Pharmacy Jurisprudence & Ethics: Ethics in Pharmacy Practice

PHRM 1102 - Pharmacy Jurisprudence & Ethics

MODULE 7: ETHICS IN PHARMACY PRACTICE

Learning Objectives

  • Define terms related to ethics.

  • Differentiate between ethics and law.

  • Describe the importance of a professional Code of Ethics.

  • Describe ACP Code of Ethics principles.

  • Discuss ethical concepts and principles:

    • Values

    • Integrity

    • Respect for persons

    • Protecting the vulnerable

    • Autonomy

    • Beneficence

    • Non-maleficence

    • Justice

    • Veracity

    • Fidelity

    • Confidentiality

    • Compassionate care

    • Proportionality

    • Conflicts of interest

    • Whistleblowing

    • Conscientious objection

    • Consent

    • Capacity

  • Differentiate between ethical issues and ethical dilemmas.

  • Describe ethical issues and dilemmas encountered in pharmacy practice.

  • Identify steps in the ethical decision-making model.

  • Discuss professional misconduct in pharmacy practice.

  • Apply ethical principles and the Code of Ethics to decision-making in the role of the pharmacy technician.

Ethics vs. Law

  • Differences:

    • Laws:

    • Rules and regulations established by governing authorities (e.g., governments, legislatures, regulatory bodies).

    • Govern conduct of individuals and society as a whole.

    • Ethics:

    • Set of moral principles and values guiding individual and professional conduct.

    • Addresses right vs. wrong, good vs. bad.

    • Influences judgment and decision-making.

Ethics

  • Definition:

    • A set of moral principles and values guiding conduct.

  • Focus:

    • Questions of right and wrong, good and bad; moral implications of actions.

  • Purpose:

    • Guide behavior based on moral principles, promoting fairness, empathy, and consideration for others.

Ethics in Pharmacy Practice

  • Why Study Ethics?

    • Importance of understanding ethical concepts and principles governing pharmacy practices, particularly as a regulated health care profession.

    • Ethics entails more than common sense; it requires rational mental exercise and sound reasoning.

  • Fiduciary Relationship:

    • Defined as a helping relationship where one person trusts/depends on another.

    • Providers must act in good faith, prioritize the beneficiary's interests, and avoid conflicts of interest.

Characteristics of Good Fiduciary Relationship

  • Focus on the good of the patient.

  • Advocate for patient needs.

  • Open communication and privacy.

  • Mutual trust and respect.

  • Ensure involvement to the best of the patient’s ability and needs.

  • Recognize the right to refuse treatment.

  • Respect patient wishes and professional integrity.

Code of Ethics

  • Purpose:

    • Guides professional behavior, actions, and attitudes.

    • Reflects the profession's values and establishes a standard for ethical practice.

  • Functions of the Code of Ethics:

    1. Defines and describes ethical values establishing a standard for practice.

    2. Educates other professions and the public about ethical conduct and obligations.

    3. Encourages professionals to strive for higher standards of ethical conduct.

    4. Guides ethical issue resolution in clinical settings.

    5. Allows for self-evaluation of practice expectations.

ACP Code of Ethics Principles

  • As health professionals, pharmacists and pharmacy technicians are expected to:

    1. Prioritize the well-being of each patient.

    2. Respect patient autonomy and dignity.

    3. Maintain professional relationships.

    4. Respect confidentiality.

    5. Respect the right to health care.

    6. Promote public health and prevent disease.

    7. Use health resources responsibly.

    8. Serve as an essential health resource.

    9. Ensure professional competence.

    10. Act with honesty and integrity.

    11. Take responsibility for self and others in health professions.

    12. Nurture the profession.

Values in Pharmacy Practice

  • Values:

    • Fundamental beliefs influencing attitudes and actions, drawn from personal experiences, culture, and teachings.

  • Value Conflicts:

    • Arise when there are incompatible values among individuals, leading to challenges in resolution due to the defense of values.

Professional Values

  • Key Values:

    • Altruism: Unselfish concern for others' welfare.

    • Fidelity: Loyalty to patients.

    • Veracity: Truthfulness and honesty.

Integrity

  • Integrity Defined:

    • Honest and trustworthy character aligned with personal dignity.

  • Ethical Behavior:

    • Providers have a duty to avoid harm and unnecessary or dishonest practices.

The Code

  1. Do No Harm: Minimize total harm in the world

  2. Respect for Persons: Regard others with honour, high opinion, and esteem

  3. Protect the Vulnerable: Those who are experiencing any area of vulnerability, from exploitation and barriers

  4. Respect for Autonomy: Give all the necessary information and options, and respect their right to choose

Key Ethical Principles

  1. Respect for Persons:

    • Acknowledgement of honor and esteem.

  2. Protecting the Vulnerable Patient:

    • Recognizes susceptibility to harm and the need to protect against exploitation.

  3. Respect for Autonomy:

    • Right to make informed decisions about one’s health; must be respected unless it burdens others unduly.

  4. Principle of Proportionality:

    • Weighing benefits against burdens in decision-making to ensure patient welfare.

Ethical Dilemmas

  • Definition:

    • A complex situation requiring a choice between conflicting moral values.

  • Examples:

    1. Refusal to Fill a Prescription:

    • Case where a high dose prescription raises concerns for patient safety versus honoring patient autonomy.

    1. Confidentiality vs. Duty to Warn:

    • Balancing patient confidentiality against the need to inform others of potential harm.

    1. Drug Shortages:

    • Ethical distribution of limited resources among patients.

    1. Conflict of Interest:

    • Navigating employer pressures versus patient-centered care.

Ethical Decision-Making Process

  1. Get the facts.

  2. Identify ethical and legal parameters.

  3. Generate alternative actions.

  4. Evaluate and rank alternatives.

  5. Make a decision.

  6. Justify your action.

  7. Implement your plan.

  8. Reflect on the outcome.

Professional Misconduct

  • Definition:

    • Violation of rules of action or performance obligations could lead to civil lawsuits.

  • Causes Include:

    • Negligence, exceeding the scope of practice, patient abandonment, and discrimination.

  • Preventative Measures:

    • Stay informed about legislation and ethical literature, engage colleagues for discussions, ensure effective communication.

Conclusion

  • Importance of Ethics in Pharmacy:

    • Essential for maintaining trust, integrity, and professionalism within the healthcare system.

    • Continuous education and adherence to ethical standards are necessary for optimal patient care.