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Ethical Dilemmas in Practice
Insulin overdose

Abstract

The dilemma in the June issue concerned a diabetic cat that was mistakenly given a tenfold overdose of insulin by an experienced nurse (In Practice, June 2010, volume 32, pages 270–271). The cat began to have seizures and a spot glucose test revealed profound hypoglycaemia, for which it was treated. Anne Fawcett commented that the impact on both the short- and long-term wellbeing of the patient needed to be considered, as well as the vet's professional obligations to the animal and the client. This was a case where a seemingly simple human error had profound and immediately life-threatening consequences for the patient. A possible way forward would be to admit the error to the client, despite the fact that the client was likely to be both angry and distressed. In this case, the client was invited to a meeting with practice managers, where staff apologised for the error and expressed their sincere regret. The client was informed that all costs associated with the treatment of the complications resulting from the error would be borne by the practice. She elected to pursue treatment and was assured that everything possible would be done to keep the animal comfortable. Anne Fawcett also pointed out that it would be helpful to inform the client about any changes to practice policy, as it might be some comfort to the owner to know that any suffering sustained was not in vain.

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