Analying Nurse Anesthetist S Practice in Many Delivery Models of Care Essay

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Drug Shortage on Anesthesia Providers

The rate of drug shortage has risen from 70 (2006) to 211 (2011). In the year 2012, the American Food and Drug Administration (FDA) reported over 225 drug shortages. These shortages affect anesthesiologists, in particular. According to the GAO (Government Accountability Office), central nervous system (CNS) drugs and anesthetics constitute 17% of total shortages; they also come under the categories of drugs regularly experiencing highest shortage frequency (Orlovich & Kelly, 2015). Eventually, drug shortage adversely impacts patients' safety. Numerous factors contribute to drug shortages, including disrupted supply of raw materials, lean inventory from producers to hospitals, and increasingly complicated international supply chain. FDA-implicated reasons for shortage include the novel Unapproved Drugs Initiative and failed inspections. A recent House Oversight Committee blamed FDA overregulation considerably. Critical supply producers are shut down due to insufficient documentation and technical breaches having marginal impact on safety. Clearly, the resultant medication shortage has threatened patient safety more than violation of regulation, which led to closing of manufacturing units. Industry consolidation, reduced profitability, variable demand and reduced manufacturing capacity have all played a role in causing specific shortage (Campbell, n.d).

Ethical Issue/Challenge

i. How drug shortage challenges "non-maleficent" and "beneficent" health care delivery

With regard to non-maleficence and beneficence, compelling evidence now exists of the fact that health systems, individual patients, and whole populations may suffer harm on account of drug shortages. A patient may be harmed when no equally effectual alternative drug can be found for his/her care, leading to compromised, precluded, or delayed care (Lipworth & Kerridge, 2013).

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Besides causing harm to individual patients, a shortage of drugs threatens public health. In fact, some regard this to be a public health emergency, as it threatens society's ability of preventing and treating acute as well as chronic illnesses (Singleton et al., 2013, 42).

Moreover, drug shortages endanger evidence creation as well as use of evidence-based drugs, as they hinder clinical research, making trials smaller, or halting or modifying them. Hence, clinicians find it hard to abide by evidence-based medical practice guidelines. Lastly, drug shortages cause harm to health systems, resulting in organizational and governmental commitment to considerable resources for supervision and management of the situation, as well as potential increased costs for alternative drugs that aren't normally used. Such expenditures constitute opportunity costs for the community and patients (Lipworth & Kerridge, 2013).

ii. How shortage of drugs challenges "just" care delivery

Shortage of drugs forces clinicians and pharmacists to make tough choices among patients, when allocating scarce resources. Sometimes, they are required to give priority to the youngest patient, or one who is most ill, or one who is on clinical trial, or is suffering from a rapidly progressing disease, or who will most likely benefit from the medication. The necessity of this sort of triage, together with its ethical consequences, is recognized by several organizations that have endeavored to come up with resource allocation guidelines in times of drug shortage. Further, it has been observed that organizations are ethically-obligated to be ready for situations of drug shortage. This can be done by.....

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