Name
Chamberlain University
NR-506: Healthcare Policy
Prof. Name
Date
In the case study presented, all members of the healthcare team face both ethical and legal implications due to the inappropriate actions of the medical assistant. Each professional role carries distinct responsibilities, and any deviation from these duties can result in patient harm, professional misconduct, or legal accountability.
The medical assistant (Stephanie) violated both ethical standards and legal boundaries.
Ethically, her duty is to uphold the principle of nonmaleficence—to avoid causing harm. By independently prescribing amoxicillin, she placed the patient at risk of adverse outcomes such as allergic reactions, incorrect dosing, or ineffective treatment.
Legally, Stephanie acted outside of her permissible scope of practice. Medical assistants cannot prescribe medications, falsify provider credentials, or forge signatures. These actions could result in suspension or revocation of certification, criminal charges, financial penalties, and permanent exclusion from medical practice (Office of Professional Licensure and Certification, 2017).
The nurse practitioner (NP) also faces ethical and legal implications.
Ethically, the NP failed to ensure justice, meaning that patient care was not supervised or delivered fairly across all patients. Lack of oversight created an unsafe care environment.
Legally, negligent supervision is a major concern. If the NP had verified prescription renewals and enforced practice protocols, the medical assistant’s misconduct could have been prevented. This failure exposes the NP to malpractice liability and possible disciplinary action by the state board (Office of Professional Licensure and Certification, 2017).
The medical director, as the overseer of the practice, holds the ultimate responsibility for organizational oversight.
Ethically, the director is accountable for inadequate staff training, poor supervision, and insufficient verification of employee competencies.
Legally, the medical director is responsible under the doctrine of respondeat superior, which states that employers are liable for the actions of their employees. Potential consequences include lawsuits, fines, and damage to the credibility of the practice (Cornell Law School, 2020).
| Role | Ethical Implications | Legal Implications |
|---|---|---|
| Medical Assistant | Breached nonmaleficence; acted outside training; endangered patient safety | Forgery, impersonation, unauthorized prescribing; possible license revocation, fines, or criminal charges |
| Nurse Practitioner | Failed justice principle; did not supervise properly | Liability for negligent supervision; risk of malpractice claims |
| Medical Director | Poor oversight, inadequate staff training, and hiring practices | Liable under respondeat superior; lawsuits, fines, or loss of organizational credibility |
To prevent recurrence of such incidents, multiple strategies should be applied at the organizational level:
Education and Training – Provide continuous education on state-specific scope of practice laws, ethical principles, and legal boundaries. Training should include case-based scenarios to reinforce safe decision-making.
Credential Verification – Require routine background checks, updated licensure verification, and credential audits for all staff members.
Clear Role Contracts – Establish written contracts outlining job responsibilities, prohibited actions, and liability expectations for each role.
Policy Development – Update and enforce protocols regarding prescription renewals, delegation of tasks, and clinical supervision.
Risk Management Practices – Encourage all team members to maintain malpractice liability insurance to protect against unforeseen human errors (Emergency Care Research Institute, 2015).
These measures can foster accountability, reduce malpractice risks, and strengthen ethical practice across the healthcare team.
As an Advanced Practice Registered Nurse (APRN), effective leadership is critical in creating a culture of accountability, safety, and collaboration. The following qualities are essential:
Collaboration and Coaching – Promoting teamwork ensures that all professionals value each other’s expertise. Coaching less experienced staff builds confidence and reduces the risk of boundary violations.
Ethical Decision-Making – Applying ethical principles (justice, beneficence, nonmaleficence, and autonomy) helps guide fair and safe care delivery.
Policy and Research Integration – Staying updated with evidence-based practices and incorporating them into protocols strengthens organizational credibility.
Communication and Transparency – Open communication channels encourage staff to report concerns without fear of retaliation, thereby preventing misconduct.
Change Management – Leaders must inspire trust while implementing new systems or regulations, ensuring staff buy-in to foster a safer practice culture (Heinen et al., 2019).
By applying these leadership qualities, the APRN can transform the culture into one that values patient safety, ethical responsibility, and continuous improvement.
Cornell Law School: Legal Information Institute. (2020). Respondeat superior. https://www.law.cornell.edu/wex/respondeat_superior
Emergency Care Research Institute. (2015). Scope of practice laws for nurse practitioners and physician assistants. https://www.ecri.org/components/PPRM/Pages/LB5.aspx?tab=2
Heinen, M., van Oostveen, C., Peters, J., Vermeulen, H., & Huis, A. (2019). An integrative review of leadership competencies and attributes in advanced nursing practice. Journal of Advanced Nursing, 75(11), 2378–2392. https://doi.org/10.1111/jan.14092
Office of Professional Licensure and Certification: New Hampshire Board of Nursing. (2017). Statements related to lying, fraud, theft. https://www.oplc.nh.gov/nursing/lying-fraud-theft.htm
