Application: The Ethics and Legalities of Medication Error Disclosure
American writer Nikki Giovanni once said: “Mistakes are a fact of life. It is the response to
the error that counts” (Goodreads, 2012). Whenever you make an error when writing a
prescription, you must consider the ethical and legal implications of your error-no matter
how seemingly insignificant it might be. You may fear the possible consequences and feel
pressured not to disclose the error. Regardless, you need to consider the potential
implications of non-disclosure. How you respond to the prescription error will affect you,
the patient, and the health care facility where you practice. In this Assignment, you
examine ethical and legal implications of disclosure and nondisclosure of personal error.
Consider the following scenario:
You are working as an advanced practice nurse at a community health clinic. You make an
error when prescribing a drug to a patient. You do not think the patient would know that
you made the error, and it certainly was not intentional.
To prepare:
Consider the ethical implications of disclosure and nondisclosure.
Research federal and state laws for advanced practice nurses. Reflect on the legal
implications of disclosure and nondisclosure for you and the health clinic.
Consider what you would do as the advanced practice nurse in this scenario including
whether or not you would disclose your error.
Review the Institute for Safe Medication Practices website in the Learning Resources.
Consider the process of writing prescriptions. Think about strategies to avoid medication
errors.
To complete:
Write a 2- to 3- page paper that addresses the following:
Explain the ethical and legal implications of disclosure and nondisclosure. Be sure to
reference laws specific to THE STATE OF CALIFORNIA.
Describe what you would do as the advanced practice nurse in this scenario including
whether or not you would disclose your error. Provide your rationale.
Explain the process of writing prescriptions including strategies to minimize medication
errors.
The Ethics and Legalities of Medication Error Disclosure
THE ETHICAL AND LEGALITIES OF MEDICATION ERROR DISCLOSURE 2
Introduction
Errors in the health care system are currently receiving much attention, even though
committing such medical errors is not new. Prescription errors are some leading cause of death
in the United States (Drug Enforcement Administration, 2006). Medication errors are common in
general practice in hospitals. Erroneous prescriptions could potentially harm the patients.
Prescription errors occur at any stage of the prescription. These errors range from omissions,
slips, lapses, and poor handwriting (Archangel & Peterson, 2013). Because medical errors have
a large impact on the patient care, it is paramount to consider the issues regarding the disclosure
of when the health care provider makes or witnesses an error.
Ethical and legal implications of prescription errors
It is ethical to disclose to patient prescription errors when they occur. The doctor patient
relationship is equivalent to the fiduciary relationship, where a partner owes another the duty of
faith, confidentiality and trust (Crigger & Holcomb, 2008). Therefore, the doctor patient
relationship has to rely on the principles of autonomy, justice and fidelity in all circumstances.
The non-disclosure of medical errors to patients violates ethical principles and it is not
justifiable. Furthermore, by not disclosing the medical error the nurse places his own interests
above the interests of the patient centered ethical care. This shows that medical error disclosure
to patients is justifiable and fundamental to the nature of the doctor patient relationship.
On the other hand, disclosing the information has negative implications such as the legal
liabilities, distress to patients and the loss of reputation and privileges. This could ultimately
lead to the revocation of nursing license. Legal liabilities could even lead to the doctors sued by
the patient’s family. This is because such error could form the basis for patients to seek legal
THE ETHICAL AND LEGALITIES OF MEDICATION ERROR DISCLOSURE 3
redress. The American Medical Association Council on ethical and judicial affairs states, that
regarding the legal liability, which could result from truthful disclosure, should not affect the
doctor’s honesty to the patient. Therefore, the implications and repercussions of disclosure of
the errors regarding damage to reputation, the revocation of the license should not prevent the
doctors from disclosing the information (Anderson & Townsend, 2010).
Strategies to minimize medication prescription errors
Acquisition of information through the error reporting system is essential in the
prevention of prescription faults. The error reporting system is important in ensuring that the
prescribers have information on the previous errors made in their working environments.
Furthermore, the use of computer based generated prescription systems are one of the most
effective tools for the reduction of errors (Philipsen & Soeken, 2011). This is because it
significantly reduces the risks arising from drug dispensing and administration. In addition, the
computerized based advice gives paramount benefits through guidance on optimal doses. In
addition, the use of uniform medication charts has greatly reduced medication errors. This is
because it forces the staff to develop interdisciplinary collaboration and procedures.
Conclusion
It is essential to disclose prescription errors to the patients, as it is a moral obligation for
the nurses irrespective of the legal implications to the medical fractioned. Disclosure of medical
errors to the patients is justifiable and important in maintaining trust between the doctor and the
patients. Furthermore, the hospital needs to devise mechanisms through which better
prescriptions achieved to reduce prescription errors. Inadequate knowledge or incomplete
information about clinical characteristics and previous medication history could result in the
THE ETHICAL AND LEGALITIES OF MEDICATION ERROR DISCLOSURE 4
administration of inappropriate medication to the patients. The complexity of prescribing
procedure should be minimized to omission errors.
THE ETHICAL AND LEGALITIES OF MEDICATION ERROR DISCLOSURE 5
References
Archangel, V. P., & Peterson, A. M. (Eds.). (2013). Pharmaco-therapeutics for advanced
practice: A practical approach (3rd Ed.). Ambler, PA: Lippincott Williams & Wilkins.
Chapter 1, “Issues for the Practitioner in Drug Therapy” (pp. 2–14).
Crigger, N., & Holcomb, L. (2008). Improving nurse practitioner practice through rational
prescribing. The Journal for Nursing Practitioners, 4 (2), 120–125.
Drug Enforcement Administration. (2006). Practitioner’s manual.
Philipsen, N. C., & Soeken, D. (2011). Preparing to blow the whistle: A survival guide for
nurses. The Journal for Nurse Practitioners, 7 (9), 740–746.
Anderson, P., & Townsend, T. (2010). Medication errors: Do not let them happen to you.
American Nurse Today, 5 (3), 23–28.