Medication Error Disclosure Ethics and Legalities

There is a common saying that nobody is perfect. No human being is immune to errors and mistakes from time to time. Not even trained professionals in the course of discharging their duties and roles. In a medical setting, the cost of even the simplest of errors could be immense. For this reason, it would be prudent to assess/examine the legal and ethical implications of disclosure and non-disclosure of a personal error and the course of action that would be most appropriate when medication errors are detected.

Further, it would also be prudent to evaluate strategies and approaches to minimize education errors. One of the most important considerations, from an ethical perspective, that health practitioners ought to make with reference to the disclosure of medication errors is whether or not they (or their loved ones) would like to be notified if they were to find themselves in a similar scenario.

For one to have a fair expectation of protection from harm, he or she should apply the same standard to others with respect to protecting them from harm. The ethical principle that would be most applicable in this case is that of nonmaleficence – which is essentially “an ethical principle that requires caregivers to avoid causing patients harm” (Pozgar, 2019, p. 16).

Failure to disclose would be akin to deliberately inflicting harm on another human being – which is hypocritical if one would expect to be shielded from harm in a similar situation. While the ethical aspect of medication error disclosure has got to do with doing the correct/right thing, the legal aspect of the same involves observation of, and adherence to, regulations. Full disclosure does have legal consequences as well as a number of benefits from a legal perspective.

It is important to note that a number of states have in the past enacted what are referred to as ‘apology laws’ whereby the courts cannot make use of statements of apology as liability evidence (Cohen, 2007). It should also be noted that there are states that do not protect admission of fault, despite protecting expression of regret (Cohen, 2007).

In reference to the laws specific to my state, it is important to note that Kansas happens to be one of the states that “require health care providers to report medical errors” (Rozovsky and Woods, 2005, p. 184).

In this case, the records as well as reports gathered under the statute of the state “are not subject to discovery, subpoena, or other means of legal compulsion and are not admissible in any legal action other than a disciplinary proceeding by the appropriate state licensing agency” (Rozovsky and Woods, 2005, p. 184). In the final analysis, it is important to note that the full disclosure of medication errors could be quite challenging from both a professional and personal perspective.

However, on the strength of the legal as well as ethical implications of nondisclosure highlighted above, disclosure appears to be the only rational course of action. As the advanced practice nurse in such a scenario, therefore, I would most definitely disclose my error. I happen to be a firm believer in the assertion that what goes around comes around – that is, the wrongs we do unto others are visited on us at some point in our lives.

In that regard, therefore, I deem myself a subscriber to the nonmaleficence ethical principle – whereby all my actions are founded on the need to ensure that I cause no harm. It should also be noted that malpractice lawsuit risks become even more pronounced when errors are brushed under the rug. This is more so the case given that a single instance of ignoring a medication error could be repeated and before long, it is a norm rather than a rarity.

As a matter of fact, Pozgar (2019) points out that even in those instances where a lawsuit follows after full disclosure, the legal losses are often lower. In general terms, from a legal as well as ethical point of view, full disclosure appears to be the safer course of action. Pollock, Bazaldua, and Dobbie (2007) highlight a systematic approach that would be appropriate in the prescription of medications.

To begin with, we have the evaluation and explicit definition of the problem the patient is suffering from, followed by the specification of the therapeutic objective so as to ensure that there are clear prescription objectives. Next, there is the selection of the relevant drug therapy followed by the initiation of the said therapy with the proper details while at the same time taking into consideration nonpharmacologic therapies. Step five involves the issuance of the relevant warnings, instructions, as well as information.

This is a critical patient education phase whose relevance cannot be overstated. Next, we have the regular evaluation of therapy. This is of great relevance in seeking to evaluate the effectiveness of the treatment and identify problems.