1. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 2 Ethics in Pharmacy Practice Jahangir Moini, MD, MPH, CPhT

2. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Overview A code of ethics publicly states the principles forming the fundamental basis of roles and responsibilities in specified field –For pharmacists – established by American Pharmaceutical Association –For pharmacy technicians – established by American Association of Pharmacy Technicians

3. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Ethics, Morals, and Values Ethics – sets of principles of good conduct; systems of moral values Morals – good principles or rules of conduct; more important socially than values Values – desirable standards or qualities, or rules about right and wrong

4. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The Relationship between Ethics and the Law Law is designed to protect society and help it function efficiently Ethics are designed to assure adherence to standards, and raise competence levels, and build values

5. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Professional Ethics “The profession’s interpretation of the will of society for the conduct of the members of that profession augmented by the special knowledge that only the members of the profession possess.” Professional ethics concerned primarily with moral issues and responsibilities

6. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Code of Ethics for Pharmacists Authored by American Pharmaceutical Association Based on moral obligations Designed to establish guidelines for professional ethical behavior

7. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The Patient-Pharmacist Relationship Must be based upon honesty and trust Patient must be comfortable discussing complete medical history Pharmacist must ensure confidentiality of information entrusted to him or her Counseling is key to eliminating medication errors and establishing trusting relationship

8. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Patient Advocacy Patient advocates can assist with choice of health care, getting information, discussing treatments, and many other areas Patient’s health and well-being must remain the focus of work

9. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Respect for Patient Autonomy Autonomy is ability or tendency to function independently Patients must be allowed to decide on medical care without undue influence from health care providers Informed consent requires patient to be competent to make health care decisions after receiving accurate information

10. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Professional Competence Achieved over time with continued learning and development Involves keeping abreast of new technologies, developments, and latest medical publications Measured with specialized testing, (written exams, reviews by peers, self-assessment)

11. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Respect for Other Colleagues Always treat colleagues with respect Discrimination results in no positive results Challenge colleagues when they behave in less-than-professional ways Any unethical behavior shows lack of respect for other colleagues

12. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Serving the Community Pharmacists are trusted to provide safe and appropriate medications to the public They serve their community by educating patients and consulting with them to prevent medication errors

13. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Equitable Treatment Pharmacists must always be ethical and moral Cannot discriminate against patients for any reason Must always follow code of ethics to treat patients equally

14. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Code of Ethics for Pharmacy Technicians Authored by American Association of Pharmacy Technicians Pharmacy technicians should strive to make the care of every patient their utmost concern, and treat them respectfully, responsibly, and honestly

15. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. They should use their best professional judgment at all times They should encourage patients to speak with the pharmacist about concerns or questions Code of Ethics for Pharmacy Technicians

16. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Maintain Health and Safety When pharmacy technician is physically or mentally unwell, it can interfere with ability to provide good care to patients Maintaining good health and safe conditions for themselves and others is essential All OSHA requirements must be met and followed

17. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Honesty and Integrity Pharmacy technicians must always be honest and immediately report errors to supervisors Patients deserve to know the truth even if it is difficult to hear Patient dignity is of utmost importance and can only be preserved by honesty and integrity in communications with them

18. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Assist and Support the Pharmacist Pharmacy technician assists pharmacist with all tasks allowed by state law A qualified pharmacy technician assists pharmacists in providing accurate, ethical health-care that is as free of errors as possible

19. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Respect for Other Health Care Professionals Pharmacy technicians must be willing to go beyond formal job description to help in other areas of the pharmacy They must respect other health care professionals and work as a team for the good of all patients

20. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Professional Competence In most states, pharmacy technicians are under the direct supervision of pharmacists Pharmacist is ultimately liable for actions of pharmacy technician Technicians must triple-check every drug dispensed, all labeling, and instructions provided by both physician and pharmacist

21. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Professional Competence Pharmacy technicians are increasingly responsible for duties that used to be the sole responsibility of a licensed pharmacist Important to alert the pharmacist to any discrepancies in information Incompetent actions may result in legal action against both technician and company

22. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Respect for Patient Autonomy Pharmacy technicians must be able to function independently, show courtesy, respect all patients Pharmacy staff must respect self- governance, rights of liberty, privacy, and patient choice A good attitude should be demonstrated to everyone on a consistent basis

23. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Maintaining Confidentiality Patient information (written, computerized, or verbal) is not to be shared with anyone except approved health care professionals Sharing private information with anyone who is not supposed to know it is a breach of ethics and may have legal ramifications HIPAA governs the disclosure of confidential information

24. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Observing Quality and Legal Standards Ethical standards are usually more severe and demanding than standards required by law Courtesy, compassion, and common sense are vital to success of pharmacy technician

25. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Maintenance of Professional Standards The pharmacy technician who works to improve his or her professional approach in the workplace will be a great asset to their employer Helps them to gain promotions to positions of more responsibility

26. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Loyalty to Employer Loyalty – faithfulness or allegiance to a cause, ideal, custom, institution, or product Supporting employer and pharmacist with loyalty is important for pharmacy technicians Pharmacy should loyally support all employees

27. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Making Ethical Decisions Pharmacy technicians must have a strong knowledge of ethical issues relating to the profession, and balance their own value systems Effects their decisions can have on other individuals must be considered Long-term and short-term consequences must be taken into account

28. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Identifying the Problem and Gathering Data Pharmacy technicians must focus on individual problem before making an ethical decision They should ask questions, review documentation, talk to patients and health care professionals, and search for further data for a complete picture of the situation

29. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Analyzing the Data and Forming an Action Plan After gathering data, the correct ethical approach must be decided upon, considering all involved individuals An action plan should be formed to evaluate all the data and ascertain the various tasks necessary to handle the situation

30. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Evaluating the Results After all steps have been taken to handle situation, it is important to evaluate the results Positive results that are fair and equitable are always desired Proper evaluation of results helps to shape the way future problems will be solved

31. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Ethical Issues in the Pharmaceutical Industry Interests of those in the pharmaceutical industry sometimes conflict with other health care professionals’ Exchange of gifts or money involves serious ethical issues Patient’s welfare must always be placed above any other consideration

32. © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Ethical Issues in the Pharmaceutical Industry Legitimate patient care must be the goal of all medication development and manufacture, not monetary gain that leads to ethical breaches No gifts or money should be accepted by anyone because they can lead to unethical decisions, potentially harming patients