical to monitor the INR continuously, given the patient’s terminal status. The physician and the nurse in charge of the patient take the first positions in the chain of unethical events since they recommended and administered INR despite being aware of the patient’s terminal status. The patient and her family have not contravened any ethical standard since they trust healthcare professionals and take medications believing in the caregivers’ expertise. Therefore, the prescriber and the nurse should be legally held accountable for engaging in an unethical practice.
In the healthcare setting, medical practitioners often recognize the occurrence of medication errors and other ethical issues concerning patient care. As a strategy to avoid the adverse implications of medication errors, healthcare organizations, state administrations, and the federal government have established strategies to facilitate reporting and response to such situations. In Georgia, the law requires that harmful medication errors be disclosed to patients and duty managers to facilitate the development of strategies to reverse the adverse implications. According to the Patient Right to Know Act of 2001, patients and their families should be informed of medication errors and other adverse events during care, after which disciplinary action is taken against the practitioner and the facility by the Georgia Composite Medical Board (Vu et al., 2020, p. 512). The essential component of the regulation is that healthcare professionals enter a detailed entry of medication errors, which is used during process improvement initiatives.
As an advanced practice nurse, I would collaborate with the patient and her family to establish the most appropriate intervention and action. It would be important to inform the patient and her family about her terminal status to obtain informed consent concerning the alternative to take. I would explain to them the importance of continuous monitoring of the patient’s INR and its associated implications, considering her terminal status. I would also inform them about the available hospice care interventions that could provide compassion to the patient in her last phase of renal failure and chronic heart failure. Such a decision-making strategy could ensure adherence to the ethical principles of integrity, honesty, and justice that prioritize the patient’s satisfaction with care.
The process of writing prescriptions should include a keen analysis of the patient’s health problem and healthcare needs, identification of patient-centred therapeutic objectives, selection of appropriate drug therapy, and reporting on the patient’s response to therapy. Analyzing the patient’s health problem and healthcare needs could allow the clinician to identify the available interventions that concur with the patient’s specific needs (Katzung, 2018). It could also involve assessing the patient’s socio-cultural background and medical history to establish the effectiveness of the available interventions further. Consequently, the clinician could develop therapy objectives that address the patient’s needs. The most appropriate drug therapy is identified based on an analysis of the patient’s problem and sociocultural background. After administering the intervention, the clinician should assess any reaction or side effects on the patient to facilitate the rapid implementation of a strategy to minimize the negative effects. Such a process could help minimise medication errors by ensuring alignment between drug therapy and the patient’s healthcare needs.
Rudzka, A., Kulesza-Mrowiecka, M., Kopański, Z., Nadashkevych, O., Tabak, J., & Rowiński, J. (2019). Objectives, assumptions and organization of palliative and hospice care in Poland. Journal of Clinical Healthcare, 131(2018_4), 30-35. http://www.jchc.eu/eng/numery/article.php?idissue=201847
Vu, M., King, A. R., Jang, H. M., & Bednarczyk, R. A. (2020). Practice-, provider-and patient-level facilitators of and barriers to HPV vaccine promotion and uptake in Georgia: a qualitative study of healthcare providers’ perspectives. Health Education Research, 35(6), 512-523. https://academic.oup.com/her/article-abstract/35/6/512/5900783
Katzung, B. G. (2018). Rational prescribing & prescription writing. Basic & clinical pharmacology, 1146. https://www.academia.edu/download/62835124/Katzung_-_Basic_and_Clinical_Pharmacolog20200405-124734-1rkdlg9.pdf#page=1160
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Published On: 01-01-1970