Ethical Dilemma in Pharmacy - Essay Example

Ethical Dilemma in Pharmacy A patient who has a daily supervised dose of methadone calls back into the pharmacy a few hours after taking his daily dose requesting a supply of safe injecting equipment. How would you manage the care of this patient? Most pharmacists find themselves in a confusion due to ethical dilemmas. Most of the ethical dilemmas that a large number of pharmacists face are issues concerning potentially dangerous drugs and ways of consuming some drugs which pharmacists find morally objectionables. Some of the dilemmas faced by pharmacists are extremely challenging to find solutions. In some states, pharmacists operate under set rules and regulations and therefore, they face ethical dilemmas when prescribing dangerous medication. This essay relies on the above scenario to discuss how pharmacists find themselves in ethical dilemmas and concludes by giving solutions on how to overcome such dilemmas. Here there is an ethical dilemma because the pharmacist is not aware of what the patient is intending to do with the injecting equipment. The patient may be planning to use the injecting equipment for purposes that may cause serious injuries or harm thus putting the pharmacist into trouble according to NHS Quality Improvement Scotland.The majority of people are currently being prescribed methadone not for drug abuse but for pain. It is true that methadone is the only type of narcotic that works in certain conditions. For instance, methadone is frequently used forrelief of cancer pains or peripheral neuropathy. Therefore, the pharmacist is in an ethical dilemma since he does not know the purpose the patient is requesting for the injecting equipment. In addition, the pharmacist cannot assume that the patient is requesting for safer injecting equipment for heroin withdrawal. Now the patient calling back in the same pharmacy for safe injecting equipment can make the pharmacist think that the patient is requesting for the injection equipment for something innocent. For instance, the patient’s grandmother may in need of insulin syringes. However, the preparation of methadone itself is such that the drug discourages injection. There is more that the pharmacist should do in such a situation but he should take the appropriate steps. Mostly, the pharmacist should first ask the patient why he is requesting for the injection equipment. In addition, methadone is temporary and supposedly the patient’s way off. If the patient is injecting other drugs, then the pharmacist should know that he should be given higher methadone dose or prescribed another powerful drug such as Antabuse, which will assist him put other things besides. The pharmacist should therefore, understand that his treatment have failed the patient. Since this is a legal situation, the pharmacist should take action and report the case to the police. The pharmacist’s occasional screen tests will be reliable and the results should be used when reporting to the police. Here there is an ethical dilemma regarding issuing the safe injecting equipment. Safe injecting equipment is only given to patients if the patient has a clear reason on what he or she is intending to do with the injection equipment due to the potentiality of the drug abuse. In this case, the pharmacist is not aware of what the patient is intending to do with the injecting equipment, although he may guess that it is being requested for something innocent because this is the same clinic where he gets his daily dose. The main ethical principle involved in the pharmacist’s case is that of beneficence. Without knowing the exact usage of safer injecting equipment, giving in to the patient’s request may cause harm and injury to the patient. The pharmacist, therefore, has the duty of protecting the patient from potential harm with the issue of the injection equipment. What responsibilities and legal recourse does the pharmacist have? Ivanovska (2011) asserts that all pharmaceutical employees should have an understanding as well as being able to operate within the laws that govern their duties and also within the scope of study field for which they were trained and licensed[1]. The pharmacist may not or may have the authority of giving the patient the requested safe injecting equipment. Although pharmacists are not supposed to give patients safe injecting equipment due to potential drug abuse possibility, this can be done only if there are legal measures taken before the patient is given the injecting equipment[2]. Methadone is a very harmful drug when abused and the pharmacists should take caution when issuing the safe injection equipment to the patient[3]. Methadone is used for anti-addictive people and mainly prescribe for those people. The patient may be requesting the injection equipment to go and inject himself with more methadone[4]. This is very harmful to the patient’s health because an overdose of methadone can slow or stop his breathing when overdosed or changed. The medicine is also habit forming even when used at regular doses. The patient may also be asking for safe injecting equipment to share the drug with another person. This medicine should not be shared with another individual especially if the person has addiction or drug abuse history.Over usage of methadone can also cause a heart rhythm disorder resulting to the death of the patient and if this occurs, the pharmacist will be liable to the death according the law. Therefore, the pharmacist will be risking both his life and the life of the patient by just giving him the requested injecting equipment without first investigating to know the exact usage of the injecting equipment. According to Health Improvement Scotland, if the pharmacist will give the patient the requested injecting equipment, this will charged as a clinical equipment hazard. According to the law, omission of pharmaceutical rules and regulation means that the pharmacist should be send to imprisonment or fined. Before the pharmacist gives the patient the safe injecting equipment, he should first take into consideration the outcomes or consequences of taking such risk. He should use all controls that he can put in place to try managing the risk, such as reporting the patient to the police. What the pharmacist should do first before giving the patient the injecting device is evaluating the risk’s consequences. The pharmacist should then identify the highest priorities before taking the necessary actions. The pharmacist should look at how he can manage the situation, have active controls, and have a contingency. First, the pharmacist should take in mind that the NHS board has not legalized provision of injecting equipment to: patients who take prescribed drugs, those who do not inject and those who use illicit drugs, and people under the age of 16 years[5]. There are several reasons why the Scotland government has provided guidelines for provision of injecting equipment. To begin with, according to the recent estimation, there are more than 25,000 injecting drug abusers in the country. Secondly, there is increased rate of health risks that are associated with drug injection. This includes infection of bacteria such as tetanus and septicemia. Collapsed veins, cellulitis, and abscesses all these result from injection using blunt needle. Those who use injections also puts themselves to a risk of infecting blood-borne virus such as Hepatitis C. The guidelines for provision of injecting equipment is written for individuals who are responsible for providing the injection equipment such as pharmacy staff and community pharmacists as it is in this case[6]. This is because they are responsible for making the right decision before they can provide an injecting equipment to a patient according to NHS rules in Scotland. Misuse of methadone includes fits of violence or rage, hostility, aggression, irritability, and excitement. The person requesting for injecting equipment may use it for other harmful and illegal purpose such as injection of illegal drugs such as cocaine[5]. One of the worst consequences of the pharmacist providing the injecting equipment to the patient is that the individual may be opiates or alcohol taker and this will definitely lead him to death[7]. For example, this type of drug combination caused deaths of Whitney Houston and Thomas Kinkade. Since tolerance is expected with methadone usages, if the person fails to achieve what he desires from this drug, he might get tempted to take alcohol in order to achieve what he was looking for. Since methadone is very harmful when combined with other drugs like alcohol, the person may end up losing his life. As a result and according to the Scotland law, both the pharmacist and the pharmacy owner will be responsible for the death. The pharmacist cannot assume that the patient is requesting for safer injecting equipment for heroin withdrawal.There is more that the pharmacist should do in such a situation, but he should take the appropriate steps. Mostly, the pharmacist should first ask the patient why he is requesting for the injection equipment. If the pharmacist is still doubting the patient, he should report the matter to the police first for him to be given a go ahead of providing the patient with the injecting equipment. Bibliography [1] Ripamonti, C., F. De Conno, L. Groff, M. Belzile, J. Pereira, J. Hanson, and E. Bruera. "Equianalgesic dose/ratio between methadone and other opioid agonists in cancer pain: comparison of two clinical experiences." Annals of Oncology 9, no. 1 (2008): 79. [2] Niveau, Gérard, Anne‐Laure Rougemont, and Romano La Harpe. "Methadone maintenance treatment, criminality and overdose‐related deaths An ecological study, 1983–1999." The European Journal of Public Health 12, no. 3 (2002): 224. [3] Gagan, Mark. "Legal aspects of independent and supplementary prescribing." Independent and Supplementary Prescribing: An Essential Guide (2010): 29. [4] Dennehy, L., and S. White. "Consent, assent, and the importance of risk stratification." British journal of anaesthesia 109, no. 1 (2012): 40-46. [5] Winfield, A. J., Judith A. Rees, and Ian Smith. 2009. Pharmaceutical practice. Edinburgh: Elsevier. http://www.123library.org/book_details/?id=108963. [6] Bryden, Daniele, and Ian Storey. "Duty of care and medical negligence." Continuing Education in Anaesthesia, Critical Care & Pain 11, no. 4 (2011): 124-127. [7] Gay, George W. "Suits for alleged malpractice." The Boston Medical and Surgical Journal 165, no. 11 (2011): 406-411. Read More