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Ethical and Legal Implications of Prescribing Drugs SCENERIO · · During your lunch break at the hospital, you read a journal article on pharmacoeconomics. You think of a couple of patients who have recently mentioned their financial difficulties. You wonder if some of the expensive drugs you have prescribed are sufficiently managing the patients’ health conditions and improving their quality of life. Write a 3 pages paper that addresses the following: · · Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family. · · Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected.

Be sure to reference laws specific to your state. · · Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation. · · Explain the process of writing prescriptions, including strategies to minimize medication errors.

Paper for above instructions

Ethical and Legal Implications of Prescribing Drugs: A Focus on Pharmacoeconomics

Introduction

Healthcare professionals are increasingly confronting the challenge of balancing patient care with the economic realities of prescription drug costs. This scenario involves a situation where a healthcare provider reflects on the financial burdens experienced by patients in light of expensive medications that may not significantly improve their health outcomes. The ethical and legal implications of prescribing costly drugs are extensive and impact multiple stakeholders including prescribers, pharmacists, patients, and their families. This paper will examine these implications, discuss strategies for managing disclosure and nondisclosure, present decision-making strategies for advanced practice nurses, and address processes for writing prescriptions to minimize medication errors.

Ethical Implications for Stakeholders

The ethical implications of prescribing expensive drugs begin with the prescriber. The principle of beneficence, which obliges healthcare providers to act in the best interest of patients, comes into play. Prescribers need to consider whether the medication truly improves patient health and quality of life. Ethical dilemmas arise if prescribing expensive drugs causes financial strain or leads to non-compliance due to cost (Naylor et al., 2021).
Patients and their families are directly affected as high medication costs can lead to adverse financial outcomes. The ethical principle of justice is relevant here. Patients should have equitable access to necessary medical treatments regardless of their financial status (Beauchamp & Childress, 2019).
Additionally, pharmacists bear ethical responsibilities in this scenario. They have a duty to ensure patient safety and can advise patients on lower-cost alternatives (Baker et al., 2020). Consequently, disclosure is paramount when discussing the costs of medications with patients.

Legal Implications

From a legal perspective, prescribers must adhere to laws regarding the prescribing of medications, which are designed to protect patient welfare. Various state laws, such as the Massachusetts Pharmacy Law, mandate ensuring prescriptions are written in a manner that prioritizes patient safety and informs them of their options (Massachusetts General Laws, 2021). If a prescriber fails to consider a patient's financial condition when prescribing, they may open themselves up to legal liability for negligence if the patient incurs financial harm as a result (Fryer & Manges, 2020).
Pharmacists also have legal obligations. They are required to inform patients about the medications they are dispensing, including costs and coverage options, which illustrates the importance of minimizing economic burden (Amal et al., 2019).

Strategies for Addressing Disclosure and Nondisclosure

In this context, addressing the issues of disclosure and nondisclosure is critical. Disclosure involves openly discussing the costs associated with medications prior to prescribing. One strategy is to conduct thorough patient assessments that also encompass discussions about finance and insurance coverage (Bynum et al., 2020).
Another approach is implementing a shared decision-making model with patients. This model encourages dialogue about financial implications and treatment options that align better with patients’ financial situations. Rather than a directive approach, this method fosters a collaborative environment where patients, prescribers, and pharmacists work together to arrive at the best potential treatment plan.
On the opposite end, nondisclosure can emerge from prescribers neglecting to consider the patient's financial limits. In this case, transparent communication is necessary to avoid potential malpractice claims or loss of trust.

Advanced Practice Nurse Decision-Making Strategies

As an advanced practice nurse (APN), decision-making must be guided by ethical principles and patient welfare. One strategy is utilizing a cost-effectiveness analysis (CEA) when considering prescription options. CEA evaluates the financial implications of various drugs against their health outcomes, allowing for informed choices beneficial to both the patient and the healthcare system (Garrison et al., 2021).
Another strategy is fostering patient education and engagement. This includes informing patients about their prescriptions and helping them understand available resources for financial assistance, such as patient assistance programs or generic drug alternatives (Sullivan & Maguire, 2020).
In terms of disclosure, it’s essential to consider whether an error was made in prescribing. If the medication is proven to be unnecessary, a disclosure is warranted to the patient, which not only aligns with ethical obligations but can foster trust and satisfaction (Gallagher et al., 2020).

Writing Prescriptions and Minimizing Medication Errors

The process of writing prescriptions should follow a systematic approach to minimize errors. Firstly, the APN should ensure clear communication of the medication name, dosage, and administration routes. Utilizing electronic prescribing systems can further reduce ambiguity associated with handwriting (Poon et al., 2010).
Moreover, educational strategies can foster better understanding amongst patients regarding their prescriptions. Providing written instructions alongside verbal explanations can help reinforce understanding. It’s essential also to confirm that patients have the ability to adhere to the prescribed regimen both clinically and economically.
Regular audits and review of prescribed medications can ensure compliance with best practices and spotlight patterns that might necessitate intervention, such as frequent prescriptions for high-cost medications.

Conclusion

The ethical and legal implications surrounding drug prescribing practices are complex and multifaceted, particularly in the context of burgeoning pharmaceutical costs. Prescribers, pharmacists, patients, and family members each have vested interests and responsibilities in this healthcare scenario. Developing strategies for disclosure and nondisclosure while emphasizing ethical principles can enhance decision-making for advanced practice nurses. Ultimately, prioritizing patient care and financial implications through effective communication, education, and ongoing assessment is essential for improving outcomes.

References

1. Amal, M., et al. (2019). The role of the pharmacist in reducing medication costs. Pharmacy Practice, 17(2), 1398.
2. Baker, S. D., et al. (2020). Ethical considerations in managing medication costs. Journal of Healthcare Management, 65(1), 10-20.
3. Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics. Oxford University Press.
4. Bynum, J. P. W., et al. (2020). The financial implications of high-cost medications in clinical practice. Health Affairs, 39(4), 720-727.
5. Fryer, C. D., & Manges, K. (2020). Legal responsibilities in drug prescribing. Law and Medicine, 46(3), 309-320.
6. Gallagher, T. H., et al. (2020). Discussing errors in the practice setting: The moral imperative. Journal of Hospital Medicine, 15(3), 139-141.
7. Garrison, L. P., et al. (2021). Cost-effectiveness of prescription medications: Balancing ethics and economy. Pharmacoeconomics, 39(1), 11-22.
8. Massachusetts General Laws. (2021). Pharmacy Regulation. Retrieved from https://www.mass.gov/regulations
9. Naylor, C. D., et al. (2021). Paying for drugs: The ethics of prescribing practices in a post-COVID world. Bioethics, 35(2), 191-198.
10. Poon, E. G., et al. (2010). The role of health information technology in reducing medication errors. American Journal of Health-System Pharmacy, 67(21), 1821-1828.
This thorough exploration of the ethical and legal implications surrounding drug prescribing aims to provide insight and understanding for healthcare practitioners. The integration of financial considerations into clinical decision-making is necessary to enhance patient outcomes ethically and legally.