1. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar The Pharmacy Technician FOUNDATIONS AND PRACTICES Chapter 4 Pharmacy Law and Ethics

2. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Constitutional Law Outlines the organization of the federal government All states must comply with constitutional law Overrides all other laws—if a state law is ruled "not legal" under the constitution (whether federal or state), it is not legal

3. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Constitutional Law (cont.) U.S. Constitution contains the Bill of Rights –Freedom of speech and religion –Right to a jury trial –Protection against unreasonable searches and seizures

4. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Statutes and Regulations Statutes: laws passed by federal, state, or local legislatures Regulations: clarify and explain statutes –Must be consistent with statute –Have the same power or authority as the statute

5. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar State Law and Regulations State constitutions establish the organization of state government Must be consistent with federal statutes and regulations State statutes and regulations may provide additional rights

6. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar State Law and Regulations (cont.) States may not guarantee rights that are explicitly not constitutionally legal (e.g., drug possession) States may not take away rights that are provided by federal law

7. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Legislative Intent The "meaning" of a law is based on its intent Legal interpretation is based on: –Words such as "may" and "shall" ("may" means optional, "shall" means required) –Punctuation (a comma may imply connected intent; a semicolon may imply a separate intent)

8. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Legislative Intent (cont.) Commonly influenced by "case law," as intent may be determined or refined when a law is challenged in court

9. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Criminal Laws Deal with homicide, illegal drugs, theft, and other antisocial behavior Enforced by state agents against specific persons or corporations Crimes are considered harmful actions against society, rather than an individual Criminal cases are thus titled State v. John Smith

10. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Civil Laws Involve personal injuries, business disputes, land deals, libel and slander, and various other commercial interests Plaintiff (injured party) brings charges against defendant (alleged wrongdoer) Parties in a civil case may be individuals, corporations, or the state itself Medical malpractice is a civil law action— harm is caused to an individual, not society

11. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Administrative Law Federal government uses administrative agencies to enforce laws –Internal Revenue Service (IRS) –Occupational Safety and Health Administration (OSHA) –Centers for Medicare and Medicaid Services (CMS) –Social Security Administration (SSA)

12. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Administrative Law (cont.) Exceptions: Defense Department and law enforcement agencies States may also operate through administrative agencies that have no federal counterpart

13. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Administrative Agencies and Regulations Administrative agencies refine laws with regulations Some laws unambiguously state an agency’s role; others are deliberately nonspecific –Americans with Disabilities Act (not much room for interpretation) –Creation of state boards of pharmacy (wide room for interpretation)

14. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Administrative Agencies and Regulations (cont.) Once the regulations are established, they have the force of law

15. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Violations of the Law Any action that harms or threatens society is referred to as a crime

16. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Violations of the Law (cont.) Crimes are classified by the punishment allowed or mandated upon conviction –Misdemeanor: considered less serious in nature, punishable by community service, parole, a fine, or imprisonment for 12 months or less –Felony: determined to be more serious; punishable by at least one year of imprisonment

17. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Regulatory Agencies Centers for Medicare and Medicaid Services (CMS) Drug Enforcement Administration (DEA) Food and Drug Administration (FDA) Joint Commission on Accreditation of Healthcare Organization (JCAHO) Occupational Safety and Health Administration (OSHA) State Board of Pharmacy

18. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Centers for Medicare and Medicaid Services (CMS) Formerly known as the Health Care Financing Administration (HCFA)

19. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Centers for Medicare and Medicaid Services (CMS) (cont.) Regulates the administration of federal healthcare programs and laws –Medicare –Medicaid –State Children’s Health Insurance Program (SCHIP) –Health Insurance Portability and Accountability Act (HIPAA) –Clinical Laboratory Improvement Amendments (CLIA)

20. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Centers for Medicare and Medicaid Services (CMS) (cont.) Conducts inspections to ensure compliance with guidelines

21. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Drug Enforcement Administration (DEA) Regulates legal trade in narcotic and dangerous drugs Manages national narcotics intelligence system Works with other agencies to support drug traffic prevention Shares jurisdiction over drug offenses with Federal Bureau of Investigation (FBI)

22. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Drug Enforcement Administration (DEA) (cont.) Agents of the two organizations work together on drug law enforcement Administrator of the DEA reports to the director of the FBI

23. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Food and Drug Administration (FDA) Reviews/approves new drugs, generic equivalents, and therapeutic indications for existing medications

24. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Food and Drug Administration (FDA) (cont.) Responsible for protecting public health Assures safety, efficacy, and security of: –Drugs –Biological products –Medical devices –Food –Cosmetics

25. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Evaluates and accredits nearly 15,000 healthcare organizations and programs Establishes and enforces standards that improve quality and safety of healthcare organizations

26. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Joint Commission on Accreditation of Healthcare Organizations (JCAHO) (cont.) Evaluates and accredits: –Hospitals –Hospice facilities –Nursing homes –Long term care facilities –Rehabilitation centers –Other healthcare organizations

27. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Occupational Safety and Health Administration (OSHA) Division of the U.S. Department of Labor Assures the safety and health of American workers by setting and enforcing protective standards Enforces occupational safety standards in all 50 states Provides technical assistance and consultation programs

28. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar State Board of Pharmacy (SBOP) State agency that registers and regulates: –Pharmacy facilities –Pharmacists –Pharmacy technicians Responsible for the actual practice of pharmacy within state domain Granted the authority to monitor, reprimand, and revoke licensures

29. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Pure Food and Drug Act of 1906 Provided for federal inspection of meat products Forbade the manufacture, sale, or transport of adulterated food products or poisonous patent medicines

30. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Pure Food and Drug Act of 1906 (cont.) Ultimately proved to be inadequate because it did not: –Cover cosmetics –Provide the authority to ban unsafe drugs –Prohibit false statements about drugs –Require labeling to identify product contents

31. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Food, Drug, and Cosmetic Act of 1938 Prompted by the sulfanilamide disaster of 1937 Limited interstate commerce in drugs to those that are safe and effective Established the Food and Drug Administration (FDA) Regulated labeling of drugs Regulated who could prescribe legend (prescription-only) drugs

32. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Durham-Humphrey Amendment of 1951 Also known as the Prescription Drug Amendment Required prescription drugs to bear the legend, "Caution: Federal law prohibits dispensing without a prescription." Later amendments approved a substitute legend that reads "RX only."

33. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Kefauver-Harris Amendment of 1962 Prompted by the thalidomide disaster of 1962 Also known as the Drug Efficacy Amendments Focused on accountability from drug manufacturers for the effectiveness of drugs

34. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Kefauver-Harris Amendment of 1962 (cont.) Manufacturers required to supply proof of effectiveness and safety Advertising of prescription drugs placed under the supervision of the FDA Established procedures for new drug applications

35. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Comprehensive Drug Abuse Prevention and Control Act of 1970 Also known as the Controlled Substances Act of 1970 Combined all federal laws dealing with narcotics, stimulants, depressants, and abused designer drugs Established the Drug Enforcement Administration (DEA) Established five "classes" or schedules for controlled substances

36. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Occupational Safety and Health Act of 1970 Ensures worker and workplace safety Requires employers to provide a workplace free from hazards such as: –Exposure to toxic chemicals –Excessive noise levels –Mechanical dangers –Heat or cold stress –Unsanitary conditions

37. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Occupational Safety and Health Act of 1970 (cont.) Created a national research institution devoted to occupational safety

38. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Drug Listing Act of 1972 Amended the Federal Food, Drug, and Cosmetic Act of 1938 Required drug establishments to register their products with the FDA Includes establishments that repackage any drug products Assigns a unique and permanent product code known as the National Drug Code

39. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Medical Device Amendment of 1976 Requires life-sustaining and life-supporting devices to have premarket approval from the FDA

40. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Orphan Drug Act of 1983 Intended to stimulate the development of drugs for rare diseases –Rare disease: affects 200,000 people or fewer

41. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Orphan Drug Act of 1983 (cont.) Provides three primary incentives: –Seven-year market exclusivity to sponsors of approved orphan products –Tax credit of 50 percent of the cost of conducting human clinical trials –Federal research grants for clinical testing of new therapies to treat and/or diagnose rare diseases

42. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Orphan Drug Act of 1983 (cont.) Congress created an additional incentive in 1997 –Companies developing orphan products receive an exemption from the usual drug application or user fees charged by the FDA

43. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Drug Price Competition and Patent Term Restoration Act of 1984 Also known as the Hatch-Waxman Act Established modern system of generic drugs Manufacturers of generic drugs can seek FDA approval for generic versions of drugs whose patent protection is set to expire

44. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Prescription Drug Marketing Act of 1987 Enacted to address certain prescription drug marketing practices –Distribution of free samples –Use of coupons redeemable for drugs at no cost or low cost –Sale of deeply discounted drugs to hospitals and healthcare entities

45. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Prescription Drug Marketing Act of 1987 (cont.) These marketing practices helped create a secondary grey market grey market—an unofficial or unregulated market

46. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Anabolic Steroid Control Act of 1990 Placed anabolic steroids into Schedule III of the Controlled Substances Act (CSA) CSA defines anabolic steroid as: –"any drug or hormonal substance chemically and pharmacologically related to testosterone (other than estrogens, progestins, and corticosteroids) that promotes muscle growth"

47. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Omnibus Budget Reconciliation Act of 1990 (OBRA ’90) Focused on federal funding of Medicare and Medicaid Increased the necessity for pharmacy technicians Mandated that pharmacists perform drug utilization reviews (DURs) and offer counseling to patients

48. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Dietary Supplement Health and Education Act of 1994 Defined dietary supplement and dietary ingredient Established a framework for assuring safety Outlined guidelines for literature displayed where supplements are sold Provided for use of claims and nutritional support statements

49. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Dietary Supplement Health and Education Act of 1994 (cont.) Required ingredient and nutrition labeling Granted the FDA authority to establish good manufacturing practice (GMP) regulations

50. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Health Insurance Portability and Accountability Act of 1996 (HIPAA) Enacted to ensure patient confidentiality and privacy Gave patients the right to review their medical records Established the requirement of patient consent for the transfer of medical records

51. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Health Insurance Portability and Accountability Act of 1996 (HIPAA) (cont.) Defines protected health information (PHI) as: –Any information created or received by the pharmacy –Information relating to a patient’s health— mental or physical; past, present, or future –Information that may identify a patient

52. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Combat Methamphetamine Epidemic Act of 2005 (CMEA) Regulates retail over-the-counter sales of ephedrine, pseudoephedrine, and phenylpropanolamine products, including: –Daily sales limits –30-day purchase limits –Placement of product out of direct customer access –Sales logbooks –Customer ID verification –Employee training

53. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Monographs Commonly known as package inserts A necessary component of drug labeling Provides all the clinical information required by the FDA

54. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Figure 4.4 Sample package insert, or monograph, for Keppra® injection. (Courtesy of UCB, Inc.)

55. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Figure 4.4 (continued) Sample package insert, or monograph, for Keppra® injection. (Courtesy of UCB, Inc.)

56. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Figure 4.4 (continued) Sample package insert, or monograph, for Keppra® injection. (Courtesy of UCB, Inc.)

57. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Figure 4.4 (continued) Sample package insert, or monograph, for Keppra® injection. (Courtesy of UCB, Inc.)

58. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Components of a Monograph Description Clinical Pharmacology Indications and Usage Contraindications Warnings

59. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Components of a Monograph (cont.) Precautions Drug Abuse and Dependence Adverse Reactions Dosage How Supplied

60. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Ethics Derived from the Greek word ethos, referring to one’s character Discipline of evaluating the merits, risks, and social concerns Commonly defined as considered reflection or systematic analysis when required actions are unclear

61. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Ethics (cont.) Based on certain universal principles such as justice, doing no harm, etc. Ethics are not morals, but can be influenced by personal morals

62. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Ethical Decisions Not clear-cut, either/or, correct or incorrect (binary) decisions Require a balance between a professional code of ethics and personal morals Are not emotional reactions, but courses of conduct that have been weighed and measured carefully

63. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Moral Philosophy An individualized set of values or value system The reasoning process that defines the subjective rightness or wrongness of conduct The reasoning process that defines good or evil conduct Often based in spiritual or religious practice and thought

64. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Practicing Ethical and/or Moral Behavior Beneficence—bringing about good Fidelity—keeping a promise Veracity—telling the truth Justice—acting with fairness or equity within the law Autonomy—acting with self-reliance

65. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Ethical Theories, Part 1 Consequentialism—all actions should bring about the greatest good to the greatest number of people –The actions are justified by the outcome –The best decisions benefit the greatest number of people, regardless of whether the decisions are "right" or "wrong"

66. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Ethical Theories, Part 1 (cont.) Nonconsequentialism—some actions cannot be justified because they are inherently wrong, regardless of the outcome –Some actions can never be condoned, regardless of the outcome –The best decision adheres to all ethical and moral principles, regardless of whether someone benefits from it or not

67. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Ethical Theories, Part 2 Social contracts—explicit or assumed expectations of people in a given situation –Pharmacists are expected to provide medication in a prompt manner; patients are expected to keep their medications current and pay a fair price –The best decision satisfies everyone’s social expectations

68. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Ethical Theories, Part 2 (cont.) Ethics of care—requires caregivers (such as healthcare professionals) to focus on moral skills –Kindness, sensitivity, attentiveness, tact, patience, and reliability are emphasized –The best decisions are moral in nature

69. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Ethical Theories, Part 3 Rights-based ethics—based on a belief in democratic human rights –Individuals in a democratic society should be allowed to do what they want without interference from outside agencies –The best decisions satisfy an individual’s desires

70. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Ethical Theories, Part 3 (cont.) Principle-based ethics—based on a belief in universal guides to action –A personal approach; the individual’s moral beliefs guide action –The best decisions satisfy the decision- maker’s personal beliefs

71. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Ethical Theories, Part 3 (cont.) Virtues-based ethics—based on specific, idealized morals or virtues –An ideal-world approach; everyone agrees on what is correct or virtuous –The best decisions satisfy the community’s sense of virtuous behavior

72. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Ethical Theories, Part 4 Law—a formalized, enforceable system of rules –An either/or system of conformity—something is legal or it is not –May not reflect moral issues—behavior may be legal but immoral, or illegal yet moral –The best decisions have already been determined; only those actions within the scope of the legal system are acceptable

73. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Ethical Theories, Part 4 (cont.) Professional code of ethics—a predetermined system of ethical guidelines for a specific group, created by members of that group –An example of virtues-based ethics –The best decisions are guided by the profession’s idea of ethical behavior

74. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Pharmacy Technician Code of Ethics, Part 1 Health and safety –Ensure the health and safety of the patient –Never assist in dispensing or distributing medications or devices that are not of good quality or do not meet the standards required by law

75. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Pharmacy Technician Code of Ethics, Part 1 (cont.) Respect and integrity –Support and promote honesty and integrity in the profession –Respect and value the abilities of other healthcare professionals –Respect and support the patient’s individuality, dignity, and confidentiality –Respect the confidentiality of the patient’s records

76. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Pharmacy Technician Code of Ethics, Part 2 Professional development –Use knowledge and skills to serve others –Maintain competency and continually enhance professional expertise –Do not engage in any activity that will discredit the profession –Associate with organizations that promote the profession of pharmacy