Medical errors can happen even to the well-trained and most experienced caregivers. Cases of advanced practice nurses making wrong drug prescription to their patients is not new in the medical field. The most important factor is the step taken by the medical nurse after making the error. The discussion will focus on the ethical and legal implications of disclosure and nondisclosure to the clinic and the nurses and examine the personal choices of the nurses on whether to disclose their errors. Finally, the paper will also focus on the strategies that can be put in place to avoid medication errors. Although experienced nurses can make errors when prescribing drugs, the decision to disclose an error might adversely affect their relationship with patient and affect the healing process, and hence should decide whether to disclose their error according to the prevailing situation.
Ethical Implication of Disclosure and Nondisclosure of Personal Error
Medical errors are common in the healthcare sector.. They pose significant threat to the patients’ safety. In cases where medical error has occurred, nurse’s disclosure of the error to the family members and the patients could lead to litigations. Therefore, the establishment of precise ethical and moral standards are utilized when developing solutions to correct the situation (Phillips-Bute, 2014). Various ethical and moral issues affect the healthcare industry, especially on issues related to medical errors. According to Sullivan (2001, p. 106), morality is the underlying social conventions that explain wrong and right and, on the other hand, ethics are the systematic and theoretical understanding of moral life. The ethical and moral issues affecting the healthcare industry in a bid to solve the underlying medical errors can be categorized into five important concepts: disclosure and right to knowledge; autonomy and right to self-determination; justice; beneficence and nonmaleficence; and veracity (Hannawa, 2012)
Autonomy and right to self-determination considers the right accorded to the patient to hold views, take action on issues regarding their beliefs and values, and make choices (Hilpold, 2017, p. 303). This ethical principle indicates that patients are entitled to have the information concerning the underlying medical error. The principle indicates that nondisclosure is unethical because the rights of the patient in regards to the medical error are infringed. The healthcare professionals have an ethical obligation of disclosing the medical error to the patient, ensure that the patient understand the magnitude of the error, and give room for the patient to make decisions (Ghazal, Saleem, & Amlani, 2014). The healthcare professional should respect the autonomy and right to self-determination of their patients by providing them with valid consent regarding all the medical intervention (Bonney, 2014). In case of medical error, the patient’s informed consent protects the healthcare professional against litigation.
Legal Implication of Disclosure and Nondisclosure of Personal Error
In order to reduce the increasing cases of preventable adverse events occurring in public health facilities, the law has played an important role by boosting a culture of safety within the healthcare professionals (Waite, 2005). The law assesses the importance of passing the apology laws and disclosure law (Yarmohammadian et al, 2010). The state has an obligation of ensuring that people’s health and safety are protected. Therefore, in case of medical errors leading to complications or death, the state must step in and identify the cause of death.. In the event that the main cause of death resulted from medical error, both the clinic and the healthcare professional must be held liable (McNeill & Walton, 2002). The law further indicates that, the patient has the right to know the status of their condition, as well as, make decisions in this regard; therefore, nondisclosure is perceived as an infringement of the patient’s right, which is unlawful. The healthcare professional might be suspended from active practice, fined or jailed in case such errors are not disclosed and have adversely affected the patient.
Personal Choice on Whether to Disclose Personal Error
Individuals are all bound to err, but the way theye rectify errors justifies the innocence in regards to those mistakes. The Kantian theory and the principle of beneficence and non-maleficence should help a healthcare professional in making their personal choices on whether to disclose their personal errors. The principle of beneficence insists on the need for doing good to others, as a way of preventing errors. On the other hand, the principle of non-maleficence insist on not causing harm to self or others. Withholding important information from the patient is equivalent to harming them. Kant states that, there are no ethics in the absence of obligations. Threfore, healthcare professionals are obligated to doing the right thing by disclosing their error to their patients in case of wrong drug prescription.
Strategies to Avoid Medication Errors
The problem of medication error is not new in the healthcare facilities and could lead to severe drug reactions or death. It is important for the healthcare professionals to practice constant review and vigilance when dealing with the patients (Athanasakis, 2012). Another strategy that can significantly reduce medication error is improving communication from one practitioner to the other, as well as between practitioners and their patients. The communication between practitioners will help in sharing experiences concerning different diseases and hence enhance accurate or better diagnosis to diseases. The communication between practitioner and the patient will prevent wrong drug prescription.
Conclusion
As it is evident from the discussion, medical errors such as wrong drug prescription are common in the healthcare facilities. The decision concerning disclosure or nondisclosure have both ethical and legal implications. Proper ethical standard are utilized when developing remedies for different situations. The laws enacted by different states help in protecting both the patient and practitioner from possible lawsuits in case of medical errors. Personal choices regarding disclosure must be in line with ethics and moral norms. Medical errors can be reduced significantly through practicing constant review and vigilance when dealing with patients. Adequate communication between practitioners and , with the patients can help in reducing cases of medical error.
References
Athanasakis, E. (2012, October- December). Prevention of medication errors made by nurses in clinical practice. Health Science Journal, 6(4), 773-783.
Bonney, W. (2014). Medical errors: Moral and ethical considerations. Journal of Hospital Administration, 3(2), 80-88.
Ghazal, L., Saleem, Z., & Amlani, G. (2014). A Medical Error: To Disclose or Not to Disclose. Journal of Clinical Research & Bioethics, 5(2).
Hannawa, A. F. (2012). Principles of medical ethics: implications for the disclosure of medical errors. Medicolegal and Bioethics, 2.
Hilpold, P. (2017). Self-determination and Autonomy: Between Secession and Internal Self-determination. International Journal on Minority and Group Rights 24, 302-335.
McNeill, P. M., & Walton, M. (2002, March 4). Medical harm and the consequences of error for doctors. Clinical Ethics, 176, 222-225.
Phillips-Bute, B. (2014). Transparency and Disclosure of Medical Errors: It’s the Right Thing to Do, So Why the Reluctance? Campbell Law Review, 35(3), 333-354.
Sullivan, M. (2001). Ethical Principle in Pain Management. Pain Medicine, 2(2), 106-111.
Waite, M. (2005). To Tell the Truth: The Ethical and Legal Implications of Disclosure of Medical Error. Health Law Journal, 13.
Yarmohammadian et al. (2010, May & June). Medical record information disclosure laws and policies among selected countries; a comparative study. Journal of research in medical sciences, 15(3), 140-149.
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