1. ETHICS 1
Ethics: the Dilemma for Standard of Care
Case for Prescription Drug
Student: Modupe Sarratt
University of Maryland University College
Turnitin: 14% Final

2. ETHICS 2
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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