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Ethics: the Dilemma for Standard of Care

Cases for prescription drug

Student: Modupe Sarratt

University of Maryland University College

Professor: Felencia McGee

October 25, 2015

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Abstract

Ethics like politics is about good and evil for dilemma. What is legal may not be the law for

practicing medicine. According to the Journal of Clinical Pharmacology “above all, do no harm”

(Smith 2005) is the ethics (beliefs) for “To Err is Human” according to Bootman, J. L. (2000) for

“confronting the myths of psychiatric drugs” Barker and Buchanan (2012). Standard of care for

drug is treatment is contradiction to drug errors and side effects that kill patients. According to

Lazarus et al, (1998), an “estimated of 106,000 deaths occur annually due to adverse drug side

effects” for standard of care “practicing medicine is “death by medicine” Null et al, (2010), to

propose preventive medicine to stop disease.

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Ethics: the Dilemma for Standard of Care

Doctors and the Hippocratic Oath for first to “do no harm” has been central to clinical

pharmacology and to the medical graduate students” for many years, except with “the recent

reexamination of the nature and magnitude of adverse reactions to drugs” for therapy, (Smith

2005). Practicing medicine is the science of diagnosis diseases, providing treatment with

prescribing drugs. The ethical dilemma is the standard of care for practicing medicine is the

problem of adverse side effects of drugs for medical law, ethics, and bioethics.

Medical law

Medical law is the “medical practice acts” to sue for malpractice in cases of negligence

for a wrong procedure that harm a patient. The medical law covers several rules and from several

sources, including the constitution of the United States. It is a law in all the 50 states to protect

citizens from unqualified doctors practicing. Medical law explains professional liability, the

meaning of standard of care; define the term tort, statute of limitation, and procedure for

administering and dispensing control substances.

The standard of care for practicing medicine (drug) for treatment (care) can never be

about ethics between doctors and patients. For the medical law to protect the doctors from

potential lawsuits by patients, although legal, is unethical. For example, in the course of

diagnosed patient for diabetes to prescribe a drug with side effects is a doctor following the law

to treat disease with drug. The problem for standard of care is patients are powerless to challenge

doctors’ order.

Recently in the news, several patients wrongfully diagnosed with cancer for

chemotherapy. According to Moghe (2015), a prominent doctor from Michigan admitted lying to

healthy patients to infuse “chemotherapy” to participate in Medicare. The doctor indicated his

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action is driven by competition for patients with health insurance. The journal of medical law &

ethics by W.K. Mariner (1995) observed, “The increased competition for a share of the market of

insured patients, which arose in the wake of failed comprehensive health care reform, has

provoked question about what, if any standard will govern care arrangement”. Raise concerns

that some doctors may withhold beneficial care from patients to provide unnecessary services.

Then again, doctors practiced unethical procedures for health care policy and coverage, a

good example is giving flu shot every year that cost millions of dollars to introduce bacteria with

virus to prescribe antibiotic for therapy. Often, we heard patient caught Flu after having a flu

shot. To think health care coverage for vaccination and immunization is standard of care for

introducing virus, bacteria and toxin to cause sickness. Catching a cold, a viral infection for

change of season is common and does not require treatment. Flu is viral and bacterial infection

for fever to fight the bacteria. Nevertheless, the worst is the adverse side effects of antibiotic

include shortness of breath, fainting, and convulsion for the use of drug outweighs the benefit of

health.

Ethics

There are no medical ethics that said ‘to treat patients’ right by giving advice’ instead, the

standard of care is drug for treatment is practicing medicine for compliance, cannot apply to the

doctrine “to do no harm”. There is no ethical issue to take “drug” or not to take “drug” is a

patient choice. Ethical depends on individual moral principle for making choices. For a doctor is

a professional standard to avoid negligence. Professional negligence is “failure to perform

professional duties according to the accepted standard of care” Lewis and Tamparo (1993). In

the practice of medicine, ethic are guidelines to ensure individual compliance that guide decision

to perform an act that a reasonable and prudent physician would perform. According to the

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ethical guidance in the Era of managed Care by Higgins & Hackett (2000), an analysis of the

American College of Healthcare Executives’ (ACHE) Code of ethics suggests, “the managed

care revolution undermining the medical ethics and that it does not adequately address several

ethical concerns.”

Bioethics

Bioethics is the study of life, moral and ethical issues for debate as it relates to medical

policy and practice that were appropriate for legal standard and standard of care, which can arise

from the relationship between biology, technology, medicine, politics, law and philosophy,

especially in the application for life and reproduction such as the recent event about plan

parenthood. Erickson & et.al (2003) said, “Americans should be able to count on receiving

health care that is safe for a new health care delivery system is needed to prevent errors and

learns from them when they occur requires first, a commitment by all stake holder for a culture

of life and safety, and second, improved health information system”.

Is there a solution to healthcare crisis?

Without a change to the current system for standard of care by prescription of drugs as

the treatment for healthcare coverage, the answer is no. To propose going back to “do no harm”

is preventing illness for preventative medicine is the legal standard. There is no harm in

preventing. Preventing an illness is better than curing a sickness.

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References

Barker, P., & Buchanan-Barker, P. (2012). First, do no harm: Confronting the myths of

psychiatric drugs. Nursing ethics, 0969733011429017.

Bootman, J. L. (2000). To err is human. Archives of internal medicine, 160(21), 3189-3189.

Erickson, S.M., Wolcott, J., Corrigan, J. M., & Aspden, P.(Eds). (2003). Patient Safety:

Achieving a New Standard for Care. National Academies Press.

Higgins, W., Gross, J. W., & Hackett, K. L. (2000). Ethical guidance in the era of managed care:

An analysis of the American College of Healthcare Executives' Code of Ethics. Journal

of Healthcare Management, 45(1), 32.

Lazarou, J., Pomeranz, B. H., & Corey, P. N. (1998). Incidence of adverse drug reactions in

hospitalized patients: a meta-analysis of prospective studies. Jama, 279(15), 1200-1205.

Lewis, M. A., & Tamparo, C. D. (1993). Medical law, ethics, and bioethics in the medical office.

FA Davis.

Mariner, W. K. (1995). Business vs. medical ethics: Conflicting standards for managed care. The

Journal of Law, Medicine & Ethics, 23(3), 236-246.

Moghe, Sonia (2015). CNN News. Doctor gives chemo treatments to health patients

http://www.cnn.com/2015/07/10/us/michigan-cancer-doctor-sentenced/index.html

Null, G., Carolyn Dean, M. D., Feldman, M., Rasio, D., & Smith, D. (2010). Death by medicine.

Surgery, 371(3), 13.

Smith, C. M. (2005). Origin and uses of primum non nocere—above all, do no harm!. The

Journal of Clinical Pharmacology, 45(4), 371-377.