Pharmacy Ethics: A Foundation for Professional Practice provides a model for examining and resolving ethical dilemmas, thereby helping student pharmacists understand the ethical decision-making process in professional practice.

This study was conducted in 1985 in Asuncion, Paraguay, 6 years after the closure of the state supported family planning services. Data from national surveys in 1977 and 1987 permit a comparison of sources of contraceptive supplies before and after the elimination of government support for family planning. The purchase of pseudo-abortifacients from private pharmacies was used as an indication of induced abortion. After the loss of government clinics, it is suggested that some women turned to pharmacists to obtain pseudo-abortifacients (...) when faced with unwanted pregnancy. There is an indication of increased pseudo-abortifacient use, particularly among unmarried women and those from poorer neighbourhoods. (shrink)

Pharmacy Benefit Managers (PBM) induce drug manufacturers to offer rebates to insurers and employers by denying coverage through formulary exclusions, impeding physician prescription through prior authorization, and reducing patient drug use through cost sharing. As they tighten these access obstacles, PBMs reduce the net prices received by the manufacturers.

: This paper examines the obligations of pharmacy licensees and pharmacists in the context of conscience-based objections to filling lawful prescriptions for certain types of medications—e.g., standard and emergency contraceptives. Claims of conscience are analyzed as means to preserve or maintain an individual's moral integrity. It is argued that pharmacy licensees have an obligation to dispense prescription medications that satisfy the health needs of the populations they serve, and this obligation can override claims of conscience. Although efforts should (...) be made to respect the moral integrity of pharmacists and accommodate their claims of conscience, it is argued that the health needs of patients and the professional obligations of pharmacists limit the extent to which pharmacists may refuse to assist patients who have lawful prescriptions for medically indicated drugs. (shrink)

'J'en suis encore à attendre la venue d'un philosophe médecin' espérait Nietzsche en préambule de son Gai Savoir. Historiquement, la relation à la médecine a été entretenue par la philosophie dès ses premiers pas, comme une nécessité de penser et de panser. Ayant la quête de la sagesse en ligne de mire, les philosophes avaient pour vocation d'en finir avec les troubles de l'âme, à l'image des médecins et des douleurs du corps. Dès lors, que signifie guérir, soigner, prescrire ou (...) diagnostiquer lorsqu'il s'agit de la philosophie? Comment cette dimension pratique de la philosophie trouve-t-elle sa place dans cette discipline prétendument destinée à l'esprit pur? C'est dans l'oeuvre de Nietzsche que nous trouvons sans doute les élaborations les plus abouties de cette problématique, aux implications extraphilosophiques. En substituant les notions de vérité, de morale ou de consolation, Nietzsche va composer une nouvelle conceptualité philosophique, dont les outils seront la valeur, la joie ou encore la santé. Cet ouvrage se propose de remonter aux origines de la philosophie comme médecine jusqu'à Nietzsche, afin de trouver, dans sa pharmacie, les traitements et les remèdes à notre nature humaine, trop humaine"--Page 4 of cover. (shrink)

Industry analysts estimate that Internet pharmacies will generate $1.4 billion in prescription drug sales by 2001 and over $15 billion by 2004. The recent rush by traditional brick and mortar pharmacies either to partner with existing Internet pharmacies or to create their own web counterparts illustrates the increasing importance of business on the Internet. Last summer, retail pharmacy giant CVS acquired the Internet pharmacy soma.com and changed its name to reflect the new ownership. Early this year, in another (...) key industry move, Walgreen's launched an upgraded, full-service Internet pharmacy in order to compete more successfully in the pharmacy industry. (shrink)

Industry analysts estimate that Internet pharmacies will generate $1.4 billion in prescription drug sales by 2001 and over $15 billion by 2004. The recent rush by traditional brick and mortar pharmacies either to partner with existing Internet pharmacies or to create their own web counterparts illustrates the increasing importance of business on the Internet. Last summer, retail pharmacy giant CVS acquired the Internet pharmacy soma.com and changed its name to reflect the new ownership. Early this year, in another (...) key industry move, Walgreen's launched an upgraded, full-service Internet pharmacy in order to compete more successfully in the pharmacy industry. (shrink)

Background There is a need for clearer guidance for pharmacists regarding their responsibilities when selling complementary medicines. A recently published ethical framework provides guidance regarding the specific responsibilities that pharmacists need to meet in order to fulfil their professional obligations and make a positive contribution to health outcomes when selling complementary medicines. Objective Evaluate the acceptability and feasibility of a new ethical framework for the sale of complementary medicines in community pharmacy. Methods Australian community pharmacists were invited to participate (...) in online focus groups and interviews. Participants were recruited via multiple methods, including social media and the professional networks of pharmacy groups. Participants were provided the ethical framework prior to the discussion. Discussions were transcribed verbatim and analysed using thematic analysis. Results Seventeen community pharmacists participated in the study. There was good representation among participants in terms of gender, years of practice, pharmacy location and script volume. Participants differed in how proactive they were in relation to selling and providing advice on complementary medicines, how they interpreted evidence in relation to complementary medicines, and how they navigated their practice within the retail environment of community pharmacy. The majority of participants found the framework was acceptable for practice and was feasible for implementation with targeted support. Participants identified two important areas for targeted support in implementing the framework: improved access to evidence-based information resources on complementary medicines and independent evidence-based education and training on complementary medicine for pharmacists and pharmacy support staff. Conclusion The ethical framework addresses an important gap in providing specific professional guidance to pharmacists when selling complementary medicines. The results of the study suggest that the framework may be acceptable to community pharmacists and be feasible to implement with targeted support. (shrink)

This article presents the development, validation and application of an instrument to measure everyday moral distress in different health care settings. The concept of moral distress has been discussed and developed over 20 years. A few instruments have been developed to measure it, predominantly in nursing. The instrument presented here consists of two factors: level of moral distress, and tolerance/openness towards moral dilemmas. It was tested in four medical departments and three pharmacies, where 259 staff members completed a questionnaire. The (...) two factors were found to be reliable. Differences in levels of moral distress were found between pharmacies and clinical departments, and between the youngest and oldest age groups; departmental staff and the youngest group experienced higher levels of moral distress. Departments reported less tolerance/openness towards moral dilemmas than pharmacies. The instrument needs to be tested further, but its strengths are the focus on everyday ethical dilemmas and its usefulness in different health care settings. (shrink)

Pharmacists who refuse to provide certain services or treatment for reasons of conscience have been criticized for failing to fulfil their professional obligations. Currently, individual pharmacists in Great Britain can withhold services or treatment for moral or religious reasons, provided they refer the patient to an alternative source. The most high-profile cases have concerned the refusal to supply emergency hormonal contraception, which will serve as an example in this article.I propose that the pharmacy profession's policy on conscientious objections should (...) be altered slightly. Building on the work of Brock and Wicclair, I argue that conscientious refusals should be acceptable provided that the patient is informed of the service, the patient is redirected to an alternative source, the refusal does not cause an unreasonable burden to the patient, and the reasons for the refusal are based on the core values of the profession. Finally, I argue that a principled categorical refusal by an individual pharmacist is not morally permissible. I claim that, contrary to current practice, a pharmacist cannot legitimately claim universal exemption from providing a standard service, even if that service is available elsewhere. (shrink)

BackgroundAs opioid use disorder (OUD) incidence and its associated deaths continue to persist at elevated rates, the development of novel treatment modalities is warranted. Recent strides in this therapeutic area include novel anti-opioid vaccine approaches. This work compares logistical and ethical considerations surrounding currently available interventions for opioid use disorder with an anti-opioid vaccine approach.MethodsThe opinions of student pharmacists and practicing pharmacists assessing knowledge, perceptions, and attitudes toward current and future OUD management strategies were characterized using a staged, multi-modal research (...) approach incorporating a focus group, pilot survey development and refinement, and final survey deployment. Survey responses were assessed using one- and two-way parametric and non-parametric analyses where appropriate, and multi-dimensional matrix profiles were compared using z-tests following an exhaustive combinatorial sum of differences calculation between items within each compared matrix.ResultsFocus group content analysis revealed a high level of agreeableness among participants regarding anti-opioid vaccine technology and a sense of shared ownership regarding solutions to the opioid epidemic at large. Pilot survey results demonstrated subject ability to consider both pragmatic and ethical considerations related to current therapeutics and novel interventions in a single instrument, with high endurance amongst engaged subjects. Access inequality was the most concerning ethical consideration identified for anti-opioid vaccines. Support for anti-opioid vaccine implementation across various clinical scenarios was strongest for voluntary use amongst individuals in recovery, and lowest for mandatory use in at-risk individuals.ConclusionsEthical and logistical concerns surrounding anti-opioid vaccines were largely similar to those for current OUD therapeutics overall. Anti-opioid vaccines were endorsed as helpful potential additions to current OUD therapeutic approaches, particularly for voluntary use in the later stages of clinical progression. (shrink)

Every pharmacist, aware or not, is constantly making ethical choices. Sometimes these choices are dramatic, life-and-death decisions, but often they will be more subtle, less conspicuous choices that are nonetheless important. Assisted suicide, conscientious refusal, pain management, equitable and efficacious distribution of drug resources within institutions and managed care plans, confidentiality, and alternative and non-traditional therapies are among the issues that are of unique concern to pharmacists. One way of seeing the implications of such issues and the moral choices they (...) pose is to look at the experiences of practitioners and the kinds of choices they have had to make in situations typically faced by pharmacists. This book is a collection of those situations based on the real experiences of practicing pharmacists. The use of case studies in health care ethics is not new, but in pharmacy it is. This text is an important teaching tool that will help pharmacy students and pharmacists address the increasing number of ethical problems arising in their profession. It is not merely a compilation of cases, but rather is organized for the systematic study of applied ethics. Part I shows how to distinguish ethical problems from other kinds of evaluative judgments and examines the sources of values in pharmacy, posing basic questions about the meaning and justification of ethical claims. Part II explores the basic principles of ethics as they have an impact on pharmacy. Specific cases from clinical settings present in a systematic way the various questions raised by each of the major ethical principles -- benefiting the patient, distributing resources justly, respecting autonomy, dealing honestly with patients, keeping promises of confidentiality, and avoiding harm. Part II examines some of the special problems of contemporary pharmacy such as the linkages between pharmaceutical care and professional practice, human experimentation, reproductive issues, genetic technology, death and dying, and mental health. (shrink)

Results of surveys in which pharmacy students and pharmacists responded to ethical dilemmas are discussed. Respondents indicated a high level of concern about patient welfare and patient rights in dilemmas involving conflicts with socio-economic issues, and with peers and physicians. Conflicts that might arise as the roles of pharmacists change and the health-care systems evolve are also discussed.

Jessica Flanigan argues that individuals have the right to self-medicate. Flanigan presents two arguments in defense of this right. The first she calls the epistemic argument and the second she calls the rights-based argument. I argue that the right to self-medicate hangs and falls on the rights-based argument. This is because for the epistemic argument to be sound agents must be assumed to be epistemically competent. But, Flanigan’s argument for a constitutionally mandated right to self-medicate models agents as epistemically incompetent. (...) For Flanigan, agents are different at the pharmacy than they are at the polls. I identify this behavioral asymmetry and advocate a symmetric and realistic behavioral postulate for both arguments. The result, however, is that the success of the epistemic argument becomes contingent which fails to justify a constitutionally mandated right. I proceed to raise skepticism about the rights-based argument as well. I conclude that there is reason to be skeptical that these arguments can justify a constitutionally mandated right to self-medicate. Ultimately, a bottom-up approach to pharmaceutical ethics is preferable. (shrink)

Talk of mechanisms is ubiquitous in the natural sciences. Interdisciplinary fields such as biochemistry and pharmacy frequently discuss mechanisms with the assistance of diagrams. Such diagrams usually depict entities as structures or boxes and activities or interactions as arrows. While some of these arrows may indicate causal or componential relations, others may represent temporal or operational orders. Importantly, what kind of relation an arrow represents may not only vary with context but also be underdetermined by empirical data. In this (...) manuscript, we investigate how an analysis of pharmacological mechanisms in terms of producing and underlying mechanisms—as discussed in the contemporary philosophy of science—may shed light on these issues. Specifically, we shall argue that while pharmacokinetic mechanisms usually describe causal chains of production, pharmacodynamics tends to focus on mechanisms of action underlying the in vivo effects of a drug. Considering the action of thyroid gland hormones in the human body as a case study, we further demonstrate that pharmacodynamic schemes tend to incorporate entities and interactions on multiple levels. Yet, traditional pharmacodynamic schemes are sketched “flat”, i.e., non-hierarchically. We suggest that transforming flat pharmacodynamic schemes into mechanistic multi-level representations may assist in disentangling the different kinds of mechanisms and relations depicted by arrows in flat schemes. The resulting Baumkuchen model provides a powerful and practical alternative to traditional flat schemes, as it explicates the relevant mechanisms and relations more clearly. On a more general note, our discussion demonstrates how pharmacology and related disciplines may benefit from applying concepts from the new mechanist philosophy to guide the interpretation of scientific diagrams. (shrink)

Despite the potential value of graduate-level research ethics training, most Middle East countries, including Jordan, do not routinely offer formal research ethics training. In students enrolled in Jordanian master’s level graduate program in pharmacy, the current study assessed: 1- differences in pre- and post-enrollment exposure to research ethics core themes, 2- whether this exposure was through a formal course or in an informal setting, and 3- student attitudes towards research ethics education and the need for integrating a dedicated research (...) ethics course into pharmacy graduate programs. A 12-item on-line survey was developed by the authors and disseminated to a convenience sample of current and former master-level pharmacy students in Jordan. A total of 61 eligible respondents completed the survey. A minority of respondents (38%) acknowledged receiving research ethics training prior to enrollment into a postgraduate pharmacy program with nearly half (16%) describing this training as informal. In comparison, a larger percentage of the total respondents (56%) had received research ethics training during their postgraduate program enrollment, with nearly half of those (25%) indicating that this training was informal. A majority of respondents reported a strong need for integrating a formal research ethics course into postgraduate pharmacy curriculum (90%) to support their research training and thesis writing (89%). Overall, the study revealed a notable lack of research ethics education for graduate-level pharmacy students in Jordan. (shrink)

This dissertation reassesses the chemical revolution that occurred in eighteenth-century France from the pharmacists' perspective. I use French pharmacy to place the event in historical context, understanding this revolution as constituted by more than simply a change in theory. The consolidation of a new scientific community of chemists, professing an importantly changed science of chemistry, is elucidated by examining the changing relationship between the communities of pharmacists and chemists across the eighteenth century. This entails an understanding of the chemical (...) revolution that takes into account social and institutional transformations as well as theoretical change, and hence incorporates the reforms brought about during and after the French Revolution. First, I examine the social rise of philosophical chemistry as a scientific pursuit increasingly independent of its practical applications, including pharmacy, and then relate this to the theoretical change brought about by Lavoisier and his oxygenic system of chemistry. Then, I consider the institutional reforms that placed Lavoisier's chemistry in French higher education. ;During the seventeenth century, chemistry was intimately entwined with pharmacy, and chemical manipulations were primarily intended to enhance the medicinal properties of a substance. An independent philosophical chemistry gained ground during the eighteenth century, and this development culminated in the work of Lavoisier who cast pharmacy out of his chemistry altogether. Fourcroy, one of Lavoisier's disciples, brought the new chemistry to the pharmacists in both his textbooks and his legislation. Under Napoleon, Fourcroy instituted a new system of education for pharmacists that placed a premium on formal scientific education. Fourcroy's successors, Vauquelin and Bouillon-Lagrange, taught the new chemistry to the elite pharmacists in the School of Pharmacy in Paris. These pharmacists also developed new analytical techniques that combined the aims of the new chemistry with traditional pharmaceutical extractive practices. The scientific pharmacist was created, who, although a respected member of the community of pharmacists, helped to define the new chemistry precisely by not being a true chemist. (shrink)

This article addresses a set of exploratory questions related to emergency contraception and the right to refuse to dispense such drugs. The paper first addresses the roles of the pharmacist in American society, i.e., as professional, employee, and business owner, and the pharmacists’s identity and belief system; second, the paper reviews the status of state law and proposed legislation concerning patient/consumer access to emergency contraceptives; third, it offers an in-depth stakeholder analysis of the ethical and legal responsibilities of pharmacies to (...) stakeholders; and fourth, the paper provides overview of the salient ethical and legal issues concerning patient/customer access to emergency contraceptives relevant to management. The conclusions discuss questionsfor further research as well as strategic/human resource management policy recommendations that balances the economic, legal, and ethical concerns of all primary stakeholders of the company/business, such as designing a management system which refers customers in a timely fashion; recognizing “conscience clauses,” while ensuring that pharmacists “do no harm” to the consumer; and disseminating management “best practices” on “conscience clauses” through joint professional/industry sponsorship. (shrink)

It is widely accepted in the pharmacy profession that pharmacists have the right to conscientiously refuse to participate in certain practices on grounds of conscience. This is allowed in recognition of differences in moral and religious views and out of respect for moral integrity. However, the “conscience clause” does not necessarily sit easily in a professional code of ethics owing to the potential tensions between a professional’s personal moral integrity and her professional obligations. At the heart of these tensions (...) are philosophical questions about the nature of conscience and integrity.These in turn lead to important practical ethical questions about the adequacy of a conscience clause to protect integrity and patient’s rights and guard against wrongdoing, whether conscientious refusals should be publicly announced in advance and what the acceptable bases of a conscientious refusal might be. Such questions apply not just to the professional, but also to pharmacy students, who may hold conscientious objections to some aspects of their training.It is concluded that the conventional compromise that is commonly in place in the pharmacy profession is a workable but imperfect solution and that better understanding of the concepts and competing obligations may be achieved by learning more about conscientious decision-making by pharmacists in practice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Welcome To The Pharmacy: Addiction, Transcendence, and Virtual RealityAnn Weinstone (bio)1. The Question of Addiction and TranscendenceIt has become a truism to say that virtual reality (VR) is addictive. Case, the protagonist of William Gibson’s Neuromancer, dreams of connection to the net like a junkie jonesing for a fix. In Jeff Noon’s novel Vurt, you get to cyberspace by tickling the back of your throat with addictive, government-produced (...) feathers. Verity of Kathleen Ann Goonan’s Queen City Jazz sports nanotechnology implants that compel her to enter virtual worlds into which she sinks with feelings of deep bliss. As in Vurt, in Pat Cadigan’s Synners, everything’s an addiction: cyberspace, people, rock and roll.But let’s move away from fiction. Graphic cyberartist Nicole Stenger, a self-professed neo-Platonist, writes, “[a]nd what if the passage to a new level of humanity actually meant abolishing indeed the natural one, or at least some part of it?... Will it not require immense effort to recover from this enhancement of the senses, from this habit of perfection? [Stenger 57]. Michael Benedikt, editor of Cyberspace: First Steps, deems VR “a new and irresistible development in the elaboration of human culture and business under the sign of technology” [1; my emphasis]. Ad copy for “Origin,” a VR game, reads, “You must die to learn how to live.... Death is not an option. It’s an addiction.” And an article in the New York Times titled “The Lure and Addiction of Life on Line” displays a graphic of a bespectacled male, tapping away at a computer located inside of a panopticon-sized rendering of a globe to which the avid user is happily chained [see Asciu]. From advertisements to scholarly texts, it is difficult to find any writing about VR that does not engage in and, as I will argue, rely upon the rhetorics of addiction. William Gibson dubbed cyberspace a “consensual hallucination.” That was 1984. In 1996, critic Robert Markley rechristened VR “a consensual cliché” [56]. Surely, the “addictiveness” of cyberspace contributes to the sense of tired familiarity. My question is this: Why does cyberspace have to be addictive? What work is addiction doing in discourses of virtual reality?In this essay, I’m concerned with the production of what might be called hyper-real transcendence. Jean Baudrillard, in his influential schema “three orders of simulacra,” identifies a first, “natural” order in which “a transcendent world, a radically different universe, is portrayed... in contrast to the continent of the real” [309]. I propose that a third-order, hyper-real, transcendence has survived the collapse of the distance between the model and the original. This transcendence relies on rhetorics of disembodiment, [End Page 77] immortality, and extra-human reproductive and generative powers within virtual spaces. Such spaces include scholarly and technical essays about VR or cyberspace, science fiction, advertisements for VR games, VR game narratives, and other advertising copy that borrows from current discourses of virtuality. My discussion takes place in a field crowded with talk of the death of logocentrism and the end of phonocentric culture. 1 Derrida has written that “scientific language [e.g. computer code] challenges intrinsically and with increasing profundity the ideal of phonetic writing” [Grammatology 10], the logocentric relation of voice to mental experiences. Baudrillard writes mournfully that the “third-order” world of simulated simulacra, of hyper-reality, leaves “no room for any kind of transcendentalism” [310]. Baudrillard and Derrida write with differing affects of the same effect—the waning or death of the foundation of Western notions of transcendence. In this tradition, transcendence commences with the penetration of the self by a supra-enlivened Other, whether that other be a king, a god, nature, the voice of logos, the Law, or an abstracted version of vitality itself. Particularly, I question the persistent coupling of rhetorics of transcendence with rhetorics of addiction. My initial point will be that following the established Western logocentric tradition, rhetorical relationships of addiction between VR users and VR narratives are the “software” with which hyper-real transcendence is produced and sustained. In other words, VR demands, as the price of transcendence, that the user become of the medium... (shrink)

Although I do not know Richard Doyle personally, I would say that Darwin’s Pharmacy: Sex Plants and the Evolution of the Noosphere is a deeply personal book. Not only does the author offer multiple accounts of his own multicontinental explorations of intraspecies cross-pollination, but he also provides many rhetorical analyses of trip reports, biological treatises, and science fiction, all of which seem to be crucial constitutive elements of his research. That is, this is not a book that offers abstract (...) erudition—though there is plenty of content that anyone can extract from it—but one that offers something more rare. Here, I am reminded of Goethe’s famous remark, which Nietzsche chose to use as the epigraph to.. (shrink)

The first section of this article examines Jacques Derrida’s essay ‘Plato’s Pharmacy’, specifically his discussion of the ancient Greek word for drug, pharmakon. It is argued that the rhetorical force of Derrida’s essay has led to the mistaken impression that he and more importantly Plato understood pharmakon to have two possible meanings: remedy or poison. In the second section a number of Platonic and other ancient Greek texts are used to demonstrate that pharmakon signified several additional things, such as (...) painters pigment, magical talisman, cosmetic, and mind-altering substance. The final section builds upon Carl Page’s observation that the Noble Lie of the Republic is itself a pharmakon, situating Plato’s Noble Lie in the context of his vision of the philosopher as a moral physician, and Plato’s on-going opposition to psychological conditions characterized by ecstatic displacement. (shrink)

This article addresses a set of exploratory questions related to emergency contraception and the right to refuse to dispense such drugs. The paper first address the roles of the pharmacist in American society, i.e., as professional, employee, and business owner, and the pharmacists's identity and belief system; second, the paper reviews the status of state law and proposed legislation concerning patient/consumer access to emergency contraceptives; third, it offers an in-depth stakeholder analysis of the ethical and legal responsibilities of pharmacies to (...) stakeholders; and fourth, the paper provides overview of the salient ethical and legal issues concerning patient/customer access to emergency contraceptives relevant to management. The conclusions discuss questions for further research as well as strategic/human policy recommendations that balances the economic, legal, and ethical concerns of all primary stakeholders of the company/business, such as designing a management system which refers customers in a timely fashion; recognizing "conscience clauses," while ensuring that pharmacists "do no harm" to the consumer; and disseminating management "best practices" on "conscience clauses" through joint professional/industry sponsorship. (shrink)

This textbook offers a unique and accessible approach to ethical decision-making for practicing pharmacists and student pharmacists. Unlike other texts, it gives clear guidance based on the fundamental principles of moral philosophy, explaining them in simple language and illustrating them with abundant clinical examples and case studies. The strength of this text is in its emphasis on normative ethics and critical thinking, and that there is truly a best answer in the vast majority of cases, no matter how complex. The (...) authors place high trust in a pharmacist’s moral judgment. This teaches the reader how to think, based on ethical principles, not necessarily what to think. This means navigating between the two extremes of overly theoretical and excessively prescriptive. The cogent framework given in this text uses the language of competing duties, identifying the moral principles at stake that create duties for the pharmacist. This is the balancing act of normative ethics, and of deciding which duties should prevail in a given clinical situation. This work presents a clear-cut pathway for resolving ethical dilemmas encountered by pharmacists, based on foundational principles and critical thinking. Presents a clear-cut pathway for resolving the ethical dilemmas encountered by pharmacists, based on foundational principles and critical thinking. Jon E. Sprague, RPh, PhD, Director of Science and Research for the Ohio Attorney General. (shrink)

Patient-centered pharmacy practice involves increased pharmacist engagement in patient care. This increased involvement can sometimes require diverse decision-making when handling various situations, ranging from simple matters to major ethical dilemmas. There is literature about pharmacy ethics in developed Western countries. However, little is known about pharmacists’ practices in many developing countries. For example, there is a paucity of research conducted in the area of pharmacy ethics in Jordan. This study aimed to explore the manner in which ethical (...) dilemmas were handled by Jordanian pharmacists, the resources used and their attitudes towards them. Semi-structured, face to face interviews were carried out with 30 Jordanian registered pharmacists. The transcribed interviews were thematically analysed for emerging themes. Four major themes were identified: legal practice; familiarity with the code of ethics; personal judgement, cultural and religious values; and Experience. Findings showed that ethical decision-making in pharmacy practice in Jordan was decisively influenced by pharmacists’ personal moral values, legal requirements and managed by exercising common sense and experience. This pointed to gaps in Jordanian pharmacists’ understanding and application of basic principles of pharmacy ethics and highlighted the need for professional ethics training, incorporating pharmacy ethics courses in pharmacy undergraduate curricula, as well as professional development courses. This study highlighted that paternalism, personal values and legal obligations were major drivers influencing decision-making processes of Jordanian pharmacists. Findings also highlighted an inclination towards lack of respect for patient autonomy. This illuminated the need for increasing pharmacists’ literacy in professional ethics. (shrink)

In early modern China, natural history and medicine were shifting along with the boundaries of the empire. Naturalists struggled to cope with a pharmacy's worth of new and unfamiliar substances, texts, and terms, as plants, animals, and the drugs made from them travelled into China across land and sea. One crucial aspect of this phenomenon was the early modern exchange between Islamic and Chinese medicine. The history of theriac illustrates the importance of the recipe for the naturalization of foreign (...) objects in early modern Chinese medicine. Theriac was a widely sought-after and hotly debated product in early modern European pharmacology, and arrived into the Chinese medical canon via Arabic and Persian texts. The dialogue between language and material objects was critical to the Silk Road drug trade, and transliteration was ultimately a crucial technology used to translate drugs and texts about them in the early modern world. (shrink)

Since antiquity, Epicurus' thought has been compared to a powerful drug able to cure the pains of the soul that have always tormented man preventing him from living a peaceful existence: but we know that the Greek term pharmakon can be interpreted in its two opposite meanings of medicine and poison; and indeed, the same duplicity animates Epicurus' philosophy which, by acting as a medicine for the human soul, also has the effect of a poison, destroying from within, philosophy traditionally (...) conceived as a disinterested contemplation of truth. The philosophical revolution undertaken by Epicurus as a fracture with respect to all the previous tradition, from Thales to Aristotle, coincides with an inversion of the traditional relation between man and cosmos, between theory and practice: the classic question "what is reality made of?" is replaced by the Epicurean question that is at the basis of his philosophical anthropocentrism: "how must reality be made and how should one understand it in order to be happy?." Each specific articulation of Epicurean philosophy is subordinate to the task of achieving a happy existence that is in no way inferior to any of the divine realities'. (shrink)

In this essay, one of Derrida’s early texts, Plato’s pharmacy, is analysed in detail, more specifically in relation to its reflections on writing and its relation to law. This analysis takes place with reference to a number of Derrida’s other texts, in particular those on Freud. It is especially Freud’s texts on dream interpretation and on the dream-work which are of assistance in understanding the background to Derrida’s analysis of writing in Plato’s pharmacy. The essay shows the close (...) relation between Derrida’s analysis of Plato’s texts and Freud’s study of the dream-work. The forces at work in dreams, it appears, are at play in all texts, which in turn explains Derrida’s contentions in relation to the pharmakon as providing the condition of possibility of Plato’s texts. The essay furthermore points to the continuity between this ‘early’ text of Derrida and his ‘later’, seemingly more politico-legal texts of the 1990s. A close reading of Plato’s pharmacy, with its investigation via ‘writing’ of the foundations of metaphysics, and thus also of the Western concept of law, is obligatory should one wish to comprehend how Derrida attempts to exceed the restricted economy of metaphysics through his analysis of concepts such as justice and hospitality. (shrink)

General practice (community) pharmacy as a healthcare profession is largely devoted to therapeutic treatment of individual patients whether in dispensing medically authorised prescriptions or by providing members of the public with over-the-counter advice and service for a variety of common ailments. Recently, community pharmacy has been identified as an untapped resource available to undertake important aspects of public health and in particular health promotion. In contrast to therapeutic treatment, public health primarily concerns the health of the entire population, (...) rather than the health of individuals (Childress et al. in J Law Med Ethics 30:170–178, 2002). Thus, an important question for the profession is whether those moral and professional values that are appropriate to the therapeutic care of individual patients are relevant and adequate to support the additional public health role. (shrink)

Traditional pharmacy education emphasizes the biological processes of diseases and their pharmacological treatments. While the intense focus on biomedical aspects of disease is vital to educating pharmacy students, this focus is often insufficient in conveying what patients experience. The humanities, however, offer powerful characterizations of the disease experience for individuals as well as its impact on the human condition more generally. In this essay, I describe how using literary texts with pharmacy students provides them with a fuller (...) appreciation of what patients face with their diseases. The goal of this endeavor is to make students more effective as pharmacists in detecting and responding to their patients’ problems and needs by connecting their biomedical knowledge to depictions and meanings of illness experiences. (shrink)

This article explores the patient consent process in modern community pharmacy practice and discusses the related ethical dilemmas in this environment. The myth of appropriately informed consent, and irrefutable evidence as to a pharmacist’s intentions when advising a patient, are core issues for discussion. The objective is to clarify where such dilemmas may exist in the consent process and to ultimately form a framework against which ethical guidelines might facilitate resolution of the dilemma faced by the pharmacist who is (...) expected to simultaneously maintain legal and duty of care responsibilities in the patient consent process. (shrink)

This publication features the stories and experiences of pharmacy professionals who identify as members of historically underrepresented groups. This collection of personal essays presents significant events in the lives of those in the pharmacy community whose experiences have been shaped by their race, ethnicity, gender or gender presentation, sexual orientation, ability, language, mental health, or other factors. The perspectives from the narratives highlight the importance of diversity, equity, and inclusion in the healthcare sector. The authors of the narratives (...) also reflect on their experience to consider what they wish would have happened in the experience, to offer advice for others that may be faced with similar situations. Access to these stories will deepen the collective understanding among pharmacy colleagues, patients, and society of the experiences that individuals from historically underrepresented groups within pharmacy have experienced. (shrink)