Ethics in Health Care Issues

Organizational Responsibilityand Current Healthcare Issues Organizational Responsibility and Current Health Care Issues Case Representation Michel Boileau, chief clinical officer for St. Charles Health System said that a hospital in Bend Oregon administered incorrect medication to a patient, Loretta Macpherson, 65, and she passed away shortly following the administration of a paralyzing agent usually made use of during a surgery instead of anti-seizure medication. The doctor said that the patient's breathing stopped and brain damage and cardiac arrest followed.

Investigation done looked at the entire process of medication: from the process of making orders of the drugs from the manufacturers, the mixing at the pharmacy, packaging and labeling and how the nurses get it and the administration to the patient. Weaknesses or gaps in the process were looked into to note the possibility of human error.

Doctors had determined that the patient required phosphenyton, an intravenous anti-seizure medication, but rocuromin was accidentally administered and this resulted in Macpherson stopping breathing and a cardiac arrest occurring, causing an irreversible brain damage. Macpherson was taken off life support later on (CBS, 2014). Ethical Issues Involved The case above was against ethics of non-maleficence. This involves the avoidance of the causation of harm (Beauchamp & Childress, 2001).

It is rested on the principle of primum non-nocere, that is, the provider has an obligation not to cause harm or injury to patients and not to take actions that can cause harm. This captures medical practice complexities. The practice's fallibility is highlighted by the phrase "actions that would harm" since harm is not predictable but can result from the complications and side effects. Moreover, tensions on the subjects of allowing to die vs.

killing, withdrawal or withholding of life-sustaining treatments, intending and foreseeing harmful outcomes and the making of a choice between ordinary and extraordinary treatments is exposed (Hannawa, 2012). Adverse events do of course point to maleficent conduct due to the lack of prevention of harm. Nonetheless, failing to disclose or incompetently making disclosures can be considered maleficent too.

Providers might make a decision to exercise "therapeutic privilege" and choose to not make a disclosure "for the benefit of the patient." A nondisclosure of that nature may lead to more harm if the required medication is delayed as a result (Hannawa, 2012: Beauchamp & Childress, 2001). Also, the case was in contravention of the principle of beneficence which says that "one ought to help others." The principle's second notion of "preventing harm from occurring to others" was not followed.

This is due to the nondisclosure as it can result I further harm to both the patient and their family (Hannawa, 2012). Legal Issues Involved The Joint Commission on Accreditation of Healthcare Organizations, in the year 2001, required that all hospitals make disclosures concerning all unanticipated care outcomes to their patients and (in cases where appropriate) to their families. 5 years after this, the National Quality Forum advanced disclosure standards for healthcare institutions and professionals, making requiring that providers ought to disclose factual information, apologize for any medical errors and express regret.

While the judiciary wasn't quick in their response to these advancements, not less than 34 states have seen apology laws adopted so that medics can apologize to their patients without fearing that the apology can be used as evidence against them in cases of negligence (Hannawa, 2012). Tort system -- professional liability - presents the legal answer to the patient safety concerns.

Indeed, professional liability legal rules are designed to meet two demands: the fair compensation of the victim affected by negligent care and the provision of incentives to professionals to make improvements in order to avoid paying damages (Kohn, Corrigan & Donaldson, 2000). Almost no one has criticized the principle that a patient harmed by medical treatment ought to have the option of being equitably compensated. In most of the countries on the North American and European continents, civil liability takes into account individual negligence or fault.

Regimes of that nature are not adequately equipped to serve the two goals mentioned above (Guillod, 2013). The contribution the hospital's structure, culture, governance and focus (or absence of focus) on social responsibility had on the adverse event is also not adequately accounted for in the legal strictures. Environmental Factors Environmental factors contributing to medication errors include clutter, inadequate and improper lighting, fatigue on the side of the caregiver, high patient acuity and distraction in the course of preparation or administration of the drug.

The focus of the clinician can shift greatly when they are distracted and this can result in serious mistakes. "No interruption" zones should be set up by hospitals so that distractions are minimized (Anderson & Townsend, 2010). Staff Education and Competency Adequately educated nurses can help reduce mistakes. Nurses should be educated on new drugs. The staff ought to be updated on both external and internal medication errors. Errors that have been made at another facility can be repeated in another facility. Such updates help avoid such mistakes.

The competency of the nurses can also be maintained by having them take part in pharmacy grand rounds (Anderson & Townsend, 2010; Guillod, 2013). The Fatigue Factor Things like decision making, reaction time, information processing, memory and vigilance can be hugely affected by fatigue. People working 12-hour shifts and having to commute long distances can be awake for up to eighteen hours continuously. As per the studies carried out in the U.S. Army, being awake for seventeen hours is like having 0.05% blood alcohol level.

Going straight for 24 hours is almost the same as having a 0.10% blood alcohol level. Nurses working 16-hour shifts may be sleeping for less than 5 hours, especially when long commutes are factored in. Given the effects of fatigue, lack of adequate sleep and rest can dramatically increase the chances of a medical professional making mistakes on the job (Anderson & Townsend, 2010; Beauchamp & Childress, 2001). Changes are needed in the structure, governance, culture, or focus on social responsibility to prevent such situations in the future.

Drug Information Current and accurate drug information should be availed to caregivers. The information can be derived from profiles of patients, records of medication administration, computerized drug information systems, order sets, text references and protocols (Anderson & Townsend, 2010). Drug Packaging, Labeling and Nomenclature Medications provided by healthcare providers ought to be labeled clearly. There should be procedures in place to help the caregivers identify the drugs they need to administer without confusing drugs that look or sound almost the same (Kohn et al., 2000;.