Introduction to Pharmacy Ethics (Theoretical Considerations) PDF

Introduction to Pharmacy Ethics (Theoretical considerations) Background ´ Pharmaceutical care practitioners should not only be clinically competent, but must also adhere to the law and ethical standards. ´ The pharmaceutical care practitioner must learn to recognize when his/her personal values (pol...

Introduction to Pharmacy Ethics (Theoretical considerations) Background ´ Pharmaceutical care practitioners should not only be clinically competent, but must also adhere to the law and ethical standards. ´ The pharmaceutical care practitioner must learn to recognize when his/her personal values (political views, religious beliefs, or social expectations) interfere with professional responsibilities and behaviors. ´ As a general rule, clinical problems should be identified and resolved first, followed by legal issues. Background ´ Pharmacists are the researchers, developers, producers, people who are trusted to give advice on drugs to all health professionals and persons who market drugs in the whole world. ´ The pharmaceutical industry is the most heavily regulated of all industries. ´ Law and ethics are not static. This means that students, and eventual practitioners, need to remain alert throughout their professional life for changes and amendments to each and to be aware of how these will affect and impact on their chosen area of practice. Why do we need a focus on pharmacy ethics? ´Most people don’t appear to give a great deal of thought to their own behaviour whether concerning domestic affairs or workrelated activities. ´For experienced practitioners, a great deal of their professional lives is devoted to dealing with relatively routine matters. ´In community or hospital pharmacy, for instance an obligation to: ´that a prescriber’s intentions are unequivocal ´that there are no potential drug-drug interactions or other incompatibilities ´that patients receive clear and unambiguous advice and instructions with their medication. ´A pharmacist may consider that a particular drug is not classified in the most appropriate schedule or that one therapeutic agent or presentation might be preferred to another. ´But more often than not, he or she has little or no discretion in these matters and such opinions must defer to statutory requirements. RPSGB guidance ´All pharmacists in the UK and in many other countries are members of a professional body that publishes and requires members to comply with a code of practice. ´A Guide for Pharmacists and Pharmacy Technicians (MEP) of the Royal Pharmaceutical Society of Great Britain (RPSGB) includes information on general legal requirements, and codes of ethics for both pharmacists and registered pharmacy technicians. Generally, there is a view that: ´ the law informs you about what you must do or must not do ´ ethics helps you to decide what you ought to do when the law is silent. What is morality and should we use the term moral or ethical? ´ The term morality refers to a moral system, and by ‘moral’, we generally mean those aspects reflecting the rightness or wrongness of an action. ´ The words ‘moral’ and ‘ethical’ are often used as synonyms. ‘Ethics’ comes from the Ancient Greek word ethikos, relating to nature and ‘moral’ is derived from the Latin moralis, meaning custom. ´ In modern usage, ‘moral’ commonly refers to qualities or descriptions such as right or wrong, good or bad, or is concerned with conformance with behavioral standards. ´ General speaking, ‘ethics’ is used in dealing with moral questions from a theoretical point of view, or put more formally, it is the science of morals in human conduct. Moral intuitions ´ Although some might argue otherwise, moral considerations are to a significant extent subjective, relating to upbringing, cultural background, reflecting personal experiences and feelings or religious teaching and faith. ´ Often, though unable to explain exactly why, we may feel intuitively that something is just plain right or wrong: an action ought to be allowed or conversely should not be undertaken. ´ Sometimes we have the sensation that conscience would not allow us to behave in a certain way. ´ We may not have given any special consideration as to why, but we know that there is something seemingly within us that provokes a sensation of unease or indeed more emphatically that something is just plain right or alternatively it is wrong. Pharmacy ethics ´Although the term pharmacy ethics is often directly linked with pharmacy law, it has received relatively little attention in the past as a distinct discipline. ´And while medical ethics has a long history and is often the subject of coverage in the news media, and nursing ethics has become increasingly prominent over the last few decades, pharmacy ethics does not have a well-established independent basis or a substantial literature. ´A reason for this may be that pharmacists have been far less likely in the past than other healthcare workers to be directly confronted with situations in which they have to make a primary decision with a significant ethical component. ´Nevertheless, all pharmacists irrespective of the branch of the profession in which they practise will almost certainly encounter circumstances at some time within their careers in which an understanding of some of the elements of moral philosophy and ethics would be advantageous. ´Community or hospital pharmacists may be uncomfortable with some aspects of industrial pharmacists feel concerned at the promotional practices of their company. Facts and values ´It is worth noting a fundamental difference between facts and values, which to some extent parallels the difference between objective matters and subjective matters. ´Facts and values are often perceived as being polar opposites. The one indisputable (facts) and the other (values) much more open to question. ´For instance, facts or objective claims are susceptible to empirical analysis or experimentation. ´They can be investigated and confirmed. If a factual claim is made that acetylsalicylic acid has a molecular weight of 180.2, then there are established and approved means of verification which most competent scientists would accept. Moral relativism ´What is considered to be wrong in the moral sense undoubtedly can and does sometimes change with time. ´In other words, what we believe to be right or wrong now may be judged differently in the future. ´Such thoughts of relativism have a long history, taught that whereas natural laws are immutable, that is unchangeable, not subject to variation, and have the same validity everywhere. Code of Ethics for Pharmacists Code of Ethics for Pharmacists ´The Code of Ethics sets out the principles that you must follow as a pharmacist or pharmacy technician. ´The principles of the Code are intended to guide and support the work you do and the decisions you make. ´They also inform the general public of the standards of behaviour that can be expected from the pharmacy professions. ´The Code is founded on seven principles which express the values central to the identity of the pharmacy professions. ´The seven principles encapsulate what it means to be a registered pharmacist or pharmacy technician. ´Making these principles part of your professional life will maintain patient safety and public confidence in the professions. 1. MAKE THE CARE OF PATIENTS YOUR FIRST CONCERN ´The care, well-being and safety of patients are at the centre of everyday professional practice. ´Even if you do not have direct contact with patients your actions or behaviour can still impact on their care or safety. 2. EXERCISE YOUR PROFESSIONAL JUDGEMENT IN THE INTERESTS OF PATIENTS AND THE PUBLIC ´The need to balance the requirements of individuals with society as a whole is a feature of professional life. ´Guidelines and financial constraints need to be taken into account, but they must not be allowed to compromise your ability to make an informed professional judgement on what is appropriate for patients in specific situations. 3. SHOW RESPECT FOR OTHERS ´Demonstrating respect for the dignity, views and rights of others is fundamental in forming and maintaining professionally appropriate relationships with patients, their carers, colleagues and other individuals with whom you come into contact with. 4. ENCOURAGE PATIENTS TO PARTICIPATE IN DECISIONS ABOUT THEIR CARE ´Patients have a right to be involved in decisions about their treatment and care. ´They should be encouraged to work in partnership with you and other members of the professional team to manage their healthcare needs. 5. DEVELOP YOUR PROFESSIONAL KNOWLEDGE AND COMPETENCE At all stages of your professional working life you must ensure that your knowledge, skills and performance are of a high quality, up to date and relevant to your field of practice. 6. BE HONEST AND TRUSTWORTHY Patients, colleagues and the public at large place their trust in you as a pharmacy professional. You must behave in a way that justifies this trust and maintains the reputation of your profession. 7. TAKE RESPONSIBILITY FOR YOUR WORKING PRACTICES ´Team working is a key feature of everyday professional practice and requires respect, co-operation and communication with colleagues from your own and other professions. Applying the principles ´It is your responsibility as a pharmacist to apply the principles of the Code of Ethics to your daily work, whether or not you routinely treat or care for patients. ´You must be able to show that you are aware of the Code and have followed the principles. ´You are expected to use your professional judgement in the light of the principles of the Code and must be prepared to justify your actions if asked to do so.