Pharmacy Ethics - Chapter 6 PDF

PHR 118 Social Pharmacy Chapter 6 Cyprus Health and Social Sciences University Faculty of Pharmacy Principles of Pharmacy Ethics Role of pharmacist: 1. Manufacturing 2. Sorting 3. Marketing 4. Regulatory affairs 5. Formulations 6. Dispensing 7. Medi...

PHR 118 Social Pharmacy Chapter 6 Cyprus Health and Social Sciences University Faculty of Pharmacy Principles of Pharmacy Ethics Role of pharmacist: 1. Manufacturing 2. Sorting 3. Marketing 4. Regulatory affairs 5. Formulations 6. Dispensing 7. Medical team 8. Academic 9.Research 10.Consultations  Introduction The role of the pharmacist continues to increase to be patient-focused. This transition results in benefit for both the patients and the pharmacists, however, pharmacists are more likely to experience ethical dilemmas. As a result, there is an ever growing need to prepare pharmacy students to make ethical decisions Why does ethical dilemmas occur? Ethical dilemmas occur when there are disagreements on ethical behavior or application. Ethics is the branch of philosophy that is concerned with moral values of right and wrong human conduct. Ethics: is the study of morals and values Morale: are rules that govern behavior  Pharmacy ethics are the values and ethical principles governing pharmacy practice encouraging right human conduct. Pharmacy ethics guides pharmacists for patient care with moral obligations and excellences. The principle of ethics includes beneficence, least harm, respect for autonomy and justice. Reasons behind Ethical dilemmas in pharmacy:  The values  Sense of justice and fairness of each party may differ The problem of legal liability affects the actions of physicians and pharmacists as each tries to maximize patient care and minimize legal liability. Increase in information about diseases and their treatment and electronic technology has caused a problem between physicians and pharmacists.  Reasons behind Ethical dilemmas in pharmacy There is a problem of flow of information between healthcare professionals and patients. Consideration of duty to inform, rights of patients, confidentiality, and truthfulness become increasingly difficult to respond to. Ethical dilemma between pharmacists & physicians Use of placebo products produces a difficult situation for both physicians and pharmacists. Dilemma involves not telling the truth for the patients benefit. The physician initiates the action and the pharmacist is expected to go along with the deception. Situation Represents an Ethical Dilemma (examples) What happen if the patients refused to take the drug, even though the pharmacist knows the patient may suffer or die as a result? What if the patient needs the drug but has no money to pay the pharmacist? What if the drug is for AIDS and the pharmacist knows that the patient’s wife is unaware of her husbands condition? Ethical dilemma between pharmacists physicians What happens when the patients asks for further information or suspects the prescription for a placebo? back to physician or supporting the physician's perceived intent. Ethical dilemma between pharmacists & patients A patient might present a prescription to a pharmacist with a dosage regimen of four times per day. A problem emerges if the patient is unable or unwilling to take the medication four times a day. However, by reducing the dosing regimen to twice a day, the patient might be more able to comply with it. Code of Ethics for Pharmacists The Code of Ethics for Pharmacists of the American Pharmacists Association (APhA) based on the following principles i. Autonomy: an action is right if it respects the autonomy, independent choice, of others ii. Veracity: telling the truth is right iii. Fidelity: keeping promises iv. Avoiding killing: taking of human life is wrong v. justice: fair distribution of good and harm is right. Code of Ethics for Pharmacists A pharmacist respects the covenantal relationship between the patient and pharmacist A pharmacist promotes the good of every patient in a caring, compassionate, and confidential manner. A pharmacist respects the autonomy and dignity of each patient A pharmacist acts with honesty and integrity in professional relationships Code of Ethics for Pharmacists A pharmacist maintains Professional competence. A pharmacist respects the values and abilities of colleagues and other health professional A pharmacist serves individual, community, and societal needs A pharmacist seeks justice in the distribution of health resources.  Professional Codes of ethics I. A pharmacist respects the covenantal relationship between the patient and pharmacist. Considering the patient-pharmacist relationship as a covenant means that a pharmacist has moral obligations in response to the gift of trust received from society. In return for this gift, a pharmacist promises to help individuals achieve optimum benefit from their medications, to be committed to their welfare, and to maintain their trust. II.A pharmacist promotes the good of every patient in a caring, compassionate, and confidential manner. A pharmacist places concern for the well-being of the patient at the center of professional practice. In doing so, a pharmacist considers needs stated by the patient as well as those defined by health science. A pharmacist is dedicated to protecting the dignity of the patient. With a caring attitude and a compassionate spirit, a pharmacist focuses on serving the patient in a private and confidential manner. III. A pharmacist respects the autonomy and dignity of each patient. A pharmacist promotes the right of self-determination and recognizes individual self-worth by encouraging patients to participate in decisions about their health. A pharmacist communicates with patients in terms that are understandable. In all cases, a pharmacist respects personal and cultural differences among patients. IV. A pharmacist acts with honesty and integrity in professional relationships. A pharmacist has a duty to tell the truth and to act with conviction of conscience. A pharmacist avoids discriminatory practices, behavior or work conditions that impair professional judgment, and actions that compromise dedication to the best interests of patients. V. A pharmacist maintains professional competence. A pharmacist has a duty to maintain knowledge and abilities as new medications, devices, and technologies become available and as health information advances. VI. A pharmacist respects the values and abilities of colleagues and other health professionals. When appropriate, a pharmacist asks for the consultation of colleagues or other health professionals or refers the patient. A pharmacist acknowledges that colleagues and other health professionals may differ in the beliefs and values they apply to the care of the patient. VII. A pharmacist serves individual, community, and societal needs. The primary obligation of a pharmacist is to individual patients. However, the obligations of a pharmacist may at times extend beyond the individual to the community and society. In these situations, the pharmacist recognizes the responsibilities that accompany these obligations and acts accordingly. VIII. A pharmacist seeks justice in the distribution of health resources. When health resources are allocated, a pharmacist is fair and equitable, balancing the needs of patients and society. Ethical decision The foundation of ethical decision making is based on three fundamental assumptions: 1. The ethical principles and values of the profession 2. The legal framework within which the profession operates 3. The professional code of ethics How to make an Ethical Decision 1- Identify the problem : technical facts, risks involved, who is involved? 2 - Moral parameters: What values are involved? The'dilemma' is usually caused by two or more Conflicting ethical principles: what are they? 3- Legal parameters: are there any legal constraints to the scenario? 4. Human values: the most important part of the framework. 5.Develop options for action, i.e. a list of possible solutions. This step is particularly difficult in some cases. It should be possible however to establish a list of alternative actions for each dilemma. 6. Identify relevant ethical principles for each Alternative. 7. Determine emerging ethical problems 8. Select concourse of action. 9. Justify your choice ; Ask yourself: - 'Why did I make this particular decision?' - after making your decision... what would you say? - Can you justify your decision with confidence?* 10. Anticipate objections: - Expect other pharmacists to challenge your decision with equally valid, carefully reasoned ethical choices of their own, each based on their own value system. - Challenges arising from factual error or faulty reasoning may also occur. - Factual error can be corrected. - Faulty reasoning can only be avoided by carefully justifying your position with general ethical principles, values or principles in the code of ethics.