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Dr. Manolakis is Vice President, Pharmacy Consulting for Aon. He received his Doctor of Pharmacy from the University of Southern California and his PhD in Philosophy with a concentration in bioethics from the University of Tennessee, Knoxville. Prior to joining Aon, he served as Associate Professor and Director of Interprofessional Education at Wingate University School of Pharmacy where he taught courses in bioethics, leadership, and the US healthcare system. In addition to his career in pharmacy education, he has practiced as a community pharmacist and a managed care pharmacist. His research interests include empathy development and leadership development.

Dr. Robinson is a Dean at the Creighton University School of Pharmacy and Health Professions. Prior to joining Creighton University he was Dean at the Western New England University College of Pharmacy and Health Sciences, where he has served since 2008. As the founding dean for the College of Pharmacy, Dr. Robinson has been involved in a variety of the foundational considerations of the program’s development and implementation. He served as the Associate Provost for Academic Affairs from September 2016 to July 2018. Prior to his position at Western New England University, Dr. Robinson participated in the development of two new schools of pharmacy.



After completing this chapter, readers should be able to:

  1. Identify key steps in the Markula Model for ethical decision-making (EDM).

  2. Describe the difference between the rationalist and nonrationalist approaches to EDM.

  3. Describe what is meant by sensemaking as it applies to problem-solving.

  4. Explain the relationship between organizational culture and ethical problem-solving.

  5. Explain the relationship between empowerment and delegation with problem-solving.

  6. Describe how influence relates to leadership/management.


  1. Do you reason first and then make an ethical decision, or do you make an ethical decision and then reason? The significance of this question will become clear as you work through the chapter, and your answer will inform how you approach EDM.

  2. What is the significance of the development of a pharmacist’s professional identity as it pertains to making ethical decisions?

  3. How does sensemaking relate to problem-solving and ethical considerations?

  4. How do ethical considerations relate to the tenets of management and leadership?

  5. How do the tenets of management and leadership relate to problem-solving?


Lynn Smith enters the hospital for an ailment that, at the time of her admission, was as yet unidentified. Lynn undergoes a battery of tests; after a few days her ailment is identified, and inpatient therapy begins. Soon thereafter, she receives the good news that she is discharged with a positive prognosis. Unfortunately, she is soon to learn that her ability to be treated, however, may be more complicated than she was ...

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