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Code of Pharmaceutical Ethics

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Introduction

•Ethics are the rules or norms for correct behaviour, conduct & action and cover the ideal ways in which one should behave or work in a society.

•Ethics: Moral principles or code of conduct.

•Written or unwritten principles.

•Not always obeyed by law – appeal to the inner conscience of the people.

•Law: help not to attack or cause injury to another.

•Ethics principles operate even outside the field of law.

•Need not be a part of one’s religious beliefs.


Conduct of individual in a society

◦Governmental controls – laws

◦Social customs and duties- left to individual and society.

◦Society lays down a code of conduct to help the individual to decide what is right and what is wrong


History

•Socrates initiated steps to construct an ethical frame work for the western civilization.

•He considered ethics as science of principles of universal validity and believed that such principles are good for one and all.

•“My neighbour’s duty is my duty also”


Situational ethics

•Professional activities are not exactly repetitive at all times or occasions.

•Each situation being different and each decision requires a separate analysis of relevant factor, outcome of actions and comparison of right and wrong.


Professional Ethics

•Professional ethics: ‘rules of conduct or standards by which a professional community regulates its actions and sets standards for its members’.

•It’s a detailed explicit operational blue print of norms of professional conduct.

•Important aspect of the study of professional ethics is its capability to internalize a framework or set of guidelines that will guide the decision making and actions of the members of the profession.


Profession and Professional ethics

•Profession are selected occupations having a reputation and status in the society.

•Profession requires higher education and specialized training.

•Pharmacy professionals are bound together by a common course of training and aspirations of the pharmacy community all of which lead to a professional purpose.

•It’s duty of the members to protect and keep up the good name of the profession.

•Professional spirit is the basic need for maintenance of its status and fulfillment of its obligation.

•Government restricts the practice of pharmacy to those who qualifies under the regulatory requirements and grants them privileges necessary denied to others.

•Standards of professional conduct for a pharmacy are necessary in the public interest to ensure an efficient pharmaceutical service.


Code of professional ethics

•Code of professional ethics are visible and explicit enunciations of norms and guidelines for the professionals.

•Code of ethics of the APhA 1852: reflects a collective values and aspirations of practitioners committed to raising the overall standards of pharmacy.

•Code of ethics tries to promote moral principles or code of conduct in the behaviour and activities of its members.

•Code of ethics: concerned with a range of professional issues like academic honesty, adherence of confidentiality concepts, importance in providing services, professional accountability, resolution of conflicts of interest and practice of professional activities.


3 types of professional codes:

Aspirational: members should strive, thereby placing a strong emphasis on human achievements.

Educational: detailed statements of principles with or without commentary or interpretations that are useful in dealing with problems encountered in professional practice.

Regulatory: sets of detailed rules intended to govern professional conduct and serves as a basis for resolving grievances.


The profession of pharmacy is noble in its ideals and pious in its character.

The attitude of service and sacrifice in the interests of the suffering humanity, In handling, selling distribution, compounding and dispensing medical substances, including poisons and potent drugs, a pharmacist in collaboration with medical team, is charged with the onerous responsibility of safeguarding the health of people.


Pharmacist in Relation to His Job

•Scope of pharmaceutical services

•Conduct of pharmacy

•Handling of prescriptions

•Handling of drugs

•Apprentice pharmacist


Scope of pharmaceutical services

•Reasonably comprehensive pharmaceutical services should be provided.

•Supply of commonly required medicines without undue delay.

•Willingness to furnish emergency supplies at all times.


Conduct of pharmacy

•Preclude avoidable risk or error of accidental contamination in the preparation, dispensing and supply of medicines.

•Appearance of the premises should reflect the professional character of pharmacy.

•Signs, notices, descriptions, wordings on business, stationery and related indications, should be controlled in size, design and terms.

•Any scheme sponsored by Govt is carried out, may be exhibited at the premises.

•Pharmacist: primarily responsible for observance of proper standards of conduct.


Handling of prescriptions

•Received by pharmacist without any discussion or comment over it regarding the merits and demerits of its therapeutic efficiency.

•Should not even show any expression of alarm or astonishment upon the receipt of a prescription.

•Don’t add, omit or substitute any ingredient or alter the composition of a prescription, without the consent of the prescriber.

•Advise the patient to use medicines or remedies, strictly in accordance with the intention of the physician, as noted in the prescription.


Handling of drugs

•Care should be taken to dispense a prescription correctly, by weighing and measuring all ingredients in correct proportions, by the help of scales and measures; visual estimations must be avoided.

•Should be judicious in dealing with drugs and medicinal products known to be poisonous or to be used for addiction or other abusive purposes.


Apprentice pharmacist

•Trainees are given full facilities for their work, so that on the completion of their training they have acquired sufficient technique and skill to make themselves dependable pharmacists.


Pharmacist in Relation to His Trade

•Price structure

•Fair trade practice

•Purchase of drugs

•Hawking of drugs

•Advertising and displays


Price structure

•Prices should be fair and keeping with quality and quantity of commodity supplied - the labour and skill required in making it ready for use, so as to ensure an adequate remuneration to the pharmacist.


Fair Trade Practice

•No attempt should be made to capture the business of a contemporary by cut throat competitions.

eg: any kind of prizes or gifts, charging lower prices.

•Labels, trade marks and other signs and symbols of contemporaries should not be imitated or copied.


Purchase of drugs

•Drugs should be purchased from genuine and reputable sources.

•Pharmacist should be on his guard not to aid or support directly or indirectly the manufacture, possession, distribution and sale of spurious or substandard drugs.


Hawking of drugs

•Hawking of drugs and medicines should not be encouraged nor should any attempt be made to solicit orders for such substances from door to door.

•Self-service method of operating pharmacies and drug stores should not be used - may lead to the distribution of therapeutic substances without an expert supervision and would encourage self-medication, which is highly undesirable.


Advertising and Displays

•No display materials, either on the premises or elsewhere should be used by a pharmacist in connection with the sale to the public of medicines or medical appliances, which is undignified in style or which contains:

(i)Any warning, design or illustration, reflecting unfavourably on pharmacists, collectively or upon any group or individual.

(ii)A disparaging reference, direct or by implication to other suppliers, products, remedies or treatments.

(iii)Misleading or exaggerated statement or claims.

(iv) The word ‘cure’ in reference to an ailment or symptoms of ill-health.

(v)A guarantee of therapeutic efficacy.

(vi)An appeal to fear

(vii)An offer to refund of money paid

(viii)A prize, competition or similar scheme

(ix)Any reference to a medical practitioner or a hospital or use of the terms ‘Doctor’ or ‘Dr.’ or ‘Nurse’ in connection with the name of a preparation, not already established.

(x)A reference to sexual weakness, premature ageing or loss of virility.

(xi)A reference to complaints of sexual nature in terms, which lack the reticence proper to the subject


Pharmacists in Relation to Medical Profession

•Limitation of professional activity

•Clandestine arrangement

•Liaison with public


Limitation of professional activity

•Medical practitioners would not take to practice of pharmacy by owning drug stores, which leads to coded prescriptions and monopolistic practices, unfavorable to the pharmaceutical profession.

•Pharmacists under no circumstances, take to medical practice (to diagnose, prescribe even if requested by patrons to do so).

•In accidents and emergencies pharmacist may render first aid to the victim.

•Pharmacist should not recommend particular medical practitioner, unless specifically asked to do so.


Clandestine Arrangement

•Pharmacist should not enter into any arrangements or contract with a physician, to offer him any commission or any advantage by recommending his dispensary or drug store


Liaison with public

•Being liaison between medical profession and public, pharmacist should always keep himself with the modern development in pharmacy and other allied sciences.

•May be able to advise the physicians on pharmaceutical matters – colours, flavours, vehicles and newer forms of administration of medicines.

•May be able to educate the people for maintaining healthy and sanitary conditions of living.

•Pharmacist should always try to promote knowledge and contribute in the advancement of learning.

•Pharmacist should never disclose any information, which he has acquired during his professional activities to any third party or person, unless required to do so by law.

•Should never betray the confidence which his customers repose in him, or which he has won by virtue of his eminent character and conduct.


Pharmacist in Relation to His Profession

•Professional vigilance

•Law-abiding citizen

•Relationship with professional organizations

•Decorum and propriety.


Professional vigilance

•It is not sufficient for a pharmacist to be law abiding and to prevent from doing things derogatory to the society and his profession.

•It should be his bounden duty to make others also fulfill the provision of the pharmaceutical and other laws and regulations.

•He should not be afraid of bringing or causing a miscreant to be brought to book, may be he is member of his own profession.

•Its essential for a pharmacist to extend help and cooperation to a fellow member in his genuine needs, scientific, technical or he is to be vigilant to weed the undesirable out of the profession and thus help to maintain its fair name and traditions.


Law-abiding citizen

•A pharmacist, has to be an enlightened citizen endowed with a fair knowledge of the laws of the land and he should be particularly familiar with the enactment pertaining to food, drug, pharmacy, health, sanitation and try to abide by them in every phase of life.

•A pharmacist is a unit whole and his life can not be divided into compartments.


Relationship with professional organizations

•Pharmacist should join and advance the cause of all professional organizations, the aims and objectives of which are conductive to scientific, moral well-being of pharmacists and in no way contrary to the code of pharmaceutical ethics.


Decorum and propriety

•Pharmacist should always avoid from doing all acts and deeds which are not in consonance with the decorum and propriety of pharmaceutical profession and are likely to bring discredit or upbraid to the profession or to himself.

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By : 

Dr. Ateendra Jha