Pharmaceutics Code of Ethics - Essay Example

PP4 Interim Assignment - What would you do Relevant Legislation: Medicines Act 1968 governs manufacture and dispensing of medicines. There are certain drugs that are to be sold by pharmacists only with a prescription. Pharmacy medicines may be sold without prescription. Further modification of the act in 2005 states that as a responsible pharmacists, they should not sell homeopathy or other natural medicines since pharmacists are not just sellers; they are healthcare professionals (Royal Pharmaceutical Society Of Great Britain 2009). Thus they have ethical responsibility to inform the customers that before using such drugs the patients must have full knowledge that use of such medicines is not evidence based, although in the UK, the authorisation and registration legislation of homoeopathic medicinal products primarily relates to assurances of safety and quality. From this angle homoeopathic medications are unlicensed, and thus pharmacists are not supposed to dispense them (Royal Pharmaceutical Society Of Great Britain 2007b). Code of Ethics Principle 1: The first principle states that the matter of first priority should be care of the patient. In their daily work, the pharmacists need to apply this principle. This means the action and behaviour of the pharmacist will place the interest of the patient in the centre. If there is a legal or ethical dilemma, it is the duty of the pharmacist to evaluate all options, risks, and benefits and decide the best option which cares the patient most. Although in the UK homeopathic medicines are sold, these are unlicensed, and this is a violation of legislation (Royal Pharmaceutical Society of Great Britain 2007a). Principle 2: The pharmacist is required to exercise his professional judgment in the interest of the patient and the population in general. Homeopathy medications have no evidence base, and according to modern scientific medicine, it is uncertain whether they actually play any role in revering the pathophysiological process underlying the patient's ailments (Royal Pharmaceutical Society Of Great Britain 2009). Therefore, decision regarding selling a homeopathic medication, will have consideration about the patient's disease, condition, and financial constraints, not by commercial interests that may be served by selling homeopathic medication. In some cases, taking these medications may compromise the safety, and other colleagues may be in favour of selling these for sales pressure (Royal Pharmaceutical Society of Great Britain 2007a). Principle 3: The pharmacist must show respect to others in the context of diversity, cultural differences, values, and belief of others including the patient. This creates a specific and relevant ethical dilemma since marketing authorisation does not allow him to sale the product, whereas, the patient's personal beliefs suggest him to continue with the homeopathic medication (Royal Pharmaceutical Society Of Great Britain 2009). In such cases, polite and considerate discussion with the patient may produce results. Many such patients may also be very vulnerable. The best strategy would be to take the patient's consent, explain the situation, help him/her to seek appropriate and prescribed medical care to get appropriately treated, and while doing so the pharmacist's personal belief system should not interfere (Royal Pharmaceutical Society of Great Britain 2007a). Principle 4: The patient must be encouraged to participate in the decision about their care. If a patient comes with a request for a particular homeopathic medication, the patient must be engaged in a discussion about his/her disease conditions and problems. Information gained in such way may provide significant insight regarding the current condition and the need for required treatment and medication (Royal Pharmaceutical Society Of Great Britain 2009). In many cases, the patients may be motivated to change their decisions when they sense that the pharmacist is their partner in care. This could again open the avenue for discussion about the available options regarding their care (Royal Pharmaceutical Society of Great Britain 2007a). Principle 5: To be able to be competent in the above standards, the pharmacist must develop knowledge and competence at the professional level. As is understood, this knowledge must be up to date, high quality, and relevant. This means when advising against or refusing to sell a homeopathic medication, the pharmacist must have adequate knowledge to prove his point. This would facilitate the decision making and would make sure that the refusal to sell a homeopathic medication is at par with the professional responsibilities (Royal Pharmaceutical Society Of Great Britain 2009). This would require him to update himself on evidence-based professional knowledge, although he must know the limitations so when in doubt, he must make a decision to refer the patient to appropriate healthcare professional (Royal Pharmaceutical Society of Great Britain 2007a). Principle 6: Honesty and trustworthiness are two very important qualities that a pharmacist must have. There is evidence that in the UK even the famous pharmacies sell homeopathic medications due to popular demands despite knowing that this is unethical. This activity improves sales and revenues, but this is dishonesty (Royal Pharmaceutical Society Of Great Britain 2009). Therefore, according to ethical standards of practice, the honest action and integrity that ensures that the pharmacist would not capitalise on the lack of the knowledge of the clients to sell something which he is not authorised to do. In such situations, adherence to standards and professional at any cost could be the ideal ethical goal to pursue and thus to refuse selling with adequate explanation as to why these medications should not be taken (Royal Pharmaceutical Society of Great Britain 2007a). Principle 7: The pharmacist must be accountable. This means the professional responsibility of the work lies on the pharmacist. This is relevant since the knowledge about current practices, recent legislations, and professional expectations can be transmitted to the professional colleagues through sharing (Royal Pharmaceutical Society Of Great Britain 2009). Since the responsibility of the work is on the pharmacist, the ethical decision of refusing to sell, stock, and dispense homeopathic medications should be his responsibility and has a need to be legally and ethically sound. This would obviously be a professional and legal obligation, and even the working conditions of the pharmacy owner do not compromise these principles (Royal Pharmaceutical Society of Great Britain 2007a). Professional Standards and Guidance: According to the professional standards and guidance the decision to refuse the sale of a homeopathic medication is absolutely correct. Given the fact that there is a lack of evidence regarding homeopathic medication regarding its efficacy in disease conditions. Despite this, there is a consumer demand, and many patients believe that these medications work. The claims of such medications are that they can treat or prevent disease through use of diluted concentrations of active ingredients (Royal Pharmaceutical Society Of Great Britain 2009). This is a system of complementary medicine which is not recognised by the current scientific medications. These medications are used based on the principle that like cures like. However, it is also to be considered that many patients believe in these medications and there is a lack of effective treatment in conventional allopathic medications in many conditions (Whitaker, S., 2002). NHS runs five GP based homeopathic treatment facilities and recognises some homeopathic medications, which have been widely criticised. Since 2006, the new legislations allow the manufacturers to claim health benefits but they must prove that these are safe (MacRae, 2009). Conventional medications have a need to demonstrate therapeutic effect, but homeopathic medications do not need such facts, and the only need is to demonstrate a history of use with established safety. Here the personal belief of the consumers plays an important role. Despite ethical requirements to deny sale, stock, or dispensing explained earlier, the need to pay respect to the consumer beliefs plays important role in ethical and professional decision making for the pharmacist, and it may as well appear that denying the medications which the patient believes work would be unjustified (Royal Pharmaceutical Society of Great Britain 2007a). Other relevant Factors: Patient and consumer health belief system is now recognised to be important consideration in medicine and healthcare. Many patients from their experiences know that homeopathic medications work. If the argument that extreme dilutions reduce the active ingredients to such a miniscule amount that therapeutic activities hardly persist be true, then it could be prudent to recognise that homeopathic medications have no effect and hence they cannot have adverse effects (MacRae, 2009). This they may be safe despite being unregulated or unlicensed. Moreover, the legislations state that there is no need to demonstrate efficacy, the only need for licensing is demonstration of history of use. Thus legally patient experience plays important roles. It has also been suggested that they would only have placebo effects, which are really acceptable principles of treatment in conventional mainstream healthcare, and people do keep buying them leading to consumer demands. Thus there is a difference of opinion, but the pharmacist should follow the strict evidence-based knowledge and professional standards to guide his practice (Barrett and Tyler, 1995). Decision: Until not licensed, the pharmacist should cease to stock, sell, or dispense homeopathic medications. Justification: Legally and ethically, the pharmacist must first respect the professional code of conduct and standards. According to these codes of conducts, the pharmacist must see that appropriate and adequate care for the health issues are provided to the patient. In such cases, according to standards of practice, the pharmacist should refuse to sale, supply, or offer for sale the homeopathic products. However, in the UK, the NHS is currently promoting homeopathy as a practice, despite its lack of evidence. Appropriate care would mean selling a product which has appropriate integrity and quality and helping the patient to see a physician for the problem he or she is buying the homeopathic medicine. There is a professional need for the pharmacist to base on evidence (Johnson and Boon, 2007). Within this continuing debate whether homeopathic medications are to be sold by pharmacies, the evidence thus far does not support any efficacy of such medications other than placebo effect. If these are recognised as drugs, all regulations also should apply to them. There is evidence that many consumers, physicians, and pharmacists use, dispense, and prescribe homeopathic medications based on their safety, without really looking for their efficacy. As professional experts, pharmacists should be able to counsel their patients as to how to safely use medications, which is not possible adequately since homeopathy has not still been proved to be based on any tried scientific theory or investigation. In such situations, the pharmacist should be ready to challenge other colleagues in order to refuse such sales. The lack of supporting evidence should be the sole criteria for refusing to promote such medications. Until a consensus is reached between warring scientific population and the legislation, this should be considered only without thinking about other factors, since they may be intentioned to earn money from the sales. Since the patients want it, their decision may be ill-informed. All information about the homeopathic medications must be shared with them, so they may make informed decisions about their mode of treatment, which again highlights the importance of impartial information (Royal Pharmaceutical Society Of Great Britain 2009). To be able to provide information, the pharmacist must be knowledgeable. Updated knowledge about the efficacy of such medications and the legal requirements of professional practice would thus help the pharmacist to serve their patients better. Research in homeopathy is incomplete, but the requirement of counselling firmly establishes the need for this knowledge so they can provide requisite and meaningful information to their patients (Royal Pharmaceutical Society Of Great Britain 2007b). Pharmacists are viewed as trustworthy and honest community health advisor who are accessible better, and conformity to standards of practice facilitates this notion. This professional role creates an image of the pharmacist in client's mind where the client expects to get ethically sound counselling without any conflict of interest. The professional requirements to provide accurate and unbiased information and involving patients in their own decision making are important parameters of the pharmacist practice. In this way the pharmacist may satisfy that he has been professionally and ethically appropriate to refuse to sell homeopathic medication to a patient seeking it (Royal Pharmaceutical Society Of Great Britain 2009). References (Harvard Style): Barrett, S. and Tyler, VE., (1995). Why pharmacists should not sell homeopathic remedies. Am J Health-Syst Pharm.;52:1004-6. [ Johnson, T., and Boon, H., (2007). Where Does Homeopathy Fit in Pharmacy Practice Am J Pharm Educ.; 71(1): 07. MacRae, F. (2009) Boots boss admits they sell homeopathic remedies 'because they're popular, not because they work'from http://www.dailymail.co.uk/news/article-1230925/Boots-sells-homeopathic-remedies-theyre-popular-work.html#ixzz0eaIGh9TF. Daily Mail (2009). Royal Pharmaceutical Society of Great Britain (2007a). Code of Ethics for Pharmacists and Pharmacy Technicians London, 2007, 1-13. Royal Pharmaceutical Society Of Great Britain (2007b). Legal and Ethical Advisory Service Fact Sheet: Five. London 2007, 1-9. Royal Pharmaceutical Society Of Great Britain (2009) Medicines Ethics and practice - A guide for pharmacists and pharmacy technicians dated July 2009 edition 33 RPSGB. Whitaker, S., (2002). If we endorse quack cures we really deserve to be dubbed "Baddy Chemists" [letter]. Pharm J.;268:288. Read More