Some fear of prosecution of doctors is warranted
May 1, 1999 2 minutes read
Some fear of prosecution of doctors is warranted
Some degree of apprehension by physicians administering high-dose opiates is appropriate, as long they do not go overboard, says Ann Alpers, JD, a professor of medicine at the University of California-San Francisco Medical School. She adds that there are no good data on how physicians actually perceive the risk.
"The role of criminal law is to deter some types of behavior, so it’s not bad that a physician should pause and consider that giving a bolus of potassium chloride might be illegal," she says. "You want physicians to be quite careful and thoughtful in these situations. They shouldn’t be fearful out of proportion with the actual risk of prosecution, so maybe that’s where risk managers can come in with some advice."
Be alert for expressed concerns
Grena Porto, RN, ARM, DFASHRM, director of clinical risk management and loss prevention services at VHA Inc. in Berwyn, PA, and president of the American Society for Healthcare Risk Manage ment, says risk managers should be on the alert for doctors or staff expressing any concern about the potential legal liability of administering high-dose opiates. Take the concerns seriously, she says, and seize the opportunity to educate not only that individual but perhaps everyone working in that unit about the facts concerning high-dose opiates and criminal prosecution.
Any expression of concern could be an early warning that the doctors and staff on that unit do not understand the issues surrounding pain relief for the terminally ill. It is possible that someone on the unit has expressed concern and started a debate, or someone may even pass on bad information with the best intentions of cautioning colleagues against criminal liability.
"I’d tell them that I understand their concerns, but that we just don’t see this kind of prosecution very much," Porto says. "You shouldn’t let this kind of concern keep you up at night, but at the same time, you should be prompted to go down and review the procedures on that unit. Everyone there needs to be briefed on the facts, right down to the unit secretary."
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