Medication

In emergency medicine, many things can go wrong. It is a fast paced environment, many things going on at once, and emergency rooms are an ideal place for mistakes to happen that can be life-threatening, and often fatal. A patient is brought in from a nursing home with a possible femur fracture and head injury. It is a busy day in the emergency room, and the nursing home did not give the paramedics any medical history on the patient. The doctor in charge of the patients left this particular patient in the hands of an intern, instructing her to contact the nursing home for the patient’s history. The intern followed the doctor’s instruction calling the nursing home and spoke to a receptionist who was no help and stated they would fax over the medication list. The patient is in severe pain, and the intern decided the patient should not continue in that pain and took it in her hand to medicate the patient with no prior medical history.

Doctors are trained to make the patient feel better, and they are ultimately there to save lives. An ethical principle the doctor faces in this scenario is beneficence. “It is the practice of doing the good thing.” (Morrison, 2009, p.11) The intern wants the patient to feel better and takes the necessary steps in order to do right for the patient. If the patient is medicated and feeling better, she did her job. The other ethical theory exemplified in this scenario is Deontology, which is “the concept of duty and respect for persons to define the appropriate ethical action.” (Morrison, 2009, p. 412) Similar to Beneficence, Deontology is performing your duty, and for doctors doing what is best for the patient, is the doctor’s responsibility, but, sometimes in the process of trying to do good; something may go wrong. In medicine, it is essential to know the history of the patient in order to properly medicate them. When no medical history is unknown, fatalities can occur.

The patient who had a femur fracture and head injury ultimately died at the hands of an intern, who decided to medicate the patient without having the medical history. The patient started seizing from a medication reaction and suffered from Serotonin Syndrome. This syndrome “is a potentially life-threatening adverse drug reaction that results from therapeutic drug use, intentional self-poisoning or inadvertent interaction between drugs.”(Boyer, 2005) Unfortunately, the intern is learning and did not have the guidance from her superior in this stressful situation in which is an area of ethical concern.

The resident in charge of the patient figured out why the patient died and falsified the medical records to cover up what the intern did. “Failing to disclose errors to patients undermines public trust in medicine because it potentially involves deception and suggests preservation of narrow professional interests over the well-being of the patient.” (Herbert, 2001) Basically, the resident failed to disclose what indeed happened and lied about the sequence of events; which is a felony. Falsifying a medical record is malpractice and it comes with a serious consequence. In most jurisdictions, it can lead to be charged with negligence or statutory port. (Shoo, n.d.) Other consequences can lead to loss of license to practice and even loss to hospital privileges. The ethics committee is going to meet to determine the consequences that the medical staff involved in this incident should face and what can be done in the future to make sure medical errors like the one that happened today will not happen again.

The ethics committee that will be meeting is formed of six participating members: The Head of the Ethics Committee, the Member of the Board, the Medical Director, Chief of Residents, Charge Nurse, and Social Services Representative. The Medical Director is the physician in charge at the time of the incident and was not directly involved with the patient, but it is the person in charge of foreseeing all emergency room