Pharmacy Ethics and the Law

Article excerpt

Goal

To study ethical and legal issues in the practice of pharmacy today, looking at the relationship of law and ethics, and the underlying principles of ethical decision making.

Objectives

1. Define the meaning of ethics as applied to pharmacy.

2. Discuss ethical virtues applicable to pharmacy practice today.

3. Describe the relationship of law to ethics.

4. Recognize the principles of ethics in pharmacy.

5. React to ethical situations, critically studying proposed answers.

6. Discuss how the legal answer and the ethical answer in a given situation may differ.

Introduction

For a decade, when the Gallup polling organization asked a representative sample of the American public to rate the ethics of various professionals, pharmacists have ranked number one. Over the years, pharmacists have taken an understandable amount of pride in these results. However, being considered the most honest and ethical profession in America carries with it responsibility to measure up to this public expectation.

While it has never been easy to constantly live up to the label of "the most ethical professional," for today's pharmacists, living in a rapidly changing profession, with new rules, duties and responsibilities, the role is becoming even more difficult. In years past, the rules under which pharmacists practiced, while never simple or easy, were clear and definite, and ethical choices to be made in the daily practice for the professional were limited.

When the pharmacist's primary function was the distribution and compounding of drugs, the main duty was to follow the law. The pharmacist was to use only approved, pure ingredients and to fill the physician's orders accurately Interaction with the patient was limited to that of a retailer. The pharmacist had little information about the patient's condition above that which could be gleaned from the prescription itself. Patient expectation was also limited. In these simpler, less demanding times, the pharmacists knew what was expected and, in spite of temptations in the form of profits from illegal distribution of controlled substances, the vast majority of pharmacists abided by the rules.

Today, the roles, duties and responsibilities placed upon pharmacists have changed along with the expectations of the public. While dispensing, compounding, and drug distribution continue to be an important part of pharmacy, today the pharmacist also has the legal and ethical duty to counsel patients, perform a prospective drug review, and intercede with the prescriber and/or the patient when pharmacy-related questions arise.

Pharmacists have more pertinent contact with the patient and with other health care providers. Greater access to information concerning the patient's medical condition, including information given by the patient through counseling, has caused a greater awareness of confidentiality issues. Possessing, or having the ability to possess, more information, combined with a duty to use the information for the patient's benefit, also places the pharmacist in a position to make dynamic decisions. Many of these decisions rest upon the concept of ethics.

Ethics is seldom as simple as right versus wrong. When the decisions are controlled by law, the decision, while not always easy, is usually clear. The law must be followed. The question is, "What does the law allow?" In the bygone days of "fill the prescription as ordered by the doctor," the rules were written in black-and-white terms. Today, many of the rules are not written. When does the pharmacist counsel, and are there times he or she benefits the patient more by remaining silent or vague? There are many such questions in the area of today's pharmacy practice and ethics.

This article will explore ethical and legal aspects of pharmacy practice for today's pharmacist. Purposefully, this article will give fewer answers than questions. …