Even though the patient may not know an error was made during a prescription, it is not possible to predict the consequences of wrong treatments, so the error should be disclosed and the correct treatment needs to be implemented. Proper disclosure of medication errors to patients is always an ethical option, especially if the error is discovered early. That approach promotes patient safety, one of the key moral standards healthcare providers should follow. Furthermore, a study by Rathert and Phillips (2010) showed that full disclosure policies promote value-based ethics and create an ethical environment in which the staff demonstrates more commitment to the organization.
However, full disclosures often place the healthcare practitioner and organization at risk of legal actions. According to the Code of Virginia (2009), healthcare providers are required to provide a written apology to patients who are damaged by medical malpractices. While portions of the statements that express sympathy, condolences, compassion, or benevolence are inadmissible as evidence, it is important to consider that expressions of fault in written apologies are admissible as evidence and can be used in any civil action.
Although avoiding disclosure seems to be an attractive option for protecting both the healthcare institution from legal actions and personal pride from decreasing, it is not an ethical decision and may lead to higher legal risks than error disclosure. According to Kachalia et al. (2010), full disclosure may actually lead to lower legal costs and fewer lawsuits because honesty with patients may lead to increased trust and patient satisfaction with healthcare service.
Furthermore, failing to disclose medical errors can lead to future legal actions if the patient experiences adverse health effects and an investigation takes place. When prescribing the medication, the practitioner’s legal signature and/or license number are required, and the drug treatment details, such as dosage or amount prescribed, need to be documented (Arcangelo & Peterson, 2013). If I choose to avoid disclosure or attempt partial disclosure, the prescription and treatment documentation will be a liability that could be used against me in court and lead to penalties for both myself and the organization.
When ethical and legal implications of error disclosures are considered, I would choose to disclose the error to the patient and correct my mistake. While I could face several consequences, including disciplinary action or job dismissal, I also need to consider that I will most likely face civil or criminal charges if the patient experiences adverse health effects. Reporting the mistake early and improving medication error prevention strategies is a better option than avoiding disclosure.
A suitable long-term solution is to implement strategies that minimize occurrences of medication errors and develop effective full disclosure policies. Before prescribing medication, all health care practitioners need to gather data from medical history and clinical assessments. To determine a drug suitable for treatment, a risk-benefit analysis is mandatory, followed by other considerations, such as subtle differences, side-effects, routes of administration, cost, effectiveness, and storage requirements (Arcangelo & Peterson, 2013).
Apart from professional standards in care, various environmental factors should be implemented to lower risks of errors, such as removing distractions during prescription preparation or risk-benefit analysis, reducing workplace clutter, and improving lighting (Anderson & Townsend, 2010). Finally, this particular case can be considered a near-miss because I noticed the error before any adverse effects became apparent, and reporting those types of errors is one of the strategies that can be used to reduce medication errors and risks of legal actions (Anderson & Townsend, 2010).
References
Anderson, P., & Townsend, T. (2010). Medication errors: Don't let them happen to you. American Nurse Today, 5(3), 23-28. Retrieved from http://www.americannursetoday.com/assets/0/434/436/440/6276/6334/6350/6356/8b8dac76-6061-4521-8b43-d0928ef8de07.pdf
Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
Code of Virginia, Title 8.01, ch. 21.2, § 8.01-581.20:1 (2009).
Kachalia, A., Kaufman, S. R., Boothman, R., Anderson, S., Welch, K., Saint, S., & Rogers, M. A. (2010). Liability claims and costs before and after implementation of a medical error disclosure program. Annals of Internal Medicine, 153(4), 213-221.
Rathert, C., & Phillips, W. (2010). Medical error disclosure training: Evidence for values-based ethical environments. Journal of Business Ethics, 97(3), 491-503.
