Qais Alefan

B.Pharm, R.Ph, M.Pharm, PhD

The seven principles of the Code of Ethics:

1. Make the care of patients your first concern
2. Exercise professional judgement in the interests of patients and the public 3. Show respect for others 4. Encourage patients to participate in decisions about their care 5. Develop your professional knowledge and competence

6. Be honest and trustworthy

7. Take responsibility for your working practices

knowing these principles and what they encompass may not actually provide an answer to ethical problems in practice They do provide a basis for trying to work out the answer Whilst the terminology can seem difficult or even incomprehensible, these four principles are really very straightforward

Beneficence

Non-maleficence
Respect for autonomy

Justice

The term beneficence refers to actions that promote the well being of others Is all about doing good Is about doing what will benefit others, such as the patient and anyone else affected by an ethical decision This is seen in the first and second principles of the Code of Ethics
The 1st principle: care of the patient is the first concern, The 2nd principle: pharmacist or technician must act in the interests of the patient

is the duty to do no harm

This is not the same as taking no action since this in itself could result in harm being caused This principle works to moderate that of beneficence since if doing good for one person caused harm to others, overall the action cannot be said to be good

The concept of non-maleficence is embodied by the phrase, "first, do no harm" It is more important not to harm your patient, than to do them good It is also important to know how likely it is that your treatment will harm a patient In ethical decision making it is important to establish who may be affected by any decision

Is about allowing individuals to have the right to make decisions for themselves Is a general indicator of health This right is tempered if one persons decision was likely to have harmful effects on others It depends on the individuals ability to appreciate and understand the issues at stake

This is about fairness

It is about providing the same level of service or care regardless of who the recipient is
It is about not judging the reasons behind a patients need such as might occur in relation to providing services to drug misusers

Principle 3 of the Code of Ethics requires that respect is shown for others This includes the legal and professional duty to obtain consent from patients for any services or treatments you provide for them or to use any information that you obtain from them

For any consent to be valid, the individual who is consenting:

must be deemed to be capable of making the decision must be acting voluntarily

must have been provided with sufficient information

must be capable of weighing up that information

This process is called informed consent

A competent patient has a right to refuse any services or treatment offered A competent patient has a right to refuse permission for you to use information for any other purpose Consent need not be obtained in writing, although if an invasive procedure is being performed this might be wise

Obviously the matter of ability to consent will depend on the patient Young children and mentally impaired patients may not be able to give consent The assessment of capacity to consent can be challenging and if unsure specialist advice must be sought Generally all adults are assumed to have capacity to provide consent, as are children aged over 16 For younger children the assessment can be more difficult; this is often seen in relation to the supply of emergency hormonal contraception under a patient group direction to girls as young as 12