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The Ethics and Legalities of Medication Error Disclosure
Kathleen Thorn
Walden University
NURS6521, Advanced Pharmacology
March 17, 2017
The Ethics and Legalities of Medication Error Disclosure
Medication error is an important cause of patient morbidity and mortality, yet it can be a
confusing and underappreciated concept. A medication error is any error that occurs at any time
in the medication course. It has been estimated by the Institute of Medicine that medication
errors cause 1 of 131 outpatient and 1 of 854 inpatient deaths. Medication, patient factors, and
health care professional factors can lead to medication errors (Wittich, Burkle, & Lanier, 2014,
August). The purpose of this paper is to discuss ethical and legal implications of
disclosure/nondisclosure local state laws, and various strategies to help prevent medication
prescription errors.
Ethical and Legal Implications of Disclosure and Nondisclosure.
Although most doctors believe that errors should be disclosed to patients when they
occur, in reality, most doctors and institutions do not disclose such mishaps to patients and their
families. Non-disclosure of medical errors to patients and/or their families is a violation of
ethical principles and cannot ever be justified. As a provider of healthcare, we have a duty to
uphold by being honest with our patients despite the circumstance, because it is our
responsibility to maintain an open and truthful functioning relationship. In the Code of Ethics
released by the American Nurses Association (2015), it states there are no exceptions for
nondisclosure and all mistakes must be reported to the appropriateauthorities to ensure patient
quality and safety (Edwin, 2009). A doctor is therefore ethically bound to disclose mistakes to
the patient. Ethical value of the action alone as considered by the possible consequences of the
action; it then becomes obvious that the right thing to do when errors occur is for practitioners to
tell patients about the errors. According to the state of Michigan is liable to provide for the
prevention and control of diseases and disabilities; to provide for the classification,
administration, regulation, financing, and maintenance of personal, environmental, and other
health services and activities (Michigan Legislature. n.d.).
Process of Writing Prescriptions
Hospitals that satisfy meaningful use criteria can receive millions of dollars.
Implementing computerized provider order entry (CPOE) with clinical decision support systems
(CDSS) that check for allergies and drug-drug interactions is one of several basic criteria for
meaningful use by hospitals. Medication errors were approximately half as common when
providers used CPOE than when they used paper-order entry.@@Errors in timing, are generally less
risky than giving a medication to the wrong patient. Many commonly used medications, such as
anti-hypertensives and antibiotics, have sufficiently long half-lives with the purpose of receiving
a dose an hour or two late has little clinical effect. By contrast, receiving an anti-hypertensive or
antibiotic intended for someone else poses risks of low blood pressure or an allergic reaction
(Nuckols, et.al, 2014).
Common consequences faced by physicians after medication errors can include loss of patient
trust, civil actions, criminal charges, and medical board discipline. Methods to prevent
medication errors from occurring have been used with varying success. When an error is
discovered, most patients expect disclosure that is timely, given in person, and accompanied with
an apology and efforts to prevent future errors. Learning more about medication errors may
enhance health care professionals' ability to provide safe care to their patients (Wittich, Burkle,
& Lanier, 2014, August).
Edwin, A. (2009). Non-disclosure of medical errors an egregious violation of ethical
principles.@Ghana Medical Journal,@43(1), 34-39.
Michigan Legislature. (n.d.). Retrieved March 15, 2017, from
Nuckols, T. K., Smith-Spangler, C., Morton, S. C., Asch, S. M., Patel, V. M., Anderson, L. J., ...
& Shekelle, P. G. (2014). The effectiveness of computerized order entry at reducing
preventable adverse drug events and medication errors in hospital settings: a systematic
review and meta-analysis.@Systematic reviews,@3(1), 56.
Wittich, C. M., Burkle, C. M., & Lanier, W. L. (2014, August). Medication errors: an overview
for clinicians. In@Mayo Clinic Proceedings@(Vol. 89, No. 8, pp. 1116-1125). Elsevier.
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