By Robert M. Veatch; Amy Haddad
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Extra info for Case Studies in Pharmacy Ethics, Second Edition
Lucas, conversely, is very likely to be affected. At least he needs to begin immediately receiving the right medication, but that may not require disclosure of the error. Then, too, disclosure may be distressing to him. A good case can be made that the error should be kept between Dr. Fowler and those who need to know in order to correct it. Utilitarianism differs from Hippocratic ethics by not focusing on the principles of beneﬁcence and nonmaleﬁcence but on which consequences are relevant. Utilitarianism holds that the option that would bring about the greatest good for the greatest number should be chosen.
Utilitarianism would consider the effects not only on the two patients, Mr. Lucas and Mr. London, but also on the pharmacist who apparently made the error and the nurses who failed to check the medications and catch the error. It would consider the families involved. Most critically, it would consider the effects on future patients who might beneﬁt if the error is reported and procedures are put in place to make sure it does not happen again. We have at this point identiﬁed several possible courses of action and the implications of various ethical principles for each of those courses.
London cannot be helped by the disclosure, and Mr. Lucas probably can be helped as much without it. A more social form of a consequence-based ethic, such as utilitarianism, leaves us in an ambiguous spot. Harms can come—to the families who will be placed in distress and certainly to the pharmacist who made the error. Signiﬁcant beneﬁts from disclosure also can be expected, perhaps to Mr. Lucas but deﬁnitely to future patients. It is possible that the family members might gain beneﬁts as well. Notes 1.
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