Professional ethics in pharmacy: the Australian experience

Abstract

Abstract Objective The profession of pharmacy has the unique characteristic of having both professional and business orientations. There is today, in addition to this unique characteristic, a strong shift in pharmacy towards more involvement in patient-centred health care, and increased emphasis on the patient's best interests and autonomy, within a framework of what is known as ‘bioethics’. With this shift of professional focus comes a heightened level of responsibility due to increased expectations of the patient and greater involvement in healthcare and decision making at a personal level with the patient. There is therefore inherent in this increased involvement an increased propensity for ethical problems to arise. The aim of this study is to investigate the application of ethical theory in the practice of pharmacy in New South Wales (NSW), Australia. Method Semi-structured interviews were carried out with 25 practitioners. The content of transcribed interviews was qualitatively analysed for emerging themes. Themes were identified by the primary researcher and independently validated by the other investigators. Key findings The majority of pharmacists interviewed in NSW Australia practised within a theoretical framework of ‘best interests of the patient’. Pharmacists experienced dilemmas in practice involving a number of ethical principles. Pharmacists relied on common sense to circumvent such dilemmas and never referred to their professional code of ethics. There appeared to be a general lack of training, and a varying perception of difficulty with decision making, regarding ethical dilemmas encountered, depending on issues such as legal requirements, personal opinions or financial demands. Conclusion Findings of this study indicated primarily that pharmacists in Australia regard the ethical principle of ‘best interest’ of the patient as the fundamental framework within which they practice. Pharmacists experience ethical dilemmas in practice, predominantly in the community setting, relying on logical reasoning, practical skills and personal morals to manage the situation, rather than consulting with a code of ethics. Also of significance in this study was the finding that financial pressure had a strong negative impact on the decision making and application of ethical principles of younger pharmacists in practice.