Ethics

Many cases have been reviewed where medical practitioners and medicine as a career has been indicted of harming patients. Quiet killings are occurring and have occurred in our medical arenas. They have made headlines but no strict action is done to prevent this from happening in future. Just like everything else it soon recedes from our reminiscence. They do not prompt any public debate. As individuals and nation we are quite certain that these cases are idiosyncratic but no any justification to prove our confidence has materialized so far. A robust discussion should be conducted to perk up the methods of detecting and above all preventing these killings. The subject can no longer be overstated because the same people we trust our lives with have the power to slay us slowly because as patients there is nothing much we can do about it. The coherent structures that are underpinning this case is based on scientific and legal standpoints. As far as law is concerned we are after justice. Is the law effective or people will continue having it the easy way As far as science is concerned, is the hospital as an organization failing To ebb this it is lucid that something has to be corrected.

In this particular case where the nurse was accused of allegedly committing murder by administering massive doses of lidocaine to 13 patients and causing deaths, the evidence showed beyond reasonable doubt that the defendant killed the 12 patients by intent. The lidocaine concentration in the body tissues of the patients was essential proof though in the matters of law it depends on how best you give logic facts. Though it was precise evidence there was a great likelihood of the same being contested at trial on the grounds of logic and intent, experts testifying for the suit relied on various types of evidence to prove to the court the 12 patients and basically the 11 of whom had received remedial doses of lidocaine died of overdose. The first evidence that could have given proof despite the fact that there were no eyewitnesses is the concentration of this drug after autopsy was done. The second evidence is the proof of seizures that resulted from massive doses of lidocaine and the final evidence is basing it on electrocardiograph readings. Electrocardiograph is a painless method used to record impulses which precede the heart muscle contractions.  

The nurse was found guilty and sentenced to death as a result of the 12 counts of murder. Whether or not I agree with the verdict of California Supreme Court is one based on reckoning and either way I think the litigation should have been mitigated. The petition was based on the medical examiners record. The nurse substantial interest in the medical records could enable him or her to show that he was actually convicted and condemned to death for murders that did not happen. The nurse had the right to appeal for the same case on the grounds that the Supreme Court in the implementation of discretion and an effective order to balance any confidential concerns in relation to the nurse interest in the records is concerned.

The major legal question is whether the applicant of a case has any right to get access to the autopsy records as suggested by Appellate Division and incase he has no right whether the case presented establish a  substantial interest in the matters of law.  It is then true that the Appellate Division applied what we can call an erroneous legal standard of application. On the other hand though these cases might be rare, the prosecution after reading on the subject issue could conclude that the symptoms presented would be the main cause of deaths from overdose of the drug. Though electrocardiograph (EKG) readings might have been inclusive the prosecution could argue that it was due to the patients broad Quantron Resonance System (QRS) in their EKG. Whichever way there are other reasons that may have caused deaths and it could not just have to be that the nurse did it on purpose. Medical records should have been produced to authenticate the grounds of the case as the law permits the release of confidential documents depending on the circumstance and to prove whether the defendant was guilty or not basing on the patients records.

The appropriate standard of care pertaining to this case is one that is paramount. The didactic value of the findings on autopsy is well recognized in the medicine field. The results can disapprove or confirm the diagnosis of the medical practitioner and place that practitioner in a better position to treat patients with similar ailments in future. Actually the information obtained in some cases could save life of another patient. Therefore it is levelheaded and logical to conclude that the hospitals concern for eradicating its staff is one that is of substantial and public interest within the grounds of county law. The hospitals should make a point of doing a thorough research on when and to who this drugs or any other drugs should be administered to and why. Some of these cases are as a result of lack of knowledge as a drug can work in some people and fail to work in others.

Medical practitioners should know that lidocaine is contraindicated in patients with a medical history of hypersensitivity, nursing mothers and people suffering from hepatic diseases. Therefore, lidocaine topical solution should only be performed by clinicians who are well versed in management and diagnosis of dose- related toxicity and other known acute emergencies that may occur.  Altered sensitivity, under ventilation and delay of dose related toxicity may lead to cardiac arrest, acidosis or death. On this ground, hospitals should hire qualified practitioners and do thorough backgrounds research on the subject matter. Vigilant and constant monitoring of respiratory and cardiovascular imperative signs and the patients state of consciousness after every anesthetic injection should be fully accomplished. It should be known that anxiety, dizziness, tremors, blurred vision, drowsiness or tinnitus may be signs of central nervous system toxicity. With this knowledge incidences of similar cases can be controlled.

Errors in administration of medicine can occur easily when drugs are marketed in normal and similar packages. Lidocaine overdosing by use of a syringe is among the drug errors since its packaging is in both bolus and concerted forms. Use of premixed bags of lidocaine for concoction is effective to prevent errors of overdosing. Lidocaine can be diluted in glass bottles to reduce overdose and impact related to it. Generally lidocaine should be used cautiously and in reduced dosages by professionals. Every person including patients, doctors, technicians and the like are in position to contribute to system errors thus keen vigilance should be maintained to prevent such errors in future.