ethics of pharmacist in community pharmacy

7/27/2019 Ethics of Pharmacist in Community Pharmacy

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ETHICS OF

PHARMACIST INCOMMUNITY

PHARMACYPRESENTED BY:

NAILA WAHEED

M.PHIL (E) Pharmacology


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9/29/2013 copyright (your organization) 2003 2

WHAT IS COMMUNITY PHARMACY

A community pharmacy is the place where most

pharmacists practice the profession of pharmacy.

Community pharmacies usually consist of a retailstorefront with a dispensary where medications

are stored and dispensed.

It is the community pharmacy where the

dichotomy of the profession existshealth

professionals who are also retailers.


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INTERACTION OF PHARMACIST

WITH PEOPLE

A community pharmacist works according to legal

and ethical guidelines to ensure the correct and

safe supply of medical products to the general

public.

They are involved in maintaining and improving

people's health by providing advice and

information as well as supplying prescription

medicines.



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They also sell over-the-counter medical products

and instruct patients on the use of medicines and

medical appliances.

They also offer specialist health checks, such as

blood pressure monitoring and diabetes screening,

weight reduction programs and are able to

prescribe alternatives as well as dispense

medicines.

advice and information to patients regarding the

dosage of medications.

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WHAT IS ETHICS

Ethics refers to well-founded standards of right

and wrong that describe what humans ought to do,

usually in terms of rights, obligations, benefits to

society, fairness, or specific virtues.

Ethical standards also include those that enjoin

virtues of honesty, compassion, and loyalty.

Moreover, standards relating to rights, such as the

right to life, the right to freedom from injury, and

the right to privacy.



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Professional Values and Ethics are a set of moral

principles and standards of conduct, supporting

the moral prestige of professional groups insociety.

Ethics is designed to educate people, to help

them to behave properly with other, to

communicate at work place.

The tasks of professional ethics are to identify

moral standards and assessments, judgments and

concepts, characterizing people as representativeof particular profession.



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ETHICS IN PHARMACY PRACTICE

Code of Ethics Statements:These statements regarding professional

behavior are often written as formal documents andprovide language to aid in the decision-making

process when ethical dilemmas present themselves

in pharmacy practice.

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PHARMACIST CODE OF ETHICS

Pharmacists are health professionals who assist

individuals in making the best use of medications.

This Code, prepared and supported by pharmacists,

is intended to state publicly the principles that formthe fundamental basis of the roles and

responsibilities of pharmacists. These principles,

based on moral obligations and virtues, are

established to guide pharmacists in relationshipswith patients, health professionals, and society.



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1. A pharmacist respects the covenantal

relationship between the patient and

pharmacist.2. A pharmacist promotes the good of every

patient in a caring, compassionate, and

confidential manner

3. A pharmacist respects the autonomy and dignity

of each patient.

4. A pharmacist acts with honesty and integrity in

professional relationships.5. A pharmacist maintains professional

competence.



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6. A pharmacist respects the values and abilities of

colleagues and other health professionals.

7. A pharmacist serves individual, community, andsocietal needs.

8. A pharmacist seeks justice in the distribution of

health resources.



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ETHICAL PRINCIPLES & MORAL

RULES

Pharmacist have an ethical obligation to care for

their patients.

Moral rules and ethical principles are used by

pharmacist on daily basis as they face ethical

situations.



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PRINCIPLES IN MEDICAL ETHICS

1. Automomy

2. Informed Consent

3. Confidentiality

4. Beneficence/ Non-Maleficence

5. Fidelity

6. Veracity

7. Distributive Justice



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1. AUTONOMY

right to information and self determination

free and informed consent

free will and accord - intentional participation in

treatment

respect and dignity maintained



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2. INFORMED CONSENT

Individual participation in clinical research &

surgery

Right to make autonomous decision

Directs that patients must be fully informed about

benefits and risks in clinical trials Dispensing a medication: risk and benefits of the

drug.



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EXAMPLE:

A physician may not desire that a patient be

informed of the side effects from chemotherapy

because of traditional paternalistic attitude that this

information may harm the patient by his or herrefusal to take a drug with certain side effects.

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ELEMENTS OF INFORMED CONSENT

1. Disclosure

2. Understanding

3. Voluntariness

4. Competence

5. Consent



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3. CONFIDENTIALITY

Based on loyalty and trust

Maintain the confidentiality of all personal,

medical and treatment information Information to be revealed with consent and for

the benefit of the patient

Except when ethically and legally required

Disclosure should not be beyond what is required



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EXAMPLE:

This occurs when a pharmacist is asked to

identify drugs found in the possession of

children or to reveal that a daughter is on birth

control pills.



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4. BENEFICENCE/ NON-MALEFICENCE

do only that which benefits the patient

patients welfare as the first consideration

care consideration competence

Taking due care avoiding harm

Prevention of harm & removal of harmful

conditions calculated risk or risk benefit



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EXAMPLE:

Pharmacists may be asked to dispensedrugs used as abortifacients such as

diethylstilbestrol, the "morning after pill."

Can a pharmacist conscientiously objectto dispense these medications



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5. FIDELITY

Pharmacist act in such a way as to demonstrate

loyalty to their patients.

To do what is in best interest of the patients.



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6. VERACITY

Truth telling

Obligation to full and honest disclosure

To be honest in their dealings with patients

EXAMPLE: This occurs when pharmacists are

called to provide drug information to be used forquestionable purposes.



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7. DISTRIBUTIVE JUSTICE

Actions are consistent, accountable and

transparent

not to discriminate on age, sex, religion, race,

position or rank Provide equal quality of care to affording and

non-affording patients

Provide equivalent amount of care

equity and distribution of burden & benefits



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EXAMPLE:

Pharmacists are being asked to ration

the use of certain high cost drugs in an era of

cost containment and limited resources.

The question is how do we morally justify the

use of new expensive drugs.



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ETHICAL-DECISION MAKING

Ethical-decision making situation in pharmacy

can be divided into two broad categories.

1. MACRO SITUATION

Issues that are not specific to a given

pharmacist, but rather addressed by all pharmacist &society.

Abortion

Assisted suicide In-Vitro Fertilization

Organ transplantation

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2. MICRO SITUATIONS

Those issues that may conflict individualpharmacist in the course of their daily practice.

Use of placebos

Patients confidentiality

Informed consent



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ETHICAL PROBLEMSRELATING TO DISPENSING

MEDICINES



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Dilemmas and Questions Facing Healthcare

Professionals:

Deciding what action to take when faced with

an ethical dilemma in the pharmacy requires

consideration of the circumstances, choosing an

action, and justifying the action. This is done byasking questions like What is the dilemma? What

pharmaceutical alternatives apply? and What is the

best alternative, and can it be justified on moral

grounds?

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1. CONTROLLED DRUGS

The most commonly cited ethical concern for

pharmacists involved situations in which a

decision had to be made by the pharmacist as to

whether to supply a controlled drug where, for avariety of reasons, doing so would not be legal.

Controlled drugs are those medicines that possess

an abuse potential and several categories are

defined in legislation ranging from specializeddrugs such as LSD, opioid analgesics and

benzodiazepines.



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A pharmacist may also feel that in dispensing an

addictive narcotic, they are introducing the

patient to substance abuse, detrimental to the

patients mental and physical health.

In this situation the pharmacist may feel theyare violating the principle of non-maleficence.



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2. EMERGENCY SUPPLIES

Ethical problems arose for several pharmacistswith respect to emergency supplies of medicines

to patients.

These involved circumstances where a

prescription was not available and a patient was

without their regular medicines and had asked

the pharmacist to provide that medicine.



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3. CHALLENGEING PRESCRIBING

Ethical concerns in relation to whether tochallenge a prescriber with respect to a clinical

problem in their prescribing.

Often the pharmacist had identified a problem on a

prescription presented to them that they believed

would not be appropriate for the patient, either in

terms of a dose or an interaction or alternative.



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4. EMERGENCY HORMONAL

CONTRACEPTION

There is the ethical issue of whether a pharmacistshould have the right to refuse to dispense

ABORTIFACIENTS based on the principle of

conscientious objection, due to moral or religious

beliefs.

Abortifacients are substances that induce

abortion.

EXAMPLE: High doses of estrogen cause a rapidshedding of the endometrium in the uterus, which

significantly decreases the chance of the fertilized

egg attaching to the uterine wall.9/29/2013 33


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5. ASSISTED SUICIDE

Pharmacists may object to filling prescriptions is inphysician-assisted suicide.

Physician-assisted suicide occurs when a

physician facilitates a patient's death by providingthe necessary means and/or information to enable

the patient to perform the life-ending act.

The issue is that, whether a pharmacist should

be able to refuse to dispense or endorse themedications used in these practices is an ethical

issue.



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6. RE-DISPENSING

Requests from patients or other health careprofessionals for the pharmacist to make-up a re-

dispensing or re-fill medication

there was no prescription available and the

request was for the pharmacist to re-fill existingmedication for the patient.

Its being ethically problematic for pharmacist

since it was not good practice to use medicinesthat could not be verified in terms of either the

original prescribing instructions or details of the

medicine itself.



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7. DRUG FORMULARY

Pharmacists as a member of a Pharmacy andTherapeutics Committee is involved in making

decisions on what drugs to include on a formulary

and to set guidelines on what drugs are used in a

hospital setting.

Pharmacists have an active role in this clinical

decision-making process.



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A potential conflict of interest could arise when a

decision on a status of a drug must be made when

there is personal interest.


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