WVPS 321
PROFESSIONAL ETHICS FOR PHARMACISTS
PROF SANDRA VAN DYK
, MORE B.PHARM NOTES AVAILABLE
ON:
https://www.stuvia.com/en-za/user/MarliMariaGeyser
Thank you for purchasing my notes! I hope that these summaries prove as useful to you as they
were to me. If you find any mistakes, spelling, copyright or otherwise, feel free to E-mail me
personally or message me by using the Stuvia website. I will rectify them as soon as possible and
upload the updated version which you can download again, free of charge. These notes will be
updated on a regular basis to accommodate change in literature, new tests, and the modules
themselves. I wish you well with your studies!
Kind Regards,
Marli Maria Geyser
i
,TABLE OF CONTENTS
STUDY UNIT 1: PRINCIPLES OF ETHICS
Study section 1.1. Theoretical approach to ethics………………………………………………………………………….1
Study section 1.2. Ethics as a multi-disciplinary discipline………………………………………………………………4
Study section 1.3. Medical ethics and the pharmacist…………………………………………………………………...4
a) Summary of the Code of Conduct of pharmacists:
Introduction………………………………………………………………………………………………………………….5
1.1 Wellbeing of the patient……………………………………………………………….…………………….........6
1.2 Honour and dignity of the profession………………………………….………………………………………6
1.3 Confidentiality………………………………………………………………….………….……………………..………6
1.4 Continuing professional development……………………………………………….………………………..7
1.5 Co-operation with health care professionals …………………………………….………………..………8
1.6 Professional independence ………………………………………………………………..……………………….9
1.7 Advertising ………………………………………………………………………………………………………….…….10
1.8 Professional appearance and nature of pharmacy ………………………………....………….……..12
1.9 Control over medicines …………………………………………………………………………..……….………..12
1.10 Chemicals sold/provided in a pharmacy ………………………………………………..………….……….14
1.11 Dual registration …………………………………………………………………………………………….………….14
1.12 The use of trading titles, brand names and logos …………………….……………………….………..15
STUDY UNIT 2: ETHICS IN PRACTICE…………………………………………………………………….…………………..…….16
ii
, STUDY UNIT 1: PRINCIPLES OF ETHICS
Study section 1.1. Theoretical approach to ethics
On completion of this module you should be able to:
- Have thorough knowledge of the theoretical approach to ethics;
- Have a clear understanding of ethics as a multi-disciplinary discipline;
- Be familiar with the principles of medical ethics with specific reference to the role of the
pharmacist;
- Be able to take a stand on the challenges of our time;
- Be able to analyse practical problems and challenges and propose solutions and
- Have a thorough understanding of responsibilities toward ourselves, our colleagues, patients
and the environment
Learning outcomes 1.1
- define the term, ethics;
- analyse the concept of ethics as a division of philosophy;
- formulate the difference between ethics and morality; and
- use world view, morality and ethics to argue appropriate examples.
a. Define ethics:
1. Refers to well-founded standards of right and wrong that prescribe what humans ought to do,
usually in terms of rights, obligations, benefits to society, fairness, or specific virtues. Such standards
are adequate standards of ethics because they are supported by consistent and well-founded
reasons:
• Obligations to refrain from rape, stealing, murder, assault, slander & fraud
• Includes virtues of honesty, compassion, and loyalty
• Include standards relating to rights, such as the right to life, the right to freedom from injury,
and the right to privacy.
2. Refers to the study and development of one's ethical standards as feelings, laws, and social norms
can deviate from what is ethical. It is therefore necessary to constantly examine one's standards to
ensure that they are reasonable and well-founded. Continuously studying our own moral beliefs and
our moral conduct, and striving to ensure that we live up to standards that are reasonable and
solidly-based
Ethics is not:
® A feeling: A person following his or her feelings may recoil from doing what is right. In fact, feelings
frequently deviate from what is ethical
® Identifiable with religion: Religion advocates high ethical standards. Yet ethics is not only confined
to religion. It applies as much to the behaviour of an atheist . Religion can set high ethical standards
and can provide intense motivations for ethical behaviour. Ethics, therefore, cannot be confined
to religion nor is it the same as religion
1
, ® The same as following the law: Laws can deviate from what is ethical, for example slavery &
apartheid laws where unethical
® Not doing what is socially acceptable: Standards of behaviour in society can deviate from what is
ethical. An entire society can become ethically corrupt example Nazi Germany
Introduction to ethics: https://youtu.be/3_t4obUc51A
b. Medical Ethics:
Ethics involves the application of a moral code to the practice of medicine
Summary of principles from the Hippocratic Oath, a solemn promise:
- Of solidarity with teachers and other physicians.
- Of beneficence (to do good or avoid evil) and non-maleficence (from the Latin 'primum non
nocere', or 'do no harm') towards patients. (In fact the well-known "first do no harm" phrase
does not feature in the classical Hippocratic Oath.)
- Not to assist suicide or abortion
- To leave surgery to surgeons
- Not to harm, especially not to seduce patients
- To maintain confidentiality and never to gossip
Principles of biomedical ethics:
i. Respect for autonomy: Patient should be informed of all aspects regarding treatment.
Pharmacists should enquire about their patient's wishes to receive information and to make
decisions. Never assume that because a patient is part of a particular culture or community,
they affirm that community's values and beliefs https://youtu.be/a3LfA_RPytU
ii. Nonmaleficence: Abstain from causing harm to others
® Do not kill
® Do not cause pain or suffering
® Do not incapacitate
® Do not deprive others of the goods of life
® The obligations of nonmaleficence include not only obligations not to inflict harm, but
also not to impose risks of harm.
® It must be remembered that the principle of nonmaleficence and its specifications in
moral rules are prima facie and not absolute.
iii. Beneficence: We should not only treat patients autonomously and refrain from harming them,
but also contribute to their welfare. These beneficial actions fall under the heading
'beneficence'. The principles of beneficence potentially require more than those of
nonmaleficence, because doctors must take positive steps to help people and not merely refrain
from harm. Patient welfare embodies medicine's goal, justification and rationale - examples
here include public health, preventative medicine and biomedical research.
2
, iv. Justice: Justice means giving each person what the deserve, a standard of rightness. equals
should be treated equally and unequal’s unequally. this principle is sometimes expressed as
follows: "Individuals should be treated the same, unless they differ in ways that are relevant to
the situation in which they are involved. Countries that lack a comprehensive and coherent
healthcare system typically have larger numbers of unprotected citizens and therefore need to
improve both utility (efficiency) and justice (fairness and equality). This is further complicated
by the fact that the construction of a unified theory of justice that captures our diverse
conceptions and use of principles of justice in biomedical ethics remains controversial and hard
to pin down.
Videos to watch on medical ethics : https://youtu.be/PrHEOdHJ_2c
https://youtu.be/R_f6ngc8y5M
Other medical ethics principles:
• Treat the patient as an individual: Important to tailor care to the needs of the individual
patient treatment and care should take into account patients' individual needs and
preferences. Also includes discarding prejudice. Patients should be provided with the best
possible care irrespective of age, sexuality, ethnicity, religious beliefs or politics. This is
particularly true of lifestyle issues. Whatever the clinician's view of smoking, obesity and drug
dependency, it is his or her ethical duty to be supportive, not judgemental.
• Confidentiality
• Informed consent
• Primum non nocere (first do no harm)
Example: A patient submits a script for a total quantity of 120 10mg Methylphenidate tablets. After
the needed investigation the doctor prescribed these tablets for the lady for weight loss and
appetite suppression. The script was inspected and met all the needed requirements
Ethical issue: Methylphenidate belongs to the group of amphetamines and could be toxic in cases of
misuse for weight loss, it is also not indicated for this purpose (off-label use)
Autonomy: The patient has a valid prescription which indicates a need for the treatment. As a patient,
she has the right to effective prescribed treatment. If she is eligible for the script according to the
prescriber, she has the right to receive a treatment which was prescribed to her. As a pharmacist we
need to explain to her the possible side-effects of the off-label use. Using this medication for control
of weight is not a safe option, since weight loss is just a side effect. The patient can experience
vomiting, nausea and accelerated heart rate. Over time your body builds up a tolerance to the drug
and you have to take more to keep losing weight. The patient must be made aware of the possible
risks and danger concerning their health. She has the right to make an informed decision based on all
the information. Due to the popular off-label prescribing, it has become a norm in South Africa and
has led to the misuse of the drugs. These drugs should not be used for weight loss, due to the
dangerous side-effects
Beneficence: methylphenidate’s off-label use will assist with weight loss, which is the goal for the
therapeutic treatment. The life quality of the patient should always be considered and by losing
3
PROFESSIONAL ETHICS FOR PHARMACISTS
PROF SANDRA VAN DYK
, MORE B.PHARM NOTES AVAILABLE
ON:
https://www.stuvia.com/en-za/user/MarliMariaGeyser
Thank you for purchasing my notes! I hope that these summaries prove as useful to you as they
were to me. If you find any mistakes, spelling, copyright or otherwise, feel free to E-mail me
personally or message me by using the Stuvia website. I will rectify them as soon as possible and
upload the updated version which you can download again, free of charge. These notes will be
updated on a regular basis to accommodate change in literature, new tests, and the modules
themselves. I wish you well with your studies!
Kind Regards,
Marli Maria Geyser
i
,TABLE OF CONTENTS
STUDY UNIT 1: PRINCIPLES OF ETHICS
Study section 1.1. Theoretical approach to ethics………………………………………………………………………….1
Study section 1.2. Ethics as a multi-disciplinary discipline………………………………………………………………4
Study section 1.3. Medical ethics and the pharmacist…………………………………………………………………...4
a) Summary of the Code of Conduct of pharmacists:
Introduction………………………………………………………………………………………………………………….5
1.1 Wellbeing of the patient……………………………………………………………….…………………….........6
1.2 Honour and dignity of the profession………………………………….………………………………………6
1.3 Confidentiality………………………………………………………………….………….……………………..………6
1.4 Continuing professional development……………………………………………….………………………..7
1.5 Co-operation with health care professionals …………………………………….………………..………8
1.6 Professional independence ………………………………………………………………..……………………….9
1.7 Advertising ………………………………………………………………………………………………………….…….10
1.8 Professional appearance and nature of pharmacy ………………………………....………….……..12
1.9 Control over medicines …………………………………………………………………………..……….………..12
1.10 Chemicals sold/provided in a pharmacy ………………………………………………..………….……….14
1.11 Dual registration …………………………………………………………………………………………….………….14
1.12 The use of trading titles, brand names and logos …………………….……………………….………..15
STUDY UNIT 2: ETHICS IN PRACTICE…………………………………………………………………….…………………..…….16
ii
, STUDY UNIT 1: PRINCIPLES OF ETHICS
Study section 1.1. Theoretical approach to ethics
On completion of this module you should be able to:
- Have thorough knowledge of the theoretical approach to ethics;
- Have a clear understanding of ethics as a multi-disciplinary discipline;
- Be familiar with the principles of medical ethics with specific reference to the role of the
pharmacist;
- Be able to take a stand on the challenges of our time;
- Be able to analyse practical problems and challenges and propose solutions and
- Have a thorough understanding of responsibilities toward ourselves, our colleagues, patients
and the environment
Learning outcomes 1.1
- define the term, ethics;
- analyse the concept of ethics as a division of philosophy;
- formulate the difference between ethics and morality; and
- use world view, morality and ethics to argue appropriate examples.
a. Define ethics:
1. Refers to well-founded standards of right and wrong that prescribe what humans ought to do,
usually in terms of rights, obligations, benefits to society, fairness, or specific virtues. Such standards
are adequate standards of ethics because they are supported by consistent and well-founded
reasons:
• Obligations to refrain from rape, stealing, murder, assault, slander & fraud
• Includes virtues of honesty, compassion, and loyalty
• Include standards relating to rights, such as the right to life, the right to freedom from injury,
and the right to privacy.
2. Refers to the study and development of one's ethical standards as feelings, laws, and social norms
can deviate from what is ethical. It is therefore necessary to constantly examine one's standards to
ensure that they are reasonable and well-founded. Continuously studying our own moral beliefs and
our moral conduct, and striving to ensure that we live up to standards that are reasonable and
solidly-based
Ethics is not:
® A feeling: A person following his or her feelings may recoil from doing what is right. In fact, feelings
frequently deviate from what is ethical
® Identifiable with religion: Religion advocates high ethical standards. Yet ethics is not only confined
to religion. It applies as much to the behaviour of an atheist . Religion can set high ethical standards
and can provide intense motivations for ethical behaviour. Ethics, therefore, cannot be confined
to religion nor is it the same as religion
1
, ® The same as following the law: Laws can deviate from what is ethical, for example slavery &
apartheid laws where unethical
® Not doing what is socially acceptable: Standards of behaviour in society can deviate from what is
ethical. An entire society can become ethically corrupt example Nazi Germany
Introduction to ethics: https://youtu.be/3_t4obUc51A
b. Medical Ethics:
Ethics involves the application of a moral code to the practice of medicine
Summary of principles from the Hippocratic Oath, a solemn promise:
- Of solidarity with teachers and other physicians.
- Of beneficence (to do good or avoid evil) and non-maleficence (from the Latin 'primum non
nocere', or 'do no harm') towards patients. (In fact the well-known "first do no harm" phrase
does not feature in the classical Hippocratic Oath.)
- Not to assist suicide or abortion
- To leave surgery to surgeons
- Not to harm, especially not to seduce patients
- To maintain confidentiality and never to gossip
Principles of biomedical ethics:
i. Respect for autonomy: Patient should be informed of all aspects regarding treatment.
Pharmacists should enquire about their patient's wishes to receive information and to make
decisions. Never assume that because a patient is part of a particular culture or community,
they affirm that community's values and beliefs https://youtu.be/a3LfA_RPytU
ii. Nonmaleficence: Abstain from causing harm to others
® Do not kill
® Do not cause pain or suffering
® Do not incapacitate
® Do not deprive others of the goods of life
® The obligations of nonmaleficence include not only obligations not to inflict harm, but
also not to impose risks of harm.
® It must be remembered that the principle of nonmaleficence and its specifications in
moral rules are prima facie and not absolute.
iii. Beneficence: We should not only treat patients autonomously and refrain from harming them,
but also contribute to their welfare. These beneficial actions fall under the heading
'beneficence'. The principles of beneficence potentially require more than those of
nonmaleficence, because doctors must take positive steps to help people and not merely refrain
from harm. Patient welfare embodies medicine's goal, justification and rationale - examples
here include public health, preventative medicine and biomedical research.
2
, iv. Justice: Justice means giving each person what the deserve, a standard of rightness. equals
should be treated equally and unequal’s unequally. this principle is sometimes expressed as
follows: "Individuals should be treated the same, unless they differ in ways that are relevant to
the situation in which they are involved. Countries that lack a comprehensive and coherent
healthcare system typically have larger numbers of unprotected citizens and therefore need to
improve both utility (efficiency) and justice (fairness and equality). This is further complicated
by the fact that the construction of a unified theory of justice that captures our diverse
conceptions and use of principles of justice in biomedical ethics remains controversial and hard
to pin down.
Videos to watch on medical ethics : https://youtu.be/PrHEOdHJ_2c
https://youtu.be/R_f6ngc8y5M
Other medical ethics principles:
• Treat the patient as an individual: Important to tailor care to the needs of the individual
patient treatment and care should take into account patients' individual needs and
preferences. Also includes discarding prejudice. Patients should be provided with the best
possible care irrespective of age, sexuality, ethnicity, religious beliefs or politics. This is
particularly true of lifestyle issues. Whatever the clinician's view of smoking, obesity and drug
dependency, it is his or her ethical duty to be supportive, not judgemental.
• Confidentiality
• Informed consent
• Primum non nocere (first do no harm)
Example: A patient submits a script for a total quantity of 120 10mg Methylphenidate tablets. After
the needed investigation the doctor prescribed these tablets for the lady for weight loss and
appetite suppression. The script was inspected and met all the needed requirements
Ethical issue: Methylphenidate belongs to the group of amphetamines and could be toxic in cases of
misuse for weight loss, it is also not indicated for this purpose (off-label use)
Autonomy: The patient has a valid prescription which indicates a need for the treatment. As a patient,
she has the right to effective prescribed treatment. If she is eligible for the script according to the
prescriber, she has the right to receive a treatment which was prescribed to her. As a pharmacist we
need to explain to her the possible side-effects of the off-label use. Using this medication for control
of weight is not a safe option, since weight loss is just a side effect. The patient can experience
vomiting, nausea and accelerated heart rate. Over time your body builds up a tolerance to the drug
and you have to take more to keep losing weight. The patient must be made aware of the possible
risks and danger concerning their health. She has the right to make an informed decision based on all
the information. Due to the popular off-label prescribing, it has become a norm in South Africa and
has led to the misuse of the drugs. These drugs should not be used for weight loss, due to the
dangerous side-effects
Beneficence: methylphenidate’s off-label use will assist with weight loss, which is the goal for the
therapeutic treatment. The life quality of the patient should always be considered and by losing
3
