6. ETHICS as related to pharmacy professionals.pptx

Medical ethics are the guiding principles for a given category of people who belong to a specific profession

1. MEDICAL ETHICS

2. Outline Define relevant terms Key concepts and principles in ethics Professional code of conduct

3. Definition of relevant terms Ethics: Ethics denote principles, written or unwritten which are accepted in the profession as the basis for proper behavior. Also refers to the moral principles that influence/control someone’s behaviour. A science “…governed by principles of universal validity, so that what was good for one was also good for all, and what was my neighbour’s duty was also my duty.” Socrates

4. Definition of relevant terms Medical ethics: Is a set of principles that attempt to guide medical professionals relationship with patients/clients and these principles are based on moral values. Also Equals to morals pertaining to medical practice; i.e. they are the moral principles or rules governing medical practice.

5. Definition of relevant terms Situational Ethics Asserts that; No set of ethical principles, no matter how carefully thought out or how well-constructed, can provide the individual professional with guidance each time he is faced with a decision about his client (s), peers or society. Life events are not precisely repetitive in every detail. Each situation is different, so each decision requires separate analysis of relevant factors, possible outcomes of available actions and weighing the right and wrong.

6. Definition of relevant terms Professional Ethics “The profession’s interpretation of the will of society for the conduct of the members of that profession augmented by the special knowledge that only the members of the profession possess.” “Those principles to which society believes any individual claiming professional status should subscribe.” The professional codes of ethics must integrate both professional and societal goals.

7. Definition of relevant terms CODE OF ETHICS / CONDUCT The Code is the Society’s core guidance on the conduct, practice and professional performance expected of you. The Code of Ethics sets out the principles that you must follow as a professional. The principles of the Code are intended to guide and support the work you do and the decisions you make. They also inform the general public of the standards of behavior that can be expected from the pharmacy professions.

8. Definition of relevant terms Morality: Is the effort to guide one’s behaviour by reason- that is to do what there are the best reasons for doing when giving equal weight to the interests of each individual who will be affected by ones actions.

9. Definition of relevant terms Law: Is a system of rules that are created and enforced through social or governmental institutions to regulate behaviour. It regulates and ensures that individuals or a community adhere to the will of the state. It is punishable.

10. Definition of relevant terms Values: The degree of importance of something or action, with the aim of determining what actions are best to do or what way is best to live, or to describe the significance of different actions. Values identify what should be judged good or evil in practice The are abstract concepts of what is important and worthwhile

11. Definition of relevant terms Rights: Are legal, social, or ethical principles of freedom or entitlement. Rights serve as rules of interaction between patients and the health care providers, and as such, they place constraints upon the actions of the health providers or patients. The rights a patient/client expects from a health worker include: Privacy Information justice Consent Confidentiality Care & concern Trust & honesty Fidelity Shall consult his colleagues when necessary Shall work in the interest of the patient to avoid weakening the patient. Should not permit motives of profit to influence the free independent exercise of professional on behalf of the patient.

12. Definition of relevant terms Customs: Also called a tradition, is a law or right or usual way, which is not written and is in practice since a long time. It is anything which lots of the practitioners do, and have done for a long time. Usually practitioners from the same country or profession.

13. Definition of relevant terms Obligations: It is an act or course of action to which a practitioner is morally or legally bound; a duty or commitment.

14. Definition of relevant terms Ethical dilemmas: Also known as a moral dilemmas are situations in which there is a choice to be made between two options, neither of which resolves the situation in an ethical acceptable fashion.

15. Examples of ethical dilemmas The ethical dilemmas explore ethics and standards of conduct for pharmacy technicians. Ethical dilemmas include but not limited to the following; Social networking explores how using Facebook, Whatsapp etc could have implications on exercising professional behaviour. You are friends with a few of your workplace colleagues on Facebook or Whatsapp. After a difficult day at work, a recently qualified pharmacy technician, has posted a comment about one of your patients. Although no names were mentioned, it is obvious, to you and your colleagues, to whom he/she is referring.

16. Examples of ethical dilemmas Using professional judgment gives you an opportunity to consider your response to an irregular practice by a colleague. You have just started work at a new pharmacy as a pharmacy technician. In your first week, you notice the pharmacist cutting the dates off some strips of tablets. When you question the practice, he says he does it if he is using tablets close to their expiry date.

17. Examples of ethical dilemmas Unprofessional colleague gives you an opportunity to consider your actions when working with a colleague who is behaving unprofessionally. It’s Saturday morning and you are working with the regular pharmacist. When they arrive you detect a hint of alcohol on their breath. You make a joke of it and they say it was a friend’s birthday last night and that they were out for a few beers. However, this is not the first time this has happened.

18. Examples of ethical dilemmas Data protection looks at appropriateness of divulging information. A regular customer approaches you with a box of tablets she has found in her 15-year-old daughter’s bedroom. She shows you the packet, which is labeled with her daughter’s name. She is quite agitated and demands to know what they are and why her daughter is taking them.

19. Examples of ethical dilemmas Age effect; according to law a person who is under age (child/ junior/ minor) is legally incompetent to give consent. If such a person is recommended for treatment requiring informed consent, a parent / guardian is the one authorized to give consent. Dilemmas occur when a 16 year old girl consults and requests for oral contraceptive pills without the parent’s/guardian’s knowledge. If the request is not granted, the same girl may come back at the age of 17 years (still a minor) pregnant and requesting for a termination of pregnancy still without then parent’s/guardian’s knowledge. If the second request is also denied, the girl may turn up again 2 days later as an emergency with incomplete illegal abortion.

20. Examples of ethical dilemmas Situations involving married subjects; a woman requesting for use of contraceptives. There are no legal requirements for involving the husbands. But when the husband later knows, he can divorce her or marries a 2 nd wife. Both are socially and economically disadvantageous to the woman

21. Consent Consent is defined as ‘permission or agreement’. Consent is a person’s agreement to receive a professional service or treatment appropriate for them and will be based on both their preferences and values and the information with which they have been provided. Patients have a basic right to be involved in decisions about their healthcare and the process of obtaining consent is fundamental for patient autonomy.

22. Valid Consent The consent you obtain must be valid. For consent to be valid the person must be: • capable of making that particular decision, • acting voluntarily, that is, they must not be under pressure from you or anyone else to make a particular decision, • provided with sufficient information to enable them to make the decision, • capable of using and weighing up the information provided during the decision-making process.

23. Forms of Consent Consent may be obtained in the following ways: • Explicit consent – verbally – the patient orally indicates their consent, e.g. by saying yes or no. – in writing – the patient signs a document stating they provide consent e.g. signing a declaration to receive a collection and delivery service, or a medicines use review. • Implied Consent - the patient indicates their consent without writing or speaking, for example, a patient who brings their prescriptions to you for dispensing.

24. Duty Of Confidentiality Patients have the right to expect that information you obtain about them is kept confidential and is used only for the purposes for which it was given. This duty of confidentiality applies to all information obtained about a patient during the course of professional practice and extends to all members of the pharmacy team. Maintaining a patient’s confidentiality is fundamental to the partnership between yourself and the patient. A patient may be reluctant to seek advice from you in your capacity as a healthcare professional where he/she has concerns that you will not maintain confidentiality.

25. Duty of Confidentiality Confidential information includes: • personal details (including information that is not directly relevant to a patient’s medical history) • information about a patient’s medication (both prescribed and non prescribed) and • other information about a patient’s medical history, treatment or care.

26. Key Concepts and Principles in Ethics The following are principles in Ethics; Autonomy Beneficence Nonmalecence Justice Veracity Fidelity

27. 1. Autonomy The right to make decision about their own life and body without coercion by others. In so far as is possible in a democracy and to the extent that their decisions do not harm others, individuals should be allowed (left alone) to make fundamental decisions (given the necessary information) that affect their own bodies. In the principle of autonomy is implied the concept of consent and confidentiality.

28. 2. Beneficence “Doing good to others” (or “ provide benefits ”) It is the basic principle of “care ” and involves acting in accordance with a patient’s welfare. Beneficence can be seen both as a principle and a religious virtue of compassion and helping others. It may sometimes come into contact with autonomy e.g. whether or not to treat a psychiatric patient against his/her will. Balancing the two in such cases may be difficult

29. 3. Non malfeasance “Not harming others” this implies that if the practitioner is not technically competent to do something, he /she should not do it. The calculation of risk in medical decision making and determining risk/benefit ratio The balance of benefit and harm = utility

30. 4. Justice Medically justice means treating similar kinds of people similarly. A just practitioner treat all patient the same way regardless of their circumstances. Justice: Be fair (distributive justice > entitlement) -the appropriate distribution of limited resources; non discrimination -transparency, accountability and consistency

31. 5. Veracity Veracity is the principle of truth telling, Honesty and accuracy and it is grounded in respect for persons and the concept of autonomy. In order for a person to make fully rational choices, he or she must have the information relevant to his or her decision. Moreover, this information must be as clear and understandable as possible.

32. 6. Fidelity Do as you say you will do PLUS respect confidentiality Fidelity is also referred to as loyalty

33. Professional code of conduct Purposes Helps in taking decisions and responsibilities Public declaration of the principles and ethical standards which govern practitioners It is a regulatory mechanism employed by any person employing the services of a Pharm tech Provides support and guidance Sets out the principles in accordance with which practitioner must act and by which they will be judged. Sets out principles for professional practice and behaviour with patients or public Legal protection Defines image of the profession

34. Ethical misconducts Over charging Disclosure of patient’s information Inappropriate behaviour e.g. drunkenness/ drug abuse Having a romantic relationship with patients Asking for incentives from patients and promoters Giving wrong information to patients Disrespecting co-workers

35. Areas of ethical consideration Relating with other health care providers (team work, advising, respect, Shall not entice patients/clients from his colleagues) Dispensing & sale of drugs (right information, should never give patients adulterated products, do not change prescription without consultation) Prescribing (right drug, right indication, referral-where/when necessary) Pharmaceutical care (team work, Always bear in mind the obligation of preserving life) Counseling

36. Relationship with professional colleagues General guidelines; Share knowledge with colleagues Do what he/she can to promote medical knowledge, education and research Avoid any action, which may be regarded as self-laudatory Not condemn his colleagues or use derogatory language about them Maintain a bond of fellowship amongst all his/her colleagues irrespective of the colleges they qualified from Shall not charge fees directly for attention to another medical practitioner or his immediate dependants. The pharmacy technician must not entice patients from his colleagues The practitioner must regard his/her colleagues as his/her brothers/sisters

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