Background
One of the challenging options in end-of-life care that raises ethical concerns is the choice to forego or stop receiving treatments or therapy. When a patient’s request to commence or continue treatment will result in severe suffering, an unnecessary or uneven allocation of resources, or a course of action that would require the practitioner to violate the law, respect for the patient’s autonomy should be called into doubt (Henry, 2017). The purpose of this paper is to reflect on the given case from the ethical and legal perspectives.
Ethical and Legal Implications
From an ethical standpoint, the patient, not the patient’s family, representative, or doctor, should decide whether to limit therapy or therapies that don’t cure but do extend life temporarily. The patient’s family, care provider, or doctor must make a choice regarding the patient’s treatment in case the person is no longer capable of doing so, given the patient’s cognitive decline (Akdeniz et al., 2021). From the legal perspective, prescribers and pharmacists must adhere to certain standard procedures when it comes to terminally treated patients and those receiving care in long-term care facilities. When filling out a prescription medicine order, the pharmacist must indicate whether the patient is “terminally ill” or is a long-term care facility patient (Minnesota Administrative Rules, n.d.). The legislation in Minnesota allows for the partial dispensing of prohibited substance prescriptions made for patients in long-term care institutions and those who are terminally ill.
Addressing Disclosure and Nondisclosure
Health care institutions in Minnesota are dedicated to taking all reasonable steps to avert errors and enhance patient care. Minnesota hospitals have advocated a crucial reform in how we monitor and report the most severe medical mistakes. A unique approach was developed to handle the list of sanctionable medical errors in 2003 (Minnesota Administrative Rules, n.d.). It was established by the Minnesota Hospital Association and the Minnesota Department of Health. As long as physicians are still imperfect human beings, there will probably still be medical blunders. The strategic actions to accomplish complete disclosure include disclosing any harmful errors, providing a rationale as to why the error happened, detailing how the impacts of the error will be mitigated, and outlining the efforts the doctor will put into preventing relapses. These elements are included in “full disclosure” of an error, together with an admission of guilt and an apology from the responsible party.
Decision-Making Strategies
The decision-making strategies applicable to this case can be guided by the autonomy and nonmaleficence principles. The decision to stop INR monitoring is justifiable when viewed in light of the nonmaleficence principle. According to the nonmaleficence principle, patient damage might be justified if it outweighs the benefit of a medical intervention (Akdeniz et al., 2021). Given the patient’s terminal condition, the specific benefit of INR monitoring is not immediately apparent.
A patient’s right to self-determination is referred to as autonomy. The importance of protecting patients’ rights to self-determination, including for those who have lost the capacity to do so, is emphasized by this notion (Akdeniz et al., 2021). The appropriate course of action is to withhold or stop the procedures if a patient and I concur that there is no benefit to proceeding the monitoring. However, because to cognitive deterioration, the patient is unable to make independent judgments. If the patient in this situation had designated a health care proxy, I would base my judgments on such papers. If there is no designated health care proxy, members of the family must make the choice. Medical error disclosure is encouraged and controlled by ethical, legal, and professional standards. An act of medical malpractice must be reported and disclosed to the patient, according to Minnesota law. So, as a nurse practitioner, it would be my primary obligation to reveal the medical mistake.
Process of Writing Prescriptions
Creating a prescription strategy may enable healthcare professionals to better focus on the treatment’s goals. A patient’s issue must be assessed and defined, the clinical goal of medication must be established, the right prescription must be chosen, and patients must be given details, instructions, and cautions. Additionally, it is vital to regularly check patients and take drug costs into account when prescribing. Prescription mistakes can be decreased by using the proper tools, such as prescribing software and computerized medication references.
References
Akdeniz, M., Yardımcı, B., & Kavukcu, E. (2021). Ethical considerations at the end-of-life care. SAGE Open Medicine, 9, 205031212110009. Web.
Henry, B. (2017). Evolving ethical and legal implications for feeding at the end of life. Annals of Palliative Medicine, 6(1), 87–90. Web.
Minnesota Administrative Rules. (n.d.). 6800 – MN Rules Chapter. Minnesota Legislature. Web.