The scenario, which this paper will examine, involves Jerry McCall, an office assistant with training as both a Licensed Practical Nurse (LPN) and a medical assistant. Jerry, alone in the office, receives a call from a patient asking him to call in a prescription for Valium to a local pharmacy. The patient states that he is heading to the airport and is in need of the prescription. The patient also relays to Jerry that he is a friend of Dr. Williams and that Dr. Williams usually gives him some Valium before he flies. Jerry is faced with an ethical dilemma on whether or not to call in a prescription for Valium. Ethically, the answer is not. Jerry, in this scenario, is working as an office assistant and even though he has both trainings as a medical assistant and an LPN, he is not authorized to refill a prescription. Even if Jerry were working as an LPN for the day he does not have the authorization from Dr. Williams to make that call. In doing so, Jerry could lose his licensure. Jerry should also be suspicious about the patient claiming that he is using Valium as and anti-depressant when it is intended to be used as an anti-anxiety medication.
Valium (Diazepam) is classified as a schedule IV controlled dangerous substance (CDS). This type of substance requires a Drug Enforcement Agency (DEA) license to prescribe. According to the U.S. National Library of Medicine (2010), within any given six-month period, Valium, along with any medication in this medication schedule, can only be refilled five times. For a prescription of this nature, the patient’s chart would need to be reviewed as well as obtaining an authorization from Dr. Williams for the prescription. If the prescription had been for something else, like blood pressure medication, Jerry might have been more apt to refilling it because it is needed to maintain the patient’s health. Regardless of what the prescription refill is for, Jerry does not have the authorization to call in any refills as an office assistant. According to Nolo’s Plain-English Law Dictionary (2011), the doctrine of respondeat superior is a common-law doctrine that states that an employer is responsible for the actions of an employee while in the scope of employment.
That being said if in the scenario Jerry did, in fact, call the prescription refill in and the patient suffered an adverse reaction Dr. Williams may not be held liable. This is because Jerry acted beyond his scope of duties assigned him. Ultimately that decision is left up to the court as to who is liable. Jerry’s dilemma can be solved in a couple of ways without resulting in unethical behavior. First, the patient is unrealistic in his request for an immediate refill for the Valium prescription. Most physicians’ offices require at least 24 hours for prescription refills; at the very least some may require at least until the end of the business day. Most likely the patient knew that he would be flying and in need of a prescription refill before this day. Jerry should refer to the office’s policy on prescription refills when speaking to the patient. Jerry could also call Dr. Williams and ask him to refill the Valium prescription.
Carrying out the patient’s request to refill a prescription would be a violation legally and ethically. Legally, Jerry is restricted from refilling the prescription because he does not have the authorization to do so and because he is working as an office assistant for the day. Ethically Jerry would be violating the trust given him by Dr. Williams if he did refill the prescription. Either way it is and lose-lose situation. There are five approaches to values that philosophers have developed to help an individual determine what standards of behavior are most appropriate in a particular situation. The utilitarian approach analyzes the various courses of action and determines which provides the greatest good for the greatest number. The rights approach determines which option respects the rights of those who have a stake in the decision. The justice approach seeks to choose which option best treats people equally. The common good approach seeks to choose the option that best serves the community.
Lastly, the virtue approach determines the course of action that leads an individual to act like a person that he/she strives to be. These approaches need to be reviewed in order to determine the best course of action when faced with an ethical dilemma. Developing a problem-solving method of working through ethical dilemmas would help Jerry to make ethical decisions more easily. The first step in solving an ethical problem is to recognize what the ethical issue is. In this scenario, the issue is Jerry fulfilling a patient request to call in a refill without proper authorization. Once determined, Jerry should gather all the facts relevant to the situation. The facts in this problem include Jerry’s lack of authority to fulfill the request, his responsibility to act in a professional manner and work within the law, and the liability for the ramifications of his actions.
Next, Jerry should evaluate the options he has in the situation by reviewing the above-mentioned approaches. Then, considering all the approaches, Jerry must decide which option suits the situation best. If Jerry chooses to refill the patient’s prescription he could end up in a situation where legal action is taken, he could lose his job and also his LPN license. If Jerry chooses not to grant the patient’s request, he takes the chance of upsetting the patient and the possible end of the patient relationship with the facility. By using the problem-solving method, Jerry should find it easy not to grant the patient’s request.
Dictionary.com. (2011). World English Dictionary; Ethics. Retrieved April 18, 2011 from http://dictionary.reference.com/browse/ethics Nolo’s Plain-English Law Dictionary. (2011). Respondeat Superior. Retrieved April 18, 2011 from, http://www.nolo.com/dictionary/respondeat-superior-term.html U.S. National Library of Medicine. (2010). Diazepam. Retrieved April 19, 2011 from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000556