Ethical Responsibility in Pharmacy Practice

Ethical Responsibility in Pharmacy Practice

Author: Robert A. Buerki and Louis D. Vottero
Publisher: American Institute of the History of Pharmacy
Year Published: 2002
Pages: 272
ISBN: 0-931292-37-9
Price: $30.00 ($18.00 for members)

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Read an excerpt from Ethical Responsibility in Pharmacy Practice.

New Material:

Added to the second edition of this comprehensive 272-page textbook:

• Case studies with full commentaries

• Glossary of pertinent terms

• Current issues of ethical concern

Praise for Ethical Responsibility in Pharmacy Practice:

“The extensive use of current pharmacy practice examples throughout Ethical Responsibility in Pharmacy Practice results in a highly accessible presentation of ethical theory which is immediately applicable by both beginning and advanced students…. The layout of Ethical Responsibility could serve as a model syllabus for a course in pharmacy ethics.” —American Journal of Pharmaceutical Education

Introduction to the First Edition:

While the teaching of professional ethics is undoubtedly labor-intensive, it can also be deeply satisfying. By introducing students to ethical concepts, giving them directed practice in applying ethical principles, and allowing them to develop skills in problem-solving and critical thinking, the instructor of professional ethics can heighten student sensitivity, increase professional awareness, and, indirectly, improve health care at the critical pharmacist-patient interface. Ethical Responsibility in Pharmacy Practice is our modest contribution to these goals.

Introduction to the Second Edition:

This new edition of Ethical Responsibility in Pharmacy Practice includes new sections on controversial topics such as terminal sedation, euthanasia, and assisted suicide; ethical issues associated with controlling prices on prescription medication; and the ethical challenges presented by alternative medications. A commentary has been added to each case study, which pharmacy students should find useful as they develop their own set of professional practice values and methods of resolving the ethical conflicts they will face in their professional practice; an extensive glossary of terms has also been added as a courtesy to the reader.

Table of Contents:

1: Chapter 1 Professional Values in Pharmacy Practice

2: Traditional professional values in pharmacy practice

5: Shifting professional values in pharmacy practice

8: Incorporating human values into pharmacy practice

13: The Pharmacist as a Health-Care Provider

13: Traditional boundaries of practice

14: Legal boundaries of practice

19: Expanding boundaries of practice

22: Concluding Remarks

23: Study Questions

24: References

28: Suggested Readings

29: Chapter 2: Foundations of Ethical Decision-Making

30: Ethical Theories and Principles as a Framework for Decision-Making

32: Traditional ethical theories applied to the practice of pharmacy

33: Newer ethical principles applied to the practice of pharmacy

34: Character and virtue in the practice of pharmacy

38: Rights and duties in the practice of pharmacy

40: Professional Codes as a Framework for Decision-Making

41: Difficulties associated with traditional codes

45: A Framework for Ethical Decision-Making in Pharmacy Practice

45: Step one: Problem identification

47: Step two: Develop alternative courses of action

49: Step three: Select one alternative course of action

50: Step four: Consider objections to alternative selected

51: Applying the Ethical Decision-Making Framework

51: Decisions influenced by professional authority

55: Decisions influenced by technical competence

57: Decisions influenced by codes or rules

59: Decisions influenced by legislation

60: Decisions influenced by personal and professional values

62: Decisions influenced by economic forces

63: Concluding Remarks

64: Study Questions

64: Situations for Analysis

65: References

69: Suggested Readings

71: Chapter 3: The Pharmacist-Patient Relationship

72: The nature of the pharmacist-patient relationship

74: The complexity of the pharmacist-patient relationship

75: The Moral Basis of the Pharmacist-Patient Relationship

76: Moral principles affecting the relationship

79: Observing faithfulness in the relationship

81: Incorporating other patient-centered values

83: Conflicts among Role Obligations

83: Maintaining patient faithfulness

86: Restricting professional services

88: Observing truthfulness in placebo therapy

91: Reconciling guilt feelings

93: Maintaining patient confidentiality

95: Concluding Remarks

95: Study Questions

95: Situations for Analysis

96: References

99: Suggested Readings

101: Chapter 4: Ethical Considerations in Professional Communications

102: Communication as an ethical standard

109: Communication as a practice standard

118: Ethical Considerations in Pharmacy Communication

118: Considerations when initiating drug therapy

120: Considerations when monitoring drug therapy

121: Considerations involving irrational prescribing

122: Considerations involving adverse drug reactions

124: Considerations involving self-medication

126: Encounters with Other Health Professionals

126: Establishing professional communications

128: Validating professional decisions

129: Reviewing therapeutic decisions

131: Encounters with Other Pharmacists

131: Dealing with impaired colleagues

132: Maintaining continuity of patient care

134: Reconciling perceived discrepancies

135: Encounters with the General Public

136: Establishing a professional image

137: Championing the cause of public health

139: Extending professional services to the public

140: Concluding Remarks

141: Study Questions

141: Situations for Analysis

142: References

147: Suggested Readings

149: Chapter 5: Ethical Considerations in Drug Distribution

150: Expansion of the drug distribution system

151: Shifting public perspectives of drug distribution

154: Impact upon Professional Pharmacy Practice

155: Freedom of choice of drugs and services

160: The fully informed consumer of drugs and services

165: Access to drugs and professional services

170: Dealing with terminal illness

174: Controlling the prices of prescription medication

178: Wrestling with the challenges of alternative medicines

182: Concluding Remarks

183: Study Questions

183: Situations for Analysis

184: References

187: Suggested Readings

Appendix A

189: Codes of Ethics

189: Hippocratic Oath, 4th century B.C.

190: Philadelphia College of Pharmacy, 1848

193: American Pharmaceutical Association, 1852

195: American Pharmaceutical Association, 1922

199: American Pharmaceutical Association, 1952

202: American Pharmaceutical Association, 1969

204: American Pharmaceutical Association, 1981

206: American Pharmaceutical Association, 1994

208: American Medical Association, 2001

211: American Nurses Association, 2001

212: American Hospital Association, 1992

216: National Association of Boards of Pharmacy, 1992

216: American Pharmaceutical Association Pledge of

218: Professionalism, 1994

219: References

Appendix B

223: Facies Pro Causis

Appendix C

231: Glossary

Table of Cases

52: Case 2.1: Conflicts in Therapy

56: Case 2.2: Conflicts in Drug Selection

58: Case 2.3: Conflicts in Professional Etiquette

59: Case 2.4: Conflicts between Legal and Ethical Practice

61: Case 2.5: Conflicts between Value Systems

62: Case 2.6: Conflicts Arising From Profit Motives

84: Case 3.1: Loyalty to Patient Care

85: Case 3.2: Observing Employment Policies

86: Case 3.3: Curtailing Counseling Services

87: Case 3.4: Managing Conflicting Services

88: Case 3.5: Interpreting Placebo Therapy

89: Case 3.6: Identifying Placebo Therapy

91: Case 3.7: Providing Comprehensive Drug Information

92: Case 3.8: Providing Incomplete Drug Information

93: Case 3.9: Establishing the Boundaries of Confidentiality

94: Case 3.10: Restricting Access to Patient Information

118: Case 4.1: Assuring Informed Consent

120: Case 4.2: Implementing Drug Utilization Review

121: Case 4.3: Establishing Rational Therapy

123: Case 4.4: Monitoring Untoward Reactions

125: Case 4.5: Assuring Rational Autotherapy

126: Case 4.6: Clarifying Physician Orders

128: Case 4.7: Questioning Drug Selection

129: Case 4.8: Monitoring Drug Utilization

130: Case 4.9: Assessing Professional Competence

133: Case 4.10: Preserving Patient Confidence

134: Case 4.11: Defending Drug Product Selection

136: Case 4.12: Advertising Professional Services

137: Case 4.13: Monitoring Questionable Products

139: Case 4.14: Performing Compassionate Acts

156: Case 5.1: Directing Prescription Orders

157: Case 5.2: Limiting Access to Service

158: Case 5.3: Fractionating Pharmacy Services

161: Case 5.4: Advertising Prescription Prices

162: Case 5.5: Choosing among Multisource Drugs

163: Case 5.6: Direct-to-Consumer Advertising

165: Case 5.7: Exercising Professional Discretion

167: Case 5.8: Managing Third-Party Program Conflicts

169: Case 5.9: Participating in Investigational Studies

171: Case 5.10: Managing Cases of Terminal Sedation

173: Case 5.11: Managing Cases of Euthanasia

175: Case 5.12: Professional Responsibility in Controlling Prescription Prices

177: Case 5.13: Serving the Patient within the Boundaries of the Health-Care System

179: Case 5.14: Dealing with Requests for Homeopathic Remedies

180: Case 5.15: Balancing Alternative and Rational Medical Practices

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