Ethics Case Study: Medical Law and Ethics

Ethics Case Study: Medical Law and Ethics

Jerry McCall is Dr. William's office assistant. He has received professional training as both a medical assistant and an LPN. He is handling all of the phone calls at the office while the receptionist is at lunch. During this period of time, a patient calls and says he must have a prescription refill for Valium, an antidepressant medication, called in right away to his pharmacy, since he is leaving for the airport in thirty minutes. The patient notes that Dr. Williams is a personal friend and always gives him a small supply of Valium when he has to fly. No one except Jerry is in the office at this time.

Does Jerry's Medical Training Qualify Him to Refill the Order?

While Jerry's medical training qualifies him to receive a prescription order and transcribe it accurately for other nurses or physicians to implement or transmit to a pharmacist to dispense, Jerry does not have the authority to refill the patient's medication, as renewing/refilling/extending a prescription/order is considered originating a prescription (MBN, 2010, p.1). While the dilemma presented to Jerry by the patient at hand may sway Jerry's ethics, his medical training underlines the fact that under no circumstance is Jerry allowed to refill the medication, especially if there are no further refills depicted on the prescription bottle. In a situation such as this, the only option Jerry has is to refer the patient to another doctor who may be able to more immediately assist them, or reject the patient's request outright, citing that his or her physician may be able to assist them further when Dr. Williams returns to the office. Despite the time constraints the patient has explained, and the ethical dilemma raised by their impending departure, the circumstances of Jerry's medical credentials remain unchanged, leaving him unable to assist the patient in this manner.

Does Critical Medicine Alter the Decision to Refill?

Even in a situation where critical medicine is needed, the fact that Jerry and other LPNs do not have the authority to refill prescriptions remains unchanged. Though the patient at hand may assert his or her frustrations with the situation, and Jerry may undergo an ethical dilemma in his own mind regarding the patient's time constraints and the need for medication, the repercussions that Jerry could face if he decided to call in a refill could prove extremely detrimental to his employment status or his licensure.

Doctrine of Respondent Superior

The doctrine of respondent superior, which literally means "let the master answer," states that in many circumstances, an employer is responsible for the actions of employees performed within the course of their employment (Lloyd, 2010, p.1). In a situation such as this, should Jerry decide to refill the medication, malpractice suits would likely be filed against Jerry and against Dr. Williams or any other physicians who hold stake in the practice. In malpractice cases involving physicians and nurses, a healthcare organizations credentialing process is questioned and can be revoked, recoveries and damages to injured parties are paid largely out of pocket, and physicians held responsible for employee actions are often held as directly culpable for the incident that took place, even in situations where the respective physician was not present (i.e. Jerry's situation) (Nowicki and Summers, 2004, p. 95).

As the case study does not specifically state whether or not Jerry, as an LPN an acting member of the physician's office, holds his own form of medical malpractice insurance, it can be inferred that such a circumstance as that previously-stated in which Dr. Williams is held accountable would go into effect.

Legal and Ethical Issues

While the legal ramifications of Jerry's decision to refill could cause significant damage to his career, Dr. Williams' career, and those affiliated with the office in which Jerry works, the ethical questions regarding the situation also come into play. Jerry may assume that because the patient on the phone notes that he or she is a close friend of Dr. Williams, asserting that the doctor prescribes medications for them on a regular basis, and would likely do so now if he had been present in the office, that a choice to call the pharmacy to refill the medication may be completely merited. In viewing the situation from an issue of morality, Jerry may feel that his inability to prescribe the needed medication may harm the patient on the phone in the long-run, which would have the capacity to alter his judgment as to whether or not to refill the medication.

In a situation such as this, Jerry faces the dilemma that is posed by many when they believe that the end justifies the means. In this case, Jerry may believe that in refilling a prescription that the patient already possesses under a circumstance which deals with extremely strict time constraints, essentially no harm would come to either him or the patient at hand. In acting in accordance with this belief, Jerry would likely believe that no one would ever know the difference, as a refilling of the prescription would aid the patient and considering the patient's relationship with Dr. Williams, likely cause no harm to the doctor or to Jerry. However, in harboring under this delusion, Jerry would place himself into a target-area for legal claims and malpractice suits, which proves that in a situation such as this, the belief that one must abide by doing good for one's fellow man is overshadowed by a need for legal compliance.

Problem-Solving to Assist in Decision-Making