Ethics Case Study
HCS 335
March 2, 2015
Victor Gibb

Ethics Case Study
Ethics is a branch of philosophy in which human actions are judged to be either right or wrong based upon a person's particular set of values, when these judgments are applied to a specific profession than they are referred to as professional ethics (Garret & Baillee, 2009). Personal and professional ethics often overlap and sometimes the two conflict. There are also scopes that apply to professional practice, and one must adhere to their scope and not practice outside of that scope. This paper will explore the ethical and legal concerns related to a case of whether or not a licensed practical nurse (LPN)/ certified medical assistant (CMA) should call in a refill for a prescription for a patient/friend of the doctor he works for.
Jerry’s medical training does not qualify him to issue an order for a refill on the prescription for Valium because prescribing medications is not listed in the scope of practice for LPN’s/CMA’s in any state. LPN’s may administer medications but prescribing of medication is limited to medical doctors, physician assistants, nurse practitioners and psychiatrists (American Nurses Association, 2015). Jerry could take a verbal order to renew the prescription from the doctor if the doctor were available to give that order as an LPN (Fremgen, 2009). CMA’s are also not able to prescribe medications and are not able to take verbal orders to for medications; therefore Jerry cannot legally call in the refill for the prescription. Drugs that require a prescription require an evaluation from a medical doctor to determine continued need and effectiveness of the medicine.
There would be no difference in the legality of Jerry calling in the prescription for high blood pressure pills versus the Valium because both pills require a prescription and Jerry is not medically nor legally qualified to make a decision as to whether or not a prescription should or should not be refilled. If the medication were high blood pressure pills the refill could be called into a pharmacy near the destination of the patient's flight to be available when he arrives so not to cause any adverse happenings from not having his medication, after an order was obtained from the doctor to do so. Valium, however, is a Schedule IV drug that requires monitoring. While the risk is low, there is still potential for addiction to and abuse of this medication (Drug Enforcement Administration, 2015). It would also not be ethical for Jerry to call in this prescription because he knows it is not within his scope of practice and while harm cold result in him not calling in the prescription whether it be the Valium or a blood pressure medication, harm could also result from him calling in the prescription without the order from the doctor, as he does know the dosage or frequency to prescribe.
The doctrine of respondent superior translates to "let the master answer", which essentially means that the doctor can be held responsible for negligent activities for those in which they employ. The liability is limited to that which is in the scope of practice of the employee and what is delegated (Fremgen, 2009). Jerry would not be protected from lawsuit if the patient were to have an adverse reaction while flying because he did not receive an order from the doctor to refill that prescription. Jerry took it upon himself and practiced outside of his scope of practice in calling in that prescription. While the physician will still hold liability because Jerry performed the act while, under his employment, Jerry can still be sued and found liable for damages.
The major legal issues that may affect Jerry’s decision would be his liability should an adverse event occur. Jerry could be sued and held financially liable if an adverse event were to occur Jerry could also face criminal charges for fraudulently prescribing a medication. Jerry could also lose his job and license for practicing outside of his scope. The major ethical issues Jerry would face would be the guilt of not being able to help the patient out immediately. The dilemma of calling in the refill versus not calling in the refill would be one that Jerry would have to weigh the consequences versus the benefits to decide which he felt would be the best possible ethical and legal decision.
The three-step ethics model would assist Jerry in making the best possible decision because he can ask himself the three questions to help in making the most legal and ethical decision. The first question is it legal for Jerry to call in a refill for this prescription for Valium, the answer no, not without a verbal order from the doctor. The second question is it balanced, can be answered by determining will him calling in or not calling in the question cause unnecessary suffering to the patient and the answer cannot be entirely determined. Jerry does not know this patient and does not know if he truly needs the medication to fly. Jerry does not know the benefits nor the consequences to the patient of calling in or not calling in this refill. The final question how does it make you feel, can be answered by Jerry asking himself how he would feel if he were to call for the refill versus if he were not to call in the refill. There is only one question Jerry can answer for sure so it would have to be deemed both unethical and illegal for Jerry to call in the refill without a doctor's order.
My advice to Jerry would be to explain to the patient that he cannot call for the refill, however he will call the doctor give him the information and have the doctor call in the refill as soon as he hangs up the phone. Jerry should not risk his license, financial security and freedom when a phone call can be made to the doctor to solve this issue. Jerry can call the patient back as soon as he hangs up with the physician to confirm with the patient as to whether or not the prescription will be refilled.
Jerry is placed in a sticky situation when this patient calls. Jerry is faced with a decision of fulfilling what the patient claims is a need with a short time frame to make that decision. Jerry must use his best judgment in making the best possible legal and ethical decision so not to impact the patient or his career negatively. The use of the three-step ethics model will help Jerry quickly determine the best possible choice. In conclusion, there are consequences to either choice Jerry makes, Jerry just has to decide which effects he feels are the least consequential to all parties involved.

References
American Nurses Association. (2015). Professional Standards. Retrieved from http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/NursingStandards
Fremgen, B. F. (2009). Medical law and ethics (3rd ed.). Upper Saddle River, NJ: Pearson Prentice Hall.
Garrett, T. M., Baillie, H. W., & Garrett, R. M. (2009). Health care ethics: Principles and problems (5th ed.). Upper Saddle River, NJ: Prentice-Hall.
US Department of Justice. (2015). Drug Scheduling. Retrieved from http://www.dea.gov/druginfo/ds.shtml