Pharmacy Ethics and professionalism 2.pptx

Pharmacy law

1. Ethics and Professionalism Paul Kutyabami

2. Ethics derives its origin from philosophy, religion and law in relation to culture It is about what practices should be accepted and why? It involves the use of rational reasoning to arrive at a decision It is a functional component of every profession Its application varies from profession to profession 2 Origin

3. Normative ethics; An inquiry into which general moral norms for the guidance and evaluation of conduct should we accept and why? Non-normative ethics; Descriptive ethics is factual investigation of moral conduct and beliefs (anthropology, sociology, psychology and historians) Meta-ethics involves analysis of the language, concepts and methods of reasoning in ethics 3 Types of ethics

4. Morality refers to norms about right and wrong human conduct that are so widely shared that they form a stable (although usually incomplete) social consensus It includes moral ideals that individuals and groups voluntarily accept 4 Morality

5. In understanding moral life, we explore the values and preferences of the different individuals This appreciation of our individual differences enables us to accommodate and tolerate the different beliefs and practices that may not be applicable in our societies If we respect other people’s choices, we are respecting others’ rights 5 Morality…

6. Utilitarianism Theories These theories are also referred to as consequentialism. They are found in the writings of Jeremy Bentham (1748 - 1832) and John Stuart Mill (1806 - 1873) Actions are right or wrong according to the balance of their good or bad consequences The right act in this case is one that produces the best overall result as determined by the relevant theory of value

7. Utilitarianism Theories These theories concentrate on the value of well being, analyzed in terms of: Pleasure Happiness Welfare Preference satisfaction Utilitarianism accepts one and only one principle of ethics – principle of utility

8. Utilitarianism Theories These theorist urge that human actions should be assessed in terms of their production of maximal value Which value should be maximized? Agent neutral or intrinsic (basic, essential) goods like happiness, freedom, health that every rational (balanced) person values

9. Utilitarianism Theories This has led to the expansion of values that must be maximized to include : Intrinsic goods Knowledge Health Success Understanding Enjoyment Deep personal relationships Individual preferences – maximize the overall satisfaction of the preferences of the greatest number of individuals

10. Utilitarianism Theories The goal of utilitarians is to realize the greatest good by balancing the interests of all affected persons Controversy has however risen on when to apply the principle of utility Is it applied in all circumstances as a rule? Rule Utilitarian Or is it applied to particular acts in particular circumstances? Act Utilitarian

11. Weakness Problems with immoral preferences and actions These theories are concerned with maximization of individual preferences even when some of those preferences are considered morally unacceptable E.g. supposing the way to achieve maximal utilitarian outcome was to perform an immoral act like killing one person and distribute his organs, would you do it?

12. Weakness Problems with unjust distribution Utilitarianism permits the interests of the majority to override the rights of minorities

13. Strength The principle of utility plays a very big role in the formulation of public policies. These take care of everyone’s interests and are there to maximize good outcomes for all parties It is a beneficence based theory with a goal of promoting welfare. It promotes acts of mercy, kindness and charity

14. Kantianarism theories This theory is deeply shaped by Immanuel Kant (1724 - 1804) and thus derives its name from him It is also referred to as deontological 1. It holds that some features of actions other than or in addition to consequences make actions right or wrong Certain actions are impermissible regardless of the consequences

15. Kantianarism theories E.g. a research involving human subjects, even if would achieve certain results that would have good consequences for millions of people but would be unethical if they violated fundamental constraints on behavior

16. Kantianarism theories 2. This theory urges that morality is grounded in reason rather than in tradition, intuition or attitudes such as sympathy An individual’s action depends exclusively on the moral acceptability of the rule on which the person acts. That rule provides the moral reason that justifies the action One must act not only in accordance with but for the sake of obligation. Act according to what is morally required of you

17. Kantianarism theories E.g. a person in need of money desperately gets to know that he will not be able to borrow unless he promises repayment within a certain time duration, to which he definitely knows that he can not pay. He goes ahead to make the promise that he/she knows that will be broken According to this theory, we should be able to act in accordance to universally valid moral principles irrespective of our desires (categorical imperative)

18. Kantianarism theories One must act to treat every person as an end and never as a means only. We must not treat another merely or exclusively as a means to our ends e.g. human subjects who volunteer to test new drugs, they are treated as a means to others’ end but they have a choice in the matter and retain control over their lives These should be treated with the respect and moral dignity to which every person is entitled

19. Kantianarism theories In regard to autonomy (participation in decision making), this theory requires that each individual “will the acceptance of moral principles” If a person freely accepts objective moral principles, that person is a lawgiver unto himself or herself It is this principle that gives people respect, value and proper motivation

20. Respect of autonomy: is to acknowledge that person’s right to hold views, to make choices and to take actions based on personal values and beliefs. Hence autonomy as a fundamental right is used to justify rights of privacy, confidentiality, refusal to participate in research, informed consent, and fair treatment. Hence right to self determination for all individuals Additional protection for individuals with diminished capacity 20 Basic Principles of Ethics

21. Beneficence: Is a group of norms for maximizing benefits and minimizing harm Beneficence denotes the practice of good deeds. It usually signifies an obligation to benefit others and to seek their good. 21 Basic Principles of Ethics

22. Non-Maleficence: Is a norm of avoiding the causation of harm. One ought not to inflict evil or harm It is an obligation 22 Basic Principles of Ethics

23. The requirement that research be justified on the basis of a favorable risk/benefit assessment bears a close relationship to the principle of beneficence. Maximize benefits and minimize possible harm. 23 Basic Principles of Ethics

24. Justice: Is a group of norms for distributing benefits, risks, and costs fairly. It can be interpreted as fair, equitable, and appropriate treatment in light of what is due or owed to persons. Hence the need for fairness to participation in research and access to results of research Injustice involves a wrongful act or omission that denies people benefits to which they have a right without good reason or distributes burdens unfairly 24 Basic Principles of Ethics

25. Other theories of ethics Communitarianism Right based theory Feminism Libertarianism

26. Used in perspective to develop professional codes Evolves over time so do the codes Ethical principles are universal but their application varies from place to place and time to time 26 Application of ethics

27. What is a Profession An occupation that requires its members to undergo specialized training and intellectual development in order to acquire specialized knowledge that can be used to solve specific problems of society Members of a profession use the acquired knowledge to engage in activities intended to solve specific problems of society as a source of livelihood.

28. What is a profession cont … A group of self selected, self disciplined group individuals who hold themselves out to the public as having special skills derived from education and training and who are prepared to exercise that skills primarily in the interest of others in solving a specific problem of society A disciplined group of individuals who adhere to ethical standards Hold themselves out as, and are accepted by the public as possessing special knowledge and skills in a widely recognized body of learning derived from research, education and training at a high level, and Are prepared to apply this knowledge and exercise these skills in the interest of others or in solving a specific problem of society. .Members of such profession should be gaining livelihood from using such knowledge and skills

29. Values held by Professions that may be seen within its code Respect Dignity is the right of all those affected by the code, and respect for one’s colleagues and others Equality Equal treatment of all, including equal opportunity, should be consistent with widely accepted principles of justice, and is often expressed alongside the profession embracing of diversity. Integrity The code of ethical conduct should supporting expectations. For example expectation of accountability. Integrity is also likely to feature as an ethical principle Recognition of excellence While this corresponds with a traditional view of fairness, it also serves to encourage effort and innovation

30. Values held by Professions that may be seen within its code Selflessness Decisions must be taken with due regard for the public interest . Integrity Those governed by the code must not allow themselves to be placed under any obligation to people or organizations that might try inappropriately to influence them in the performance of their duties . Objectivity Actions and decisions must be taken impartially, fairly and on merit, using the best evidence and without discrimination or bias. Accountability Those governed by the code are accountable for their decisions and actions and must submit themselves to the scrutiny necessary to ensure this.

31. Values held by Professions that may be seen within its code Openness Decisions must be taken in an open and transparent manner. Information should not be withheld from the public unless there are clear and lawful reasons for doing so. Honesty Those governed by the code must be truthful. Leadership All those governed by the code must exhibit these principles in their own behavior. They must actively promote and robustly support the principles and be willing to challenge poor behavior wherever it occurs

32. Elements of Professions Intellectual discipline and standard of knowledge Governance of the profession Legal status Code of conduct Service provision

33. Intellectual discipline and standard of knowledge In order to gain membership to a particular profession, one must meet a minimum standard of knowledge

34. Governance of the profession M embers of a profession must have a representative body comprising of members elected from its membership to oversee the affairs of the profession

35. Legal status The profession must be legally recognized through an act of Parliament in the country where it is situated

36. Code of conduct Members of a profession a required to observe a standard of behavior. Such standards are set and accepted by members as guide on matters concerning professional conduct

37. Service provision Professions exist for solving particular problems of society through the provision of services or advice which forms the basis of livelihood for the members of the profession

38. Guiding principles of Professional ethical Codes Codes should be based on the best available science and other acceptable knowledge sources referencing those sources wherever possible and providing a rationale for requirements and recommendations. Requirements and recommended practices should be defensible and changed as new and improved information is brought forward. In addition, requirements and recommended practices should be practical, manageable and consider economic implications.  Codes should be clearly articulated to ensure easy understanding by all users. The layout and design of Codes should facilitate an understanding of basic acceptable practices/requirements and recommendations that promote a higher level of care Codes should primarily deal with the criteria that need to be met in order to achieve an acceptable level of professional practice. Requirements should be clearly worded (i.e., using the term ‘must’) and have measurable components, recognizing that they may be used in an assessment process. 

39. Guiding principles of Professional ethical Codes Codes should also strive for continuous improvement in practice through recommendations that promote sound management and good professional practices . Codes should be regularly reviewed to ensure they are current with government policy/regulations and scientific research.   Codes should take into consideration other standards or Codes that may have implications on the practice. Codes should avoid redundancy and aim to be consistent where there may be overlap

40. Principles of professional ethics P rovide person-centred care; be directed to maintaining and improving the health, wellbeing, care and safety of the patient W ork in partnership with others; maintain the highest professional standard in his conduct, and in his professional relations with members of his own profession and other allied professions Maintain , develop and use their professional knowledge and skills; employ his/her professional competence, skills and standing in a manner that brings health gain and value to the community and the society in which he/she lives and works. U se their professional judgement; maintain a level of competence sufficient to provide his/her professional services effectively and efficiently.

41. Behave in a professional manner; be aware of his/her obligations under this Code and should not do anything in the course of practising as a pharmacist, or permit another person to do anything on his/her behalf, which constitutes a breach of this Code or impairs or compromises his/her ability to observe this Code. uphold reasonably accepted standards of behaviour both within and outside their professional practice and must refrain from any conduct that might bring the profession into disrepute or impair the public’s confidence in R espect and maintain a person’s confidentiality and privacy; never abuse the position of trust which they hold in relation to a patient and they must respect a patient’s rights, including their dignity, autonomy, and entitlements to confidentiality and information. S peak up when they have concerns or when things go wrong Demonstrate leadership Communicate effectively