Ethical Case Study
B’s nurse, took the phone order for the medication. Inwriting down the order, she mistakenly wrote “1000 mg IV bolus,followed by a drip at 2 mg per minute,” rather than “100 mg IVbolus, followed by drip at 2 mg per minute.” Amanda K, another RNwho had been pulled to the ICU from the pediatric unit, offered togive the medication because Karen was so busy. Amanda gave themedication as the order was written, and Mr. B promptly went intocardiac arrest. Resuscitative measures, including a pacemaker,proved futile in reviving him.
It was only after the code was over and Karen wascompleting her chart that she realized her error in writing down adose that was 10 times more than what was the usual dose. If shehad been giving the medication herself, she would have discoveredthe error immediately, but the pediatric nurse was unfamiliar withthe ICU medications and had given the full dose. The patient hadarrested so quickly after the medication was given that Amanda didnot have time to chart it. Because Karen was the only one who hadseen the chart and the order, it would be very easy for her tochange it. Amanda had already gone back to the pediatric unit anddid not even realize she had given a wrong dosage of this lethalmedication. It is also likely that no one else would ever discoverwhat really happened to Mr. B.
About that time, Mr. B’s wife arrived to collect hispersonal belongings. She stopped at the desk where Karen wascompleting her chart to thank Karen for her care of her husband.Karen felt very guilty about the incident and wondered if sheshould tell Mr. B’s wife what really happened.
Questions for Thought
1. Identify the key ethical principles that are involved in Karen’sdecision.
2. How would the decision be made based on each of thetwo major ethical systems?
3. What would be the consequences of the possiblechoices of action?
