The Ethics and Legalities of Medication Error Disclosure

Administering medications is a basic and essential skill of practicing nurses but the errors in prescription may have serious legal implications for nurses and health effects for the patients. Medical errors are not unusual in the health care systems and at times, they are responsible for delayed patient’s recovery and causing harm to the patient.  However, when such errors occur, it is necessary for health care professionals to observe the established code of ethics and legal provisions to ensure that patients are not harmed. Disclosing a medication error is not easy, but legally and ethically, it is the appropriate thing to do. The patients who are affected deserve to be told and be involved with any health issues or concerns that relates to them.

 The health practitioner is required to disclose the personal harmful errors, explain the reason for such errors and how their effects can be minimized and even ensure that such errors are eliminated or minimized in future (Bernat, 2008).  Just a simple acknowledgement of such mistakes and offering apologies can go a long way in dealing with arising issues. Deciding whether to the error should be reported depends on the kind and seriousness of the error, the evidence about the issue and the potential impacts and costs. It is therefore, necessary to have an effective reporting procedure and a conducive environment that encourages reporting, especially one that is anonymous and secure. An important point that should be considered in health care actions such as drug prescription, every situation is serious and any health practitioner is capable of making mistakes (Mazor, Simon & Gurwitz, 2004). There are also effects relating to whether the personal errors committed will be disclosed or not.  

Errors in medication may not cause permanent problems in the health of patients, but in small number of cases the errors may lead to serious health effects or even death. Disclosing such errors to the patients holds both ethical and legal implications on the part of the health practitioner. Ethical professional code may require the disclosure of personal errors to the client but the consequences cannot be anticipated. Disclosure of the personal error is important since it preserves the trust existing between a health care provider and the patient. Especially in cases where more treatment is needed so as to counter the effect of errors such as in prescription, disclosure will be very important in securing the consent that is informed (Edwin, 2009). In addition, disclosure can assist physicians in introducing various constructive changes in their practices with an aim of ensuring that the errors are minimized as much as possible or eliminated altogether (Bernat, 2008). By doing this , the practitioner will have abided by the Code of Ethics and the various professional practice guidelines that obligates a physician to inform a patient about their personal errors. This is to assist the patient in understanding what has happened especially if they experience a considerable medical complication from the aforementioned mistakes. If such information is essential for the well-being of the patient or is important for their future treatment, it has to be disclosed.

  In addition, the patient is likely to be accommodative and trust the genuineness of the mistakes made by the healthcare provider and as being human errors. In this case, the patient reactions may not be negative like a situation where they find out about the mistakes themselves and hence press legal charges (Bernat, 2008).  There are some consequences that may drive the desire by medical professionals to hide personal errors which relate their image. The professionals in the medical filed values perfection and may feel that their reputation will be tainted once they reveal the error (Bernat, 2008). The destroyed reputation also means that referrals to their practice will reduce which can lead to a huge loss of their income. This can be attributed to the fact that anxiety may increase among some patients and thereby eroding their trust for the medical professional on future health care. It also possible that disclosing the errors can affect the other stakeholders in the health industry such as the health insures where the affected patients can lead to poor outcome in lawsuits against professionals that is can affect these organizations.  

The disclosure is, however, important for the sake of the patients’ safety since the primary ideas is to offer health solutions to the patients.  This means that disclosing personal errors will be of great assistance to the well-being of the patient and it is ethically and morally right to do so.  It is not justifiable to hide a personal prescription or medical error with an aim of preventing malpractice lawsuit if the error presents health problem to the patient (Guillod, 2013). Ethics should provide guidance to the medical professional so that they disclose the truth if a patient suffer poor outcome because of a human error. It is also to not that even if the ethical code is not observed and information disclosed, the truth will eventually come out. Disclosure will go a long way in ensuring the safety of the patients and less cases of malpractice lawsuit since the patients will be aware of the cause of the mistake (Guillod, 2013).  

 On the other hand, failure to disclose personal medical and medication errors can have profound ethical and legal consequence for the health care providers. The dilemma presented to the clinicians is one of which attitude they should embrace, whether to withhold or to honestly sharing the information with the patients. Ideally, disclosure is appropriate since it makes it easy to take measures that can redress and prevent future personal errors (Chamberlain, Koniaris & Pawlik, 2012). Failure to disclose such information will erode the trust and confidence the patient had with the health practitioner and this opens the door for malpractice lawsuits. The attitude of non-disclosure tantamount to deception and it violates the moral ethical rule of not deceiving. The violation of the ethical code cannot be justified unless everybody agrees that the violations are such that if they can be justified for any individual, they can be justified for everyone when every morally relevant aspect is the same as others. The failure to disclose may also be justified if it is rational in favoring the violation even if it is known by everybody that the violation is allowed. However, failure to disclosures doesn’t satisfy such conditions and hence, it adds up as a violation of the ethical code (Chamberlain, Koniaris & Pawlik, 2012). The perception by the patients that a health practitioner does not observe ethical codes in their work leads to loss of trust if the patient find by himself or herself that the errors were committed and such errors can affect their health and well-being.

 It is evident that the risk of legal liability is present in health or medical practice, and this is true when things do not turn out as expected by the patients or their family. The health professionals will face lawsuits when personal errors are detected by patients especially if they affect the outcome of the health care services. It is also evident that ineffective communication between the practitioner and the patient after an error has happened is a major contributing aspect in malpractice lawsuits (Guillod, 2013). The patient becomes dissatisfied if the health practitioner holds an attitude of denial than they would because of negligence itself. This means that many malpractice litigations could be avoided if there was enough disclosure followed by an apology on the same. What most patients want is just a simple explanation by the health practitioner of what transpired and where necessary an apology. Where neither is adequately offered, the patients will feel deeply wronged and thus seek legal counsel on the same.  The various litigations by the patients will aim at obtaining compensation especially if their health has been affected by the personal errors by the practitioners. This concept is based on the principle of justice and if the human errors are portrayed as negligence damages will have to be paid to the patients (Guillod, 2013). The litigations will also have the opposite effect of inhibiting further medical and prescription disclosure out of fear of such lawsuits.

 In conclusion, disclosure and non-disclosure can have both desirable and non-desirable legal and ethical implications. Even if disclosure of personal errors may expose health practitioners to litigations, reduced reputation and penalties, patients mostly react positive and participate in addressing the effects of the errors. Non-disclosure on the other hand has been shown to lead to litigation since patients feel that they have been deceived.

References

Bernat, J. L. (2008). Ethical issues in neurology. Philadelphia: Lippincott Williams & Wilkins.67-69

Chamberlain, C. J., Koniaris, L. G., Wu, A. W., & Pawlik, T. M. (2012). Disclosure of “nonharmful” medical errors and other events: duty to disclose. Archives of Surgery, 147(3), 282-286.

 

Mazor, K. M., Simon, S. R., & Gurwitz, J. H. (2004). Communicating with patients about medical errors: a review of the literature. Archives of internal medicine, 164(15), 1690-1697.

 

Guillod, O. (2013). Medical error disclosure and patient safety: legal aspects. Journal of public health research, 2(3).

 

Edwin, A. K. (2009). Non-disclosure of medical errors an egregious violation of ethical principles. Ghana medical journal, 43(1), 34.