INTRODUCTION TO ETHICS IN PHARMACY PRACTICE PHCL 437

Pharmacy profession: Supply medication Patient medication

Role of pharmacist: Manufacturing Sorting Marketing Regulatory affairs Formulations Dispensing Medical team Academic Research Consultations

Introduction The role of the pharmacist continues to increase to be patient-focused. Benefits of this transition for patients and pharmacista 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 .

Ethical issues Ethics: is the study of morals and values Morale: are rules that govern behavior Value (what is wrong/what is right?) Ethical problems Ethical dilemmas Ethical conditions

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 dilenunas in pharmacy (cont.): There is a problem of flow of information between professionals and 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 ph. Knows the pt. may suffer or die as a result? What if the patient needs the drug but has no money to pay the ph ? What if the drug is for AIDS and the ph knows that the pt wife is unaware of her husbands condition?

Ethical dilemma between pharmacists physicians (cont.) • 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 • APhA Code based on the following principles i. Autonomy: an action is right if it respects the autonomy, independent choice, of others Veracity: telling the truth is right Fidelity: keeping promises Avoiding killing: taking of human life is wrong 5. justice: fair distribution of good and harm is right.

Ethics for Pharmacists PRINCIPLES CODES

Code of Ethics for Pharmacists A pharmacist respects the covenantail 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 (cont.) 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.

Ethical decision • The foundation of ethical decision making is based on three fundamental assumptions: The ethical principles and values of the profession The legal framework within which the profession operates 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 Conflictingethical principles: what are they? 3- Legal parameters: are there any legal constraints to the scenario?

How to make an Ethical Decision? 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.

How to make an Ethical Decision? 6. Identify relevant ethical principles for each Alternative. 7. Determine emerging ethical problems 8. Select conecourseof 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?*

How to make an Ethical Decision? 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.

Questions?