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I cannot but have reverence for all that is called life. I cannot avoid compassion for everything that is called life. That is the beginning and foundation of morality. Once a man has experienced it and continues to do so—and he who has once experienced it will continue to do so—he is ethical.
Albert Schweitzer, 19191
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Objectives: Upon completion of the chapter and exercises, the learner will be able to
Describe the ethical obligations pharmacists carry in their professional lives and occupational roles, and from where these obligations originate.
List professional and occupational roles and environments in which pharmacists carry ethical obligations, including those not part of providing direct patient care.
Describe the four components of analysis and response when possible ethical problems are encountered in the course of professional and occupational activities.
List resources pharmacists can use for general ethics knowledge and for help with individual ethical problems.
Reflect on ethical problems they have encountered in the past that were managed properly or should have been managed differently.
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What is the right method a pharmacist should use in deciding which patients get a treatment in scarce supply? What is the right action for a pharmacist to take when a colleague's behavior threatens public safety? What is the right balance a pharmacist should achieve between cost and clinical benefits in developing prescription drug insurance coverage policies? More broadly, how should pharmacists proceed in any situation attached to the question: “What is the right thing to do?” These kinds of questions concern ethics. Their answers, and the way in which they were attained, determine whether the pharmacist is ethical.
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Pharmacy students and pharmacists who entered practice recently might wonder about the value studying health care ethics offers; are they not ethical as a consequence of their clinical education and training? Health care professionals and educators seem highly ethical, and most are ethical. History, though, is replete with cases—some notorious, some unwitting, and some considered appropriate at the time—all wholly unacceptable today.2 While this sorted history concerns mostly research activities, its implications encompass health care provider services and the many other roles pharmacists take. For more detail about the ethical problems spawning ethics codes, principles, laws, and other reform mechanisms, see the chapter, “Ethics in Medical Research,” in the book Research Methodology in the Health Sciences.
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Pharmacists carry obligations for identifying and solving ethical problems as much as they carry obligations for identifying and solving problems with drug compounding, drug distribution, and drug therapeutics. Pharmacists acquire these obligations implicitly as health care professionals. Western societies establish health care professions through their support of professional education and training programs, accreditation standards, and licensure requirements. Entry barriers into these professions provide a degree of monopoly on their services. In return, societies expect health professions to make the health needs of society members their ...