The document discusses the ethical dilemma of the standard of care for prescribing drugs as medical treatment. While prescribing drugs is the legal standard of care, it can often do more harm than good due to dangerous side effects. An estimated 106,000 patients die annually due to adverse drug reactions. The standard of care seems to prioritize legal and financial concerns over the Hippocratic oath of "first, do no harm". There is a need for reforms that shift the standard of care towards preventative medicine and away from over-prescription of drugs.

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Ethics: the Dilemma for Standard of Care
Cases for prescription drug
Student: Modupe Sarratt
University of Maryland University College
Professor: Felencia McGee
October 25, 2015

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Abstract
Ethics like politics is about good and evil for dilemma. What is legal may not be the law for
practicing medicine. According to the Journal of Clinical Pharmacology “above all, do no harm”
(Smith 2005) is the ethics (beliefs) for “To Err is Human” according to Bootman, J. L. (2000) for
“confronting the myths of psychiatric drugs” Barker and Buchanan (2012). Standard of care for
drug is treatment is contradiction to drug errors and side effects that kill 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 “practicing medicine is “death by medicine” Null et al, (2010), to
propose preventive medicine to stop disease.

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Ethics: the Dilemma for Standard of Care
Doctors and the Hippocratic Oath for first to “do no harm” has been central to 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). Practicing medicine is the science of diagnosis diseases, providing treatment with
prescribing drugs. The ethical dilemma is the standard of care for practicing medicine is the
problem of adverse side effects of drugs 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. The 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. Medical law explains professional liability, the
meaning of standard of care; define the term tort, statute of limitation, and procedure for
administering and dispensing control substances.
The standard of care for practicing medicine (drug) for treatment (care) can never be
about ethics between doctors and patients. For the medical law to protect the doctors from
potential lawsuits by patients, although legal, is unethical. For example, in the course of
diagnosed patient for diabetes to prescribe a drug with side effects is a doctor following the law
to treat disease with drug. The problem for standard of care is patients are powerless to challenge
doctors’ order.
Recently in the news, several patients wrongfully diagnosed with cancer for
chemotherapy. According to Moghe (2015), a prominent doctor from Michigan admitted lying to
healthy patients to infuse “chemotherapy” to participate in Medicare. The doctor indicated his

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action is driven by competition for patients with health 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.
Then again, 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 to cause sickness. Catching a cold, a viral infection for
change of season is common and does not require treatment. Flu is viral and bacterial infection
for fever to fight the bacteria. Nevertheless, the worst is the adverse side effects of antibiotic
include shortness of breath, fainting, and convulsion for the use of drug outweighs the benefit of
health.
Ethics
There are no medical ethics that said ‘to treat patients’ right by giving advice’ instead, the
standard of care is drug for treatment is practicing medicine for compliance, cannot apply to the
doctrine “to do no harm”. There is no ethical issue to take “drug” or not to take “drug” is a
patient choice. Ethical depends 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

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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.”
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 system”.
Is there a solution to healthcare crisis?
Without a change to the current system for standard of care by prescription of drugs as
the treatment for healthcare coverage, the answer is no. To propose going back to “do no harm”
is preventing illness for preventative medicine is the legal standard. There is no harm in
preventing. Preventing an illness is better than curing a sickness.

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References
Barker, P., & Buchanan-Barker, P. (2012). First, do no harm: Confronting the myths of
psychiatric drugs. Nursing ethics, 0969733011429017.
Bootman, J. L. (2000). To err is human. Archives of internal medicine, 160(21), 3189-3189.
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.