Free Essay Sample on Ethical Implications of Prescribing Drugs

Introduction

Medical practitioners have a huge responsibility for care as the societal custodians of the health of citizens of any country. Treatment plans and the prescription of drugs must align with universal and national legal and ethical standards of professional, safe, and quality healthcare. Any deviation from the standard procedures of nursing practice has numerous legal and ethical implications including litigation. With immense trust and power placed on nurses by the patients and their families, practitioners must follow the state, federal, and universal operating procedures. This article will explore the measures used by nurses to respond appropriately to scenarios, such as medical errors when prescribing drugs to a 5-year old patient, by administering a dose suitable for an adult. The article will also reference laws in the state of Texas to highlight the differing standards (across states) for prescribing prescription drugs and for addressing medication errors.

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Responding to Medical Errors

In a scenario where a nurse administers a dosage suitable for an adult to a 5-year old patient, the practitioner must abide by the law in rectifying the medical error. The nurse should act according to the patient’s diagnosis, offer the right dosage of corrective medication, and check patient-factors that might impede the correction of the medical error. Failure to adhere to the standard procedures, hospitals risk placing the prescriber, pharmacist, patient, and patient’s family in jeopardy. According to Edwin (2009), doctors should disclose medical errors (wrong prescriptions) to patients to fulfill the mission of patient-centered care but sometimes fail to disclose such information to ‘protect’ the patient from potentially harmful information.

The most concerning prescription error that affects children is that of painkillers and anti-epileptics, which carry adverse effects on the patient. This common error occurs from prescribing common epilepsy drugs in addition to a morphine regiment for pain management without considering factors like the weight of the patient (Panahi et al., 2019). Nurses could wrongfully administer high doses of morphine when fighting epileptic seizures. In such a scenario, the nurse should administer an opiate antagonist such as naloxone to counteract the excess morphine. 1 mg/kg of naloxone in mice is enough to reverse the anticonvulsant effects of a morphine overdose, translating to a 1.86 mg/kg dose for humans (Panahi et al., 2019). The nurse should administer 1 to 2 mL of dilute naloxone (40 mg/mL) only once, slowly via IV, and wait up to three minutes for the patient to respond. Wermeling (2015) adds that individual factors like the presence of other opioids in the patient’s blood, opioid tolerance, and comorbid CNS and mental health issues could hinder the effectiveness of naloxone.

Differing State Regulations

International standards warrant the intravenous and intramuscular administration of naloxone only for life-threatening emergencies, not to revive normal consciousness. The treatment reduces the risk of respiratory arrest from the toxicity of opiates (morphine). Sohn et al. (2019) uncovered that legally mandated naloxone prescriptions for at-risk patients improves the availability of naloxone in fighting the opioid crisis.

However, many states lack mandatory prescriptions of naloxone for patients receiving opioid treatment; therefore falling at risk of opioid overdoses from wrongful prescriptions. Vermont and Virginia became the first states to mandate naloxone prescriptions for patients receiving more than 90 mg of morphine per day.

Texas lacks this legal mandate thus reduces the amount of naloxone available to at-risk patients. This gap in law hinders the availability of naloxone to the prescriber, pharmacist, patient, and patient’s family.

Strategies to Guide Ethical and Legal Responsibility

Simple strategies to avoid wrong prescriptions include using eligible writing, writing the precise dosage, considering the patient’s age and weight, and adhering to the duration of treatment. However, disclosure and non-disclosure of the prescription error could guide ethical and legal responsibility. Nurses must disclose the scenario of wrongful prescriptions to the patient as well as the legal gap in the availability of naloxone per state. This information could help the patient in deciding whether to seek healthcare assistance elsewhere. Non-disclosure of such information as an attempt to cover-up an error could cause legal backlash and an ethical dilemma on the patient’s ethical right to notification about their condition.

Conclusion

Conclusively, Vermont and Virginia legally avail naloxone to anyone at risk of an opioid overdose to increase its availability, unlike in Texas. This differing legal and ethical position causes inadequacies in the nationwide response to wrongful opioid overdoses by practitioners. Treatment plans should abide by state regulations, meaning that nurses in Texas cannot provide a mandatory naloxone prescription to at-risk patients, like in Vermont or Virginia. Understanding these differing regulations helps in overcoming the lapse in the treatment plan for patients across states.

References

Edwin A. (2009). Non-disclosure of medical errors an egregious violation of ethical principles. Ghana medical journal, 43(1), 34–39.

Panahi, Y., Saboory, E., Roshan-Milani, S., Drafshpoor, L., Rasmi, Y., Rassouli, A., & Sadeghi-Hashjin, G. (2019). Acute and chronic effects of morphine on Low-Mg2+ ACSF-induced epileptiform activity during infancy in mice hippocampal slices. Research in pharmaceutical sciences, 14(1), 46–54.
https://doi.org/10.4103/1735-5362.251852

Sohn, M., Talbert, J. C., Huang, Z., Lofwall, M. R., & Freeman, P. R. (2019). Association of Naloxone Coprescription Laws With Naloxone Prescription Dispensing in the United States. JAMA network open, 2(6), e196215. https://doi.org/10.1001/jamanetworkopen.2019.6215

Wermeling D. P. (2015). Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access. Therapeutic advances in drug safety, 6(1), 20–31. https://doi.org/10.1177/2042098614564776.