Aga Khan University, School of Nursing and Midwifery, Pakistan
Received Date: October 29, 2016; Accepted Date: December 14, 2016; Published Date: December 19, 2016
Citation: Ameen F (2016) Drug Abuse among Health Care Providers. J Clin Res Bioeth 7:293. doi: 10.4172/2155-9627.1000293
Copyright: © 2016 Ameen F. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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I would like to commence my commentary article with the most frequently asked question in every society that why does man become a drug addict? The answer is that, one usually does not intend to become an addict. Someone woke up in the morning and become a drug addict, studies has shown that it takes at least three months’ shooting twice a day to get any habit et al. . Studies have proven that mostly drugs addict’s start taking narcotics without any reason (WHO, 2011). Drug addiction is a chronic, often deteriorating brain disease that causes compulsive drug seeking and use, despite the harmful significance to the drug addict and those around them, and if we specifically talk about the narcotic drug addiction which is taken intravenously, it is more dangerous and harmful than the others . Moreover many studies have shown that, influence of narcotic drugs is its availability . The aim of this commentary article is to discuss clinical scenario on the ground of ethical principal of autonomy, beneficence, and non- maleficence.
I had noted this incident in one of the famous hospital of Karachi, who provides tertiary care to their patient on an optimum level. A senior registered nurse (RN) become addicted to an injection nalbuphine hydrochloride after his road traffic accident (RTA), at that time doctor advised him to take injection nalbuphine hydrochloride on need basis, and then stop. Nevertheless as he recovered from the injury, he continued taking the drug and became addicted. As the days passed, quantity of drug was also increased, which was very perilous for his health and wealth. It was very surprising for me that, he start stealing the injection from the unit drug stock and there were few staffs who knew that, they also supported and help him to arrange the injection, ultimately the staff became ill and did not paid attention on his work, moreover he started issuing extra medication on patients in order to complete unit stock medicine, indeed ethically this is not good. When I came to know this incident, I was confused either should I informed this incident to the authority or not?
This scenario highlighted a dilemma, when the co-workers also supported the drug addicted staff, and confused in their decision that, should they disclose this incident to the higher management or not. The nurse’s code of ethics articulates the ethics and the values of nursing profession by affirming that nurse’s responsibility is to be professional, stay true with the lawfulness of their practice, and follow the nursing code of ethics as well as hospital policy in truth telling. Moreover it was a challenging ethical issue, if we look around the organization then we come to know that organization was International Organization for Standardization (ISO) certified and working on Joint Commission International Accreditation (JCIA), this type of record puts negative impact on the organization. In addition to this, a study has shown that organizational factors, staff performance, and geography of inspiring behavior on individually basis, and staff makes potentially difference by their own personal efforts . In addition decisions making based on a sound foundation of ethics is an indispensable part of nursing practice in all specialties and circumstances.
There are various ethical theories and principles applicable in this scenario. According to the liberal individualism i.e; Right Based Theory “statement of right provides vital protection of life, liberty, expression and, property” . If there was liberty in the hospital where the incident has been occurred, then those who were involved along with concern person would have easily informed to the management, but unfortunately they did not, and also involved in this crime, if the management gave the enough liberty to their staff then there was possibility to stop and control the recurrence of this kind of events, as a regular practice. In addition to this, theory also protests against oppression, unequal treatment, intolerance and arbitrary invasion of privacy.
Blaming is a common attitude in our society, we often find it easy to blame rather than digging out for cause. Studies have confirmed that encourage narcotics abuses is major cause of unhappiness of life . Nevertheless, there are several reasons which influence a person towards addiction such as; personal problems, work overload, social injustice, poor lifestyle, disappointment with the co-workers and family, and lack of self-realization . These are all the thing which really matter and influence toward drugs abuse. As the matter of fact same ethical dilemma existed in the scenario that is, fear of action among coworkers. We cannot even deny from the anxiety of outcome that is the core factor behind it, staff did not notify to the management. There is proper time for every action; once the time has gone then the usefulness of action is no more recognized. Same situation happened in this scenario, when there was initial time to report, staff did not bother to tell the truth, but when the management came to know about the incident, they took cruel decisions and fired all those staffs who were involved in this incidence.
In our society doctors are more dominant than nurses, which weaker the nurses to take their decision into action, and ultimately management also give support to doctors more. On the other hand the nurses ensure that their decisions are in beneficences of patient and organization rather than personal perspectives. In addition for medical staff who took an oath of non-maleficence and beneficence this could be viewed as a breach of duty .
The staff has also rights that they can take the decision for their patient and organization benefits. However, the patient and organization will not suffer by their convention. The clinical decision underlying health care is essential for the excellence and quality of nursing care. Though, nurses have in-depth knowledge about their patients, whereas patients are the experts in their value beliefs and preferences . Nurses are always forefront of the hospital and patient care, so they must be efficient in their work, in this way patient can get maximum benefits from them , but when we talk about the autonomy of the nursing staff then he has full rights to take their own decision from patient and organization perspective because the nurses spend more time in patient care and act like backbone of every health care setup, Staff have rights to take early decision to inform to the management confidently, if they saw any unethical act around them which protect them from hazards. Moreover if it this could apply here so the addict would not get suffered, nor the other staff would be fired from their jobs and the patient’s financial burden was not increased.
There are several schools of thoughts which have highlighted a relationship between friends and colleague. According to Beauchamp and Childress (2001), there is an “Ethics of Care Theory” which is based on relationship which refer the care from emotional aspect as well as commitment of an act on behalf of one has a significant relationship .
It is hard to deny from this fact that those staff who were involved to help their friend, faced several conflicts with relationship , famous psychologists [9,10], explained two modes of relationship, first one is ethics of care and second is ethics of rights and justice. Those nurses who were involved in this event were actually worked on ethics of care. Moreover, on the other hand they were failed to act on ethical rights and justice with patient as well as organization.
In the light of literature review related to my commentary article, I consider my stance that if I were in their shoe, then I would not even consider to help him to stolen the drugs from the unit stock, not only I would have informed the higher management but also warned the concern staff too. However, he was my colleague but I put my friendship after my duty and commitment with the organization. According to the American nurses association code number seven, nurses always initiate the activities that would contribute in development of professional advancement.
In above scenario, I would like to recommend that narcotic drug should be locked and camera must be placed at the front of the cabinet in this way whenever staff will open it he will be recorded In addition to this; the stock of narcotic drugs should be limited in number, because due to this action, chance of blunder could be minimized. As I have mentioned in my scenario that coworkers were also involved so we can make proper handling and taking over and give the key to the team leader only. Beside this we can arrange an in-service session on narcotic policy for R.N’s Technicians and doctors, in this way the record will be maintain properly and chances of dishonest would be reduced. I think these are all the recommendations that would play key role to reduce the chance of miss use of narcotic drugs.
In the end, I conclude that drug addiction is not acceptable in any circumstance, if we identify the person in our society and surrounding then we should inform to an authorized person, insisted to help him and support him in this crime. Study has shown that drug addiction can be managed effectively like other disease such as diabetic, asthma, coronary artery disease; nonetheless it requires a lot of effort and motivation to quit .