NURS 6512 Ethical and Legal Implications of Prescribing Drugs The patient in this case scenario is an elderly 85-year-old lady

with significant cognitive decline at her end-of-life phase. She has renal failure, and heart failure, and has been on prophylactic anticoagulants. She is currently in immense pain and can barely tolerate procedures. The purpose of this paper is to explore the ethical and legal implications of prescribing drugs in this scenario. The aspects that will be addressed include the ethical and legal implications on all stakeholders, strategies to address disclosure and nondisclosure, the prescription writing process, and the minimization of medical errors.  
Ethical and Legal Implications for All Stakeholders 
The prescriber is ethically and legally obligated to prescribe medications that are safe and effective in attaining the therapeutic objective. This may necessitate the prescription of restricted medications such as opioids since the patient is in agony for adequate end-of-life care. The pharmacist is obligated to dispense the correct medication in appropriate doses. Both the prescriber and pharmacist should take responsibility and accountability for any medical errors. The patient and their families should disclose any information that may contribute to adverse outcomes such as comorbidities and current medications. The patient should also follow recommendations for the best therapeutic outcomes and seek clarification for any concerns about their management. 
 Strategies to Address Disclosure and Nondisclosure 
Disclosure and nondisclosure of medical errors are complex issues within the healthcare setting. Strategies for effective disclosure include avoidance of blame and speculation, sincere apology, reassurance of mitigation of resultant effects, strategies to prevent a recurrence, and training of healthcare professionals (Kalra et al., 2019). In Canada, policies dictate that healthcare professionals are obligated to fully disclose harmful, near-harm, and near-miss incidents to patients (Advice to the profession: Disclosure of harm. CPSO, n.d.). This will allow for the adoption of measures to mitigate resultant adverse outcomes, prevent future recurrence, and promote patient autonomy in making informed decisions. 
Strategies to Guide Decision-Making 
The patient in this scenario has significant cognitive decline which may necessitate the use of advanced directives, the patient’s family, and care teams in decision-making regarding treatment interventions. The decisions will be guided by the ethical principles of beneficence, nonmaleficence, autonomy, and justice (Varkey, 2020). The benefits and harms of each intervention should be weighed to avoid any harm to the patient. There should not be any coercion to therapeutic interventions. In case of medical errors, integrity should be upheld by promptly informing the patient and their family which prioritizes the patient’s interest.  
 Prescription Writing Process and Strategies to Minimize Medication Errors 
Prescription writing errors significantly contribute to medical errors with implications on quality of care, patient safety, legal, and economic sequelae. The prescription writing process follows a set standard that includes certain elements in prescriptions. These include the date of prescription, patient identifiers such as name, age, and gender, prescriber identifiers such as name, registration number, and contacts, and treatment description that meets the therapeutic objective (Nkera-Gutabara et al., 2020). The treatment should include the full drug name, dose, frequency, and duration of the regimen. Generic names, use of standard abbreviations, and legibility should be ensured to minimize medication errors (Nkera-Gutabara et al., 2020). The patient should also be educated on appropriate and correct drug use. 
Conclusion  
Drug prescription is an integral component of patient care that sometimes result in unexpected medical errors. These errors can have implications on patient safety, quality of care, and legal issues. In the event of harmful, near-harm, and near-miss incidents, healthcare professionals are legally and ethically obligated to disclose such events to patients and their families. This provides room for mitigation measures against resultant adverse outcomes, prevention of recurrence, and promotion of informed decisions by the patient. 
References 
Advice to the profession: Disclosure of harm. CPSO. (n.d.). Retrieved December 13, 2022, from https://www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Disclosure-of-Harm/Advice-to-the-Profession-Disclosure-of-Harm#:~:text=Physicians%20have%20a%20legal%20duty,valid%20consent%20for%20subsequent%20treatment.  
Kalra, J. (J., Campos-Baniak, M. G., Saxena, A., & Rafid-Hamed, Z. (2019). Medical error disclosure – A Canadian perspective in improving quality of health care. Advances in Intellig