Full Answer Section

Patient’s Family: The patient’s family has a right to be involved in decision-making about the patient’s healthcare. This includes the right to be informed about the potential risks and benefits of the new medication, as well as the right to refuse to allow the patient to participate in the study.

Disclosure and Nondisclosure

The advanced practice nurse in this scenario has a duty to disclose all relevant information to the patient or the patient’s parents before enrolling the patient in the study. This includes disclosing the following information:

• The fact that the new medication is not approved for children under the age of 12
• The potential risks and benefits of the new medication
• The fact that the patient will be randomly assigned to receive either the new medication or a placebo

The patient or the patient’s parents have the right to make an informed decision about whether or not to enroll the patient in the study, based on this information.

Strategies for Addressing Disclosure and Nondisclosure

The advanced practice nurse should use the following strategies to address disclosure and nondisclosure in this scenario:

• Provide the patient or the patient’s parents with written information about the study, including the potential risks and benefits of the new medication.
• Answer any questions that the patient or the patient’s parents have about the study.
• Allow the patient or the patient’s parents to take their time to make a decision about whether or not to enroll the patient in the study.
• Respect the patient’s or the patient’s parents’ decision, even if they decide not to enroll the patient in the study.

Strategies to Guide Decision-Making

The advanced practice nurse can use the following strategies to guide decision-making in this scenario:

• Consider the patient’s individual circumstances, including the severity of the patient’s asthma and the patient’s response to previous treatments.
• Weigh the potential risks and benefits of the new medication.
• Respect the patient’s or the patient’s parents’ right to make an informed decision.

Whether to Disclose an Error

In this scenario, the advanced practice nurse must decide whether or not to disclose to the patient or the patient’s parents that the new medication is not approved for children under the age of 12. The advanced practice nurse should disclose this information to the patient or the patient’s parents so that they can make an informed decision about whether or not to enroll the patient in the study.

Justification

The advanced practice nurse has a duty to act in the best interests of the patient. This includes disclosing all relevant information to the patient or the patient’s parents before enrolling the patient in the study. The advanced practice nurse also has a duty to be honest with the patient or the patient’s parents.

Writing Prescriptions

To minimize medication errors, the advanced practice nurse should use the following strategies when writing prescriptions:

• Use clear and concise language.
• Avoid abbreviations.
• List all medications the patient is currently taking.
• Specify the dose, frequency, and route of administration for each medication.
• Provide the patient with written instructions on how to take the medication.
• Review the prescription with the patient or the patient’s parents before dispensing it.

Conclusion

This scenario raises a number of ethical and legal implications for all stakeholders involved. The advanced practice nurse must carefully consider all of these factors before making a decision about whether or not to enroll the patient in the study.

Laws Specific to California

In California, the following laws are specific to disclosure and nondisclosure:

• California Civil Code Section 43.93 requires healthcare providers to disclose all relevant information to patients before obtaining informed consent for treatment.
• California Business and Professions Code Section 2238