In order to ensure the proper pharmaceutical care, each employee shall have a well-defined algorithm of behavior when releasing pharmacy products, interacting with colleagues, etc. In this regard, the purpose of this study was to develop the main directions for the development of a uniform code of pharmaceutical ethics. Created for each individual state these documents do not provide the common action strategy in a particular situation, do not always provide for responsibility for any misconduct, moreover, the boundaries of these actions are often blurred and unclear. Besides, this makes international communication difficult and cannot ensure a unified approach to the problem of corporate ethics. There is a need to take into account the national characteristics of the pharmaceutical market, but in general this document should be uniform. Pharmaceutical codes and regulatory documents of various countries were studied with the help of content analysis. The analysis made it possible to formulate the main directions of a uniform code of pharmaceutical ethics. To assess the criterion of “importance” of this document, the analysis was conducted among 425 employees of pharmacies, the results of which confirmed the need to develop this code, thereby strengthening a single pharmaceutical space.
In modern conditions, the following varieties of pharmaceutical codes were studied in detail – professional and corporate codes, codes regulating the relationships of people within the study groups. Created for each individual state these documents do not provide the common action strategy in a particular situation, do not always provide for responsibility for any misconduct, moreover, the boundaries of these actions are often blurred and unclear (Lopatin, 2009). Besides, this makes international communication difficult and cannot ensure a unified approach to the problem of corporate ethics. Ethical compliance is especially relevant in the provision of pharmaceutical care, as it is directly related to the patient’s care management in terms of health improvement.
Currently, in the pharmaceutical market of various states the pharmaceutical workers comply with the codes of pharmaceutical ethics in their professional activities, which, for the most part, are advisory in nature. Even the developed by the International Pharmaceutical Federation only serves a recommendation for most states. In this regard, this study presents some aspects that need to be included in the development of a uniform code of pharmaceutical ethics.
The subject of this study was codes of pharmaceutical ethics of different countries.
Purpose of the Study
The purpose of this study is to identify the main aspects for the development of a uniform code of pharmaceutical ethics.
Research methods included content, logical, system analyses.
The first modern code of ethics, based on which the remaining pharmaceutical codes were compiled, was the Code of Ethics of the American Association of Pharmacists approved in 1852. This problem began to be actively studied in Russia after the First All-Union Conference on Medical Deontology held in the 1970s. The Code of Ethics for the Pharmaceutical Worker of the Russian Federation was approved in 1996.
In 1997, the International Pharmaceutical Federation (FIP) participated in the development of the Code of Ethics for Pharmacists, which is actively used in various countries and on the basis of which pharmaceutical codes of the respective states were developed. At the moment, a model of the pharmaceutical code has been formed, which directly consists of two parts: introduction and basic principles. For example, the purpose of the FIP Code is to declare the basic principles of the studied profession, which is based on moral values that are a guide for specialists in their relationship with the society. The next part of pharmaceutical codes is formed from ethical standards and principles of pharmacists. It is worth noting that quite often each state develops its own principles in pharmaceutical codes (Zorina et al., 2019).
The Code of Ethics for Pharmacists presents the basic requirements for the personal qualities of a pharmacist, who should be open-minded and fair and be able to provide high-quality pharmaceutical care putting the patient’s health in the foreground. It should be noted that the requirements of the Code of Ethics for Pharmacists are advisory in nature. But there are countries in which this document is accepted for mandatory execution (Great Britain and Canada). Authorized organizations have the right to apply appropriate measures in case of non-compliance with any provisions of the Code. In Moldova, the considered Code has legal effect. Depending on the measure of violations, the members of the ethical committee who consider the revealed violations have the right to send an appropriate appeal with the initiative for sanctions to the Ministry of Health of the Republic of Moldova.
The pharmaceutical codes of the Russian Federation and Ukraine consider the requirements for interaction of a pharmaceutical worker with a consumer of a pharmacy organization (World Health Organization, 2019). The main provisions of this interaction include: the patient’s right to receive the information he needs about any medicinal product, the pharmacy employee shall provide this information in the most complete form, as well as inform about the proper use of the released medicinal product. The release of medicinal products should not be based on the personal interests or preferences of a pharmacist, but should be objective and rational. It is also the responsibility of a pharmacist to provide pharmaceutical aid to a patient of any status, age and gender, despite his nationality, religion, financial situation.
Pharmacists in most countries of the world face the problems of moral decision, which are formed by all kinds of contradictions, including between ethical requirements and legislative provisions. There is a need to develop a uniform legal code of pharmaceutical ethics for all countries. In order to develop a uniform code of pharmaceutical ethics, it is important to formulate provisions that are directly binding and enforceable among those countries that have adopted a uniform code of pharmaceutical ethics. The mandatory execution and application of the sanction in the uniform code of pharmaceutical ethics will ensure that the document will have force among those countries that have approved it and there will not be a situation when the code of pharmaceutical ethics of a particular country is not bound to the national legislation and is not applied in practice. The current FIP Code serves the basis for the final document.
It is important to understand that pharmaceutical organizations need to create basic ethical principles in pharmaceutical activities, so it is necessary to develop and include them as the main basic recommendations in the development of the uniform code of pharmaceutical ethics. The content analysis of regulatory documents, pharmaceutical codes, and literary sources on the studied problem made it possible to identify the main points that should be considered in the uniform code of pharmaceutical ethics. Accordingly, this phase of the study confirmed the importance of developing common documents for pharmaceutical employees in a single global pharmaceutical space (Elyashevich, 2013).
The Uniform Code of Pharmaceutical Ethics should contain requirements for the autonomy of pharmaceutical workers and their independent decisions, and consider religious and other policies of pharmaceutical workers. The main point of control over pharmaceutical activities and the acquisition of various kinds of responsibility should be the oath of a pharmacist, which should become evident for a future pharmacist (Ministry of Health of the Republic of Belarus, 2014).
The following aspects should be identified in the uniform code of pharmaceutical ethics:
- pharmaceutical activities shall be carried out in good faith and honestly to patients and other persons, excluding damage to the moral and physical health of the above-mentioned;
- main activities of pharmaceutical workers shall include accounting of the maximum safety of medical prescription (prescribed by a doctor), assistance and, if possible, full patient satisfaction;
- independent and impartial operations of pharmacists in the healthcare system shall be guaranteed;
- pharmaceutical activities shall be strictly regulated on the basis of pharmaceutical scientific principles and standards;
- pharmacists shall be obliged to cooperate with patients and health professionals in order to carry out the highest quality pharmaceutical activities;
- strict confidentiality with respect to information on patients whom, for whatever reason, a pharmaceutical worker has access to due to his professional activity, and any dissemination of such information only with the permission of the patient or on the basis of relevant legal acts shall be required;
- in the event of conflicts a pharmacist shall honor the rights, needs and other settings of patients or their authorized persons, and continue to consult and treat the patient despite misunderstanding and conflict with patients or their authorized persons;
- pharmacists shall be obliged to continuously increase their competence and level of professional education. Hence, most of these aspects are contained in the Code of Ethics for Pharmacists.
Then a sociological study we conducted among 425 employees of pharmacy organizations to directly evaluate the criterion of “importance” of developing a single document. The sociological study was carried out using developed original questionnaires. The respondents mainly consisted of women – 96 %, and 4 % – were men. In total, pharmaceutical workers with secondary specialized education participated in the sociological study – 23 %, the remaining specialists, which were the majority, were with higher pharmaceutical education. Among the latter there were the directors of pharmacies – 34 %, heads of departments – 47 %. In terms of labor experience, specialists “with 20–30 years of experience” prevailed – 48 %. The criterion was evaluated using a scoring system. The survey contained the following options: “yes”; “more likely than not”; “very unlikely”; “no”. The following points: “5”, “4”, “3”, “2”, respectively we offered for each possible answer. The respondents named the following main reasons for creating this document: convenience of working in a single pharmaceutical space, accessibility of the profession of a pharmacist to a specialist from another country, uniform conditions for pharmaceutical employees.
The study performed a content analysis of ethical codes of different countries, which made it possible to identify aspects for the creation of the uniform code of pharmaceutical ethics. It was also established that the predominant majority of aspects are presented in the Code of Ethics for Pharmacists developed by the International Pharmaceutical Federation. The analysis of questionnaires of pharmaceutical specialists conducted at the second stage of the study showed that the predominant majority supported the development of the uniform code of pharmaceutical ethics.
Elyashevich, E. G. (2013). History of pharmaceutical ethics. Pharmacy Bulletin, 1(59), 77–80.
Lopatin, V. P. (2009). Role of a pharmaceutical worker in the healthcare system. In: V.P. Lopatin (Ed.), Bioethics (4th ed.). Textbook for university.
Ministry of Health of the Republic of Belarus (2014). On the approval of Good Pharmacy Practice. Resolution of the Ministry of Health of the Republic of Belarus of December 27, 2006, National Register of Legal Acts of the Republic of Belarus.
World Health Organization (2019). The legal and regulatory framework for community pharmacies in the WHO European Region. Denmark, World Health Organization Regional Office for Europe.
Zorina, O., Shitova, T., & Kharchenko, G. (2019). Professional growth opportunities of the provider: classic and new solutions. Journal Provisor, 22. https://provisor.com.ua/archive/2009/N22/prosp_229.php
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23 December 2022
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Gribkova, E. I., Sudarenko, K. V., Vdovichenko, A. A., & van De, C. (2022). “Importance” Criterion For The Development Of A Uniform Code Of Pharmaceutical Ethics. In D. K. Bataev, S. A. Gapurov, A. D. Osmaev, V. K. Akaev, L. M. Idigova, M. R. Ovhadov, A. R. Salgiriev, & M. M. Betilmerzaeva (Eds.), Knowledge, Man and Civilization- ISCKMC 2022, vol 129. European Proceedings of Social and Behavioural Sciences (pp. 510-514). European Publisher. https://doi.org/10.15405/epsbs.2022.12.64