In line with Buerki and Vottero, (45), on the framework for decision-making procedure in pharmacy, the process of making a judgment supports professional actions towards valid choices that are based on reflection and reason.
The first step ought to involve recognition of a dilemma that exists. The systematic identification of the problem is the foundation for analysis by the law. Problem identification ought to be a clearly defined procedure to reduce uncertainty or ambiguity. According to Buerki and Vottero, the critical process of problem identification involves the distinct steps of gathering or identifying the technical facts, identifying moral parameters which may exist, analysis of the legal constraints involved, and identification of relevant human values.
Identifying the technical facts
Having the required facts at hand, one is in a position to analyze the ethical implications and moral dilemmas associated with the problem. In our case study, the fact is that Mary’s problem revolves around the issue of weighing between saving the organization’s reputation over the patient’s care through the provision of the newly released strong antibiotics. The initial question which she has to answer is whether she will be reacting ethically if she were to endorse or recommend the newly approved drugs.
About Buerki and Vottero (46), on the identification of moral parameters, it would be important to engage in a personal debate over the extent to which the decision made would have on the reputation of the organization for instance, to what extent would the high pricing affect segments of the clientele? The process of problem analysis and identification should also involve analysis of the effects of legal constraints that are involved.
Another ethical issue represented in the case study involves invoking the conscience clause about the law. Knowing that sometimes pharmacists prescribe expensive drugs due to the influence on sales, colleagues and management have a different perspective over the issue of antibiotics possibly because they are being driven by their consciousness. She needs to analyze the consciousness and validate them against the laws governing pharmaceutical companies.
Relevant human values
A competent clinical pharmacist should be in a position to identify bioequivalent drugs equitable to the costly drug. The decision one makes ought to enhance the relationship between the pharmacists and the patients rather than conform to a fixed professional code of ethics or organizational culture. Some of these internal bureaucratic rules and regulations are crafted in such as way that they enhance the internal efficiency of the firm but on the other hand argument the good patient care. Ethically these are third-party constraints.
By denying approval, will she be cutting short the life of dying patients who need it? On the other hand, will she be subjecting the patient to exploitation by pharmacists or physicians by approving it? Will the public perception or reputation of the care organization change if the drugs are allowed? These are questions Mary has to find answers to and act ethically.
Morally, she has to approve the drugs since she does not have any decision to make in connection to the existence of human life. It is not evident that the use of these drugs on patients at the verge of their life necessarily means prolonging or avoiding the inevitable. This would go against some of her colleagues and management expectation but not the human conscience.
Developing alternative courses of action
Her alternative course of action to take is first to involve the public. The probability is that she has to perform relevant research before settling on her verdict. The research to be conducted must be based on the past experiences of similar situations and also her experience in the industry. Making her dilemma public within a reasonable time of data mining just before making her final decision would assist her to make the right one and strengthen it. By publicizing the issue, people would probably argue their point of view and this would make her find the better and stronger option of approving or not.
The second alternative would be to weigh her moral principles with regards to the ethics of healthcare and compare them with the immediate consequences on the firm and the colleagues. Sometimes the firm’s cultural ethics might be the final basis for decisions curried out within the organizations and thus she will have to play by the rules or stipulated ethics on the agreement she may have signed. They are third-party rules which she can freely decide to play by since they protect her.
Selecting alternative courses of action
Depending on the developed alternatives throughout the action to take, Mary would possibly wish to make personal investigations, come up with some logical suggestions to reveal her intentions to the colleagues to strengthen the final verdict. In the field of pharmacy, the ethical issue Mary would wish to consider as per the given situation would be the modern ethical theories. Consequential theory indicates that ethically one would be concerned with the outcomes or the consequences of the action taken. The action becomes right or wrong about the outcome which is a benefit or harm. From this theory, lying to the patient would be permitted if it had a positive result or benefit to another patient.
This opposes the non-consequential theory which looks at the action as right or wrong without depending on the outcome for instance lying to a patient would be wrong from the word go regardless of whether it would benefit or not. Consciously it is apparent that a pharmacist, who tells the truth, would speak frankly and kindly over a serious situation while one who practices nonconsequential theory would struggle and find it hard to choose between giving truth or false information because they need to assess the one that would be more beneficial.
Reasonably in line with Robert and Vottero (46), “Non-consequential theory tends to be less paternalistic by allowing its proponents to focus upon a more objective goal—telling the truth becomes a good” that outweighs the consequences associated with telling the truth or the patient’s ability to handle the truth.” Moral standards are widely accepted in the quest for outcomes. They may include the principles that accept behaviors of pharmacists to support the patient’s health or those that urge them to avoid harmful behaviors or actions.
The cause of action taken would depend mainly on ethical values. In line with the Rowlsian theory of distributive justice, the life-saving drugs that are very expensive such as the strong antibiotic on the case study ought to be considered as a “primary social good” by pharmaceuticals such that it is afforded to any person. This might have been one lacking ethical value among Mary’s contemporaries since they know that most newly approved drugs can sometimes be very expensive and are prescribed due to influences by pharmaceutical sales. It would be recommendable to consider an appropriate and affordable or reasonable price for such drugs which can still maintain reasonable profits.
Objections for an alternative that is selected
Virtue is an important aspect of professional ethics. Virtue is known as the trait and character of a person. It is certainly a basic conceptual basis for ethical practice in the pharmacy where the practitioner is expected to be virtuous such that if he/she makes a judgmental mistake that may lead to a morally wrong act, then blame would not automatically fall onto him/her because the intention was out of utmost good faith. “The vultures of faith, fortitude, and compassion have been associated with and in some cases driven the moral motivation of health care practitioners” (Buerki and Vottero, 47)
It is not necessarily right to state that a practitioner who makes morally defensible decisions is right since he/she may purposefully avoid giving shocking news to the patient but end up violating the patient’s rights to self-determination. In this case, the study pharmacist may act out of royalty and good faith to the organization or management and tolerate the potential dangers of neglecting the duty of ensuring patients’ safety. Virtues are held by individuals and they reflect the unique characters and believe of the person.
There are some virtues that most pharmacists believe to be most essential for their practice today. Altruism is the good quality of being concerned about the welfare of others. In this case, altruism is focused on the attention to patients in assisting them, providing medical care, and being sensitive to their social issues. This calls for a pharmacist to be committed, have compassion, and be generous.
Equality is the virtue of being concerned about the patient’s rights, privileges. All patients ought to be treated in a just and fair way with regards to their needs and relation to others. Lastly, the virtue of justice stipulates that the patient should be treated in a non-discriminatory manner where all the morals and legal principles are upheld with required integrity.
Buerki, Robert and Louis Vottero. Ethical Responsibility in Pharmacy Practice Chicago: Amer. Inst. History of Pharmacy Publisher, 2002.