Errors in the healthcare industry are known to receive a lot of attention nowadays, although such errors are not a new phenomenon. Although nurses are taught to avoid such errors, they unfortunately still make them. The following paper is focused on the discussion of ethical implications of medication errors. It is obvious that no one is protected from committing mistakes. However, the main task of nurses and doctors is to do their best in preventing such errors. The life and health of patients are of paramount importance.
The Ethical Implications of Nursing Medication Errors
Medicine is supposed to be the most complex form of human activities. It requires deep expertise, skills, as well as high moral qualities, that’s why nursing education so important. For centuries, representatives of the medical profession have not been allowed to commit any errors as they are responsible for the most precious thing, that is, the human lives. However, doctors and nurses make mistakes as they deal with a very complex issue, treating the human body, which poses a large number of challenges every day.
In medical literature, medical errors are often understood as actions or inaction of a doctor or a nurse which are based on the imperfection of modern medical science, objective working conditions, lack of qualification or the failure to use available knowledge. Medical errors are often described as involuntarily made by the doctor or any other healthcare professional in their professional activity.
The objective circumstances that lead to medication errors imply the conditions under which there is no possibility or resources in order to investigate or intervene into the course of the disease (for example, the absence of endoscopes which diagnose gastric cancer, and so on).
However, errors can be caused by the variability of individual tenets and principles in the field of theoretical and practical medicine. Therefore, views on the etiology, pathogenesis, as well as assessment of the disease can be changed. In fact, errors which are caused by the imperfection of medical science can occur even in the practice of experienced doctors, as they have to deal with the most intricate and complicated cases.
Errors caused by medical ignorance are the most numerous. In each case, the question of the relation between the nurse’s actions and the medical error caused by lack of professional skills as well as basic medical ignorance is discussed on the basis of specific characteristics of the disease, the duration of observation, survey capabilities, and so on.
The compliance to ethical standards in the course of professional activities of the healthcare industry is a complex issue. It requires a high level of morality of every healthcare worker. Relations between nurses and patients should be built in accordance with the principles of biomedical ethics. The American Nurses Association Code of Ethics states that everything should be done in accordance with the principle of respect for the rights and dignity of the patient. Nurses should create an atmosphere of respect for the values, customs, and spiritual beliefs of patients.
The fundamental principles of medical ethics imply respect for the rights and dignity of patients, as well as doing no harm to them. The responsibility for the patient is a professional and ethical duty of healthcare professionals. The nurse is responsible for the implementation and support of the measures designed to meet the public demand for health. It suggests that nurses should do everything possible for patients and take care of their well-being. Nurse have the right to make independent decisions in their professional field. This means taking responsibility for professional solutions. Nurses are responsible for the quality of their work, the patient, their family, working group leaders, and society as a whole. Nurses are also dependable and liable. Their actions must comply with the legislation and other regulations on health and social protection.
In fact, medical errors can be divided into deontological, diagnostic, and therapeutic. Deontological errors imply the violation of the principles of good behavior towards the patient, that is, non-compliance to the ethics of medical practice.
The main reasons for diagnostic errors are as follows:
· neglect or unskilled use of the anamnesis, which is the medical history;
· incomplete examination of the patient;
· improper interpretation of the clinical data;
· unskilled assessment of radiological and laboratory investigations;
· carelessness and haste in the survey;
· improper formulation of diagnosis.
Medical errors are usually related to incorrect clinical diagnosis. As a result of such diagnoses, patients are prescribed the treatment that does not meet the true nature of their disease. It means the absence of the required therapy.
A Latin proverb states “Errare humanum est,” which means “Everyone can make a mistake.” Healthcare professionals are no exception. In fact, any activity can lead to errors. However, there are areas where mistakes are not allowed. The medical practice belongs to the fields where errors are the most dangerous. Medical errors can be fatal to the patient. Doctors or nurses who have made a mistake are exposed not only to moral and ethical evaluation by others, but they can be punished by civil, legal, and sometimes criminal penalties.
The human health and life are the most important values in the world. They can neither be bought nor created. It means that they need to be protected and preserved, developed and improved, as well as enhanced and strengthened.
Negative consequences of errors in the medical care imply the negative development of the disease due to treatment, prophylactic or diagnostic activities that cause the following (Kohn et al.):
· death of the patient;
· death threats;
· significant disability;
· complete loss of employability;
· mental disorder;
· drug addiction;
· infection of AIDS or other serious infectious diseases;
· long-term health disorders.
The conditions that are likely to increase the number of medical errors are as follows (Koppel et al):
· extreme situations that require instant decisions. It has long been observed that most of the errors occur in critical situations. For example, sudden profuse bleeding, cardiac arrest, and so on. Therefore, the more complex a situation is, the more focused a doctor or a nurse should be.
· fatigue of a nurse or a doctor which follows after some complex actions can also lead to errors. Nurses and doctors must remember that the time period after a night duty is not good for making serious decisions or operations.
· forced need to do the work which is not typical of the profession. Unfortunately, lack of workforce and urgency of some situations often force a doctor or nurse to carry out some extra operations. Despite the rapid preparation for unusual transactions, maximum concentration will help even in the most difficult situations. However, duties should be performed by specialists.
In conclusion, errors are inevitable in the medical practice. Also, errors in this field have a lot of sad consequences. The only good thing that emerges from errors in medical practice is the possibility to avoid them in the future. No one is protected from committing mistakes. However, the main task of nurses and doctors is the prevention of errors, as they may cause irreparable damage to patients’ life and health.