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Ethics: the Dilemma for Standard of Care

Case for Prescription Drug

Student: Modupe Sarratt

University of Maryland University College

Turnitin: 14% Final

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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. Ethics for the doctors’ moral code for medicine is, “First, To Do No Harm”

for standard of care. The dilemma to use drugs for treatment as the standard for care creates

problems for drug side effects that cause harm and death of patients. According to Barker &

Buchanan (2012), “First, do no harm: Confronting the myths of psychiatric drugs”. The problem

of the drug side effects and prescription errors kill more 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 for “practicing medicine”. According to Null et al., (2010) is “death by

medicine.” to suggest we need a new system of health care delivery that can be counted on for

patient safety because the purpose of practicing medicine is to help patients.

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Ethics: the Dilemma for Standard of Care

In the case of prescription drug, the ethical issue is standard of care for treatment, and is

complicated because of adverse drug effect. Doctors and the Hippocratic Oath for first to “do no

harm” has been central to the 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). The dilemma for standard of care by drugs is the

problem for unexpected adverse reaction to drug that harms patients 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. 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. Lewis & Tamparo (1993) medical law “explain

professional liability, the meaning of standard of care; define the term tort, statute of limitation,

and procedure for administering and dispensing control substances” (p. 57-60). Therefore,

doctors do not require being an expert in medical law in order to respond constructively to the

ethical dilemmas encounter in the course of practicing medicine.

The standard of care for practicing medicine is a drug for a treatment can never be about

ethics between a doctor and a patient. For the medical law to protect the physician from potential

lawsuits, although sometimes legal, is by definition unethical. For example, in the course of

diagnosed a patient for diabetes to prescribe drugs that cause harm with side effects is a doctor

following the law to prescribe drugs to treat disease. The problem for standard of care is patients

are powerless to challenge doctors’ order.

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Recent news by CNN (Moghe 2015) involving several patients wrongfully diagnosed to

have cancer for chemotherapy. According to CNN, a prominent doctor from Michigan admitted

lying to healthy patients to infuse “chemotherapy” to cause cancer for participating in health care

coverage. The doctor indicated his action is driven by competition for health care 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”. Alternatively, some 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 cause sickness for

practicing medicine (use of drugs) for treatment. To catch the flu without a flu shot is rare.

However, catching a cold, a viral infection for change of season is common and does not

require treatment. The difference between a cold and flu is flu comes with fever, stomach cramp;

nausea and body ache for fighting bacteria mixed with viral for the flu shot. Nevertheless, the

worst is the side effects of antibiotic for treating flu include shortness of breath, fainting, and

convulsion, Flu vaccine to cause sickness to prescribe antibiotic is practicing medicine “drugs”

to hamper bacteria and damage tissues is to do harm by treatment.

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Ethics

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

standard of care is prescribing drugs with side effect is practicing medicine “drug” for

compliance with treatment that cannot apply to the doctrine “to do no harm”. There is no ethical

issue to take “drug” or not to a drug for a choice. Ethics depend 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 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.” Because health is one value to another for willingly

to accept some risk to health to pursue other goods.

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 systems”. To suggest that department

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of health and human service can lead by create health information standard for critical and time

sensitive communication for patient safety.

Is there a solution to healthcare crisis?

Without a change to the current system for standard of care of practicing medicine by

diagnose diseases to prescribe drugs for treatment for health care coverage, the answer is no. To

propose going back to “do no harm” is preventing illness by advising is practicing preventative

medicine for legal standard for “to do no harm”. Preventing an illness is better than curing a

sickness and there is no harm in preventing. While diagnosing a disease to prescribe drug to cure

a disease is the cause of a sickness from the use of drug to mark a disease cause by damage for

lasting effect is a scar because there is no cure for a disease. A drug to cure cancer is a scar of a

treatment for tissue damage. A sickness is scar of drug treatment. The solution will be the

technology of telemedicine for telehealth care as the alternative to the tradition of practicing

medicine for primary care.

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References

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

psychiatric drugs. Nursing ethics, 0969733011429017.

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.

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