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Ethical and Legal Implications of Prescribing Drugs

New and complex ethical challenges in clinical settings will occur frequently as the scope of practice for advanced practice nurses continues to broaden. Advanced practice nurses will consider a treatment plan for a patient that will include prescribing the appropriate medication (Arcangelo and Peterson, 2013). The ethical and legal implications to consider related to the scenario: 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.

Ethical and Legal Implications

With prescription authority, it is vital for advanced practice nurses to be aware of current professional, legal, and ethical standards. No matter how seemingly insignificant a medication error may seem, one must consider the ethical and legal implications. Fear of consequences may discourage one from disclosing a medication error. In the state of Michigan, nurse practitioners may prescribe non-controlled drugs as a delegated act of a physician, and controlled substances with written authorization. Authority to prescribe schedule II drugs is limited to a hospital (or surgical center, oncology practice, or hospice) for less than 7 day supply (Bryn, 2011).

Nurse Practitioner-When a nurse practitioner prescribes medication for a pediatric patient it is their responsibility to calculate the dose and write the correct dose (Arcangelo and Peterson, 2013). It is the requirement of professional code of ethics to do well and not to harm our patients.

Pharmacist-It is the pharmacy's responsibility to double check for drug dosing interactions (Arcangelo and Peterson, 2013). The pharmacist has a corresponding liability as well to ensure the prescription itself is the correct medication and dosage for a patient (Drug Enforcement Administration, 2006).

Patient and Family- According to the principle of autonomy it is patient’s right to have full information about the treatment and any error if occurred. There could be legal implications to the nurse practitioner, brought on by family, if harm occurs from the medication error.

Strategy One- The first strategy I would use would be to collect accurate and update any demographic information prior to prescribing. Accurate demographic information is vital in medication administration. Required patient information includes name, age, birth date, weight, allergies, diagnosis, current lab results, and vital signs (Anderson and Townsend, 2010).

Strategy Two- The second strategy would be to always be aware of special population considerations. Arcangelo and Peterson (2013) reported doses for children are usually based on weight in kilograms and it is the prescriber's responsibility to calculate the dose and write the correct prescription (p. 7).

References

Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced

practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.

Anderson, P., & Townsend, T. (2010). Medication errors: Don't let them happen to you.

American Nurse Today, 5(3), 23-28. Retrieved from

https://www.americannursetoday.com/medication-errors-dont-let-them-happen-to-you/

Bryne, W. (2011). U.S. nurse practitioner prescribing law: A state-by-state summary. Medscape

Nurses. Retrieved from http://www.medscape.com/viewarticle/440315

Drug Enforcement Administration. (2006.). Practitioner’s manual. Retrieved from

            http://www.deadiversion.usdoj.gov/pubs/manuals/pract/index.html