US Pharm. 2015;40(4):1.
During a typically busy day in a retail pharmacy, pharmacists have to deal with a variety of issues regarding the prescriptions that are filled and dispensed under their watchful eyes. These include, but are not limited to, tasks such as calling a physician's office for permission to refill a prescription that has no more refills or checking on a dosage to make sure it reflects what the doctor meant to write. Maybe it's answering the phone that seems to be constantly ringing in the background, to transcribe a called-in prescription or respond to a patients who has questions about prescribed medications. Clearly, these duties pull today's pharmacists in many directions. Nevertheless, pharmacists still have the legal and moral responsibility to ensure that they fill prescriptions accurately. It is also imperative that they maintain their composure and follow a code of ethics and professional standards as expected of them by their patients and colleagues.
There is no shortage of ethical dilemmas facing pharmacists daily. While federal and state laws are in place to help guide pharmacists to do the right thing, interpreting how to apply those laws in a practice setting can be challenging. That's where ethics kicks in. Even the term ethics can vary much in its definition. The one I like to use is from Merriam-Webster's online dictionary: "Rules of behavior based on ideas about what is morally good and bad." But because a set of morals can differ from person to person, how does one determine what is, or is not, ethical? A few years back I was asked to review a paperback book that does a pretty good job of helping sort out that very question. It is titled Law and Ethics in Pharmacy Practice, written by Ruth Rodgers, Catherine Dewsbury, and Andrew Lea. I generally do not review books, but I thought this topic was important enough to read the book and use it from time to time as a reference.
Over the years a number of organizations and associations have taken a stab at formalizing a code of ethics for pharmacists. In 2007 the Oath of a Pharmacist was adopted by the House of Delegates of the American Association of Colleges of Pharmacy and approved by the American Pharmacists Association. To the best of my knowledge, this oath is still in use today in colleges of pharmacy across the country. It can be found at this web address: www.aacp.org/resources/studentaffairspersonnel/studentaffairspolicies/Documents/OATHOFAPHARMACIST2008-09.pdf.
More recently, the International Pharmaceutical Federation (FIP) Council approved a code of ethics for pharmacists. While the FIP admits that the role of the pharmacist is continuing to change, it suggests that "a profession is distinguished by the willingness of individual practitioners to comply with ethical and professional standards, which exceed minimum legal requirements." It maintains that to practice as a pharmacist means "undertaking any role, whether remunerated or not, in which the individual uses his/her professional skills and knowledge" and that "the code of ethics will therefore apply to pharmacists in all practice settings." It continues by explaining that pharmacists can only fulfill their role "if they are afforded the necessary professional autonomy to act in the best interests of patients and [caregivers]." The complete document can be found here: www.fip.org/www/uploads/database_file.php?id=351&table_id=.
Ethical and moral decisions are never easy, particularly for healthcare professionals whose actions sometimes influence life and death outcomes. While personal moral and ethical standards should never be ignored, pharmacists need to remember that as difficult as it may be, they should never stand in the way of offering what is in the best interests of their patients' health.
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