Exam 1 Flashcards
Ethics
The branch of philosophy that seeks to understand the nature, purposes, justification, and founding principles of moral rules and the systems they comprise.
●Focuses on the rightness and wrongness of actions, as well as the goodness and badness of motives and ends
Morals
Ideas about what is right and wrong
Morality
Rules held by society to govern the conduct of its individual members
■ Morality legislated: Law distinguished from morality in that:
● Law has explicit rules and penalties
● Laws set boundaries for societal behavior
● Laws are enforced
Moral judgements
judgments concerned with what an individual or group believes to be right or proper behavior in a given situation
Code of Conduct
Standards, principles, rules of conduct
- prescribes for standards of conduct
- states principles expressing responsibilities
- defines the rules expressing duties of professionals to whom they apply
Consequentialism
ethical system that judges a moral action by its outcomes or results
Metaethics
The study of the origin and meaning of ethical concepts
Normative ethics
Attempts to what moral standards should be followed so that human behavior and conduct may be morally right
Descriptive (Comparative) ethics
The study of what people believe to be right and wrong, and WHY they believe it
Applied ethics
The use of moral norms and concepts to resolve practical moral issues such as abortion, euthanasia
Consequential ethics
A theory of ethics based on the principle that the morally right action is whatever action that leads to the maximum balance of good over evil.
Rightness or wrongness is based on the consequences/effects of the action (consequentialism)
Utilitarian ethics
moral worth of an action is determined solely by its contribution to overall usefulness
● Advocates greatest good for the greatest number
Deontological (Duty-based) ethics
The idea that actions are right and wrong in themselves independently of any consequences; consequences are not the determinant of what is right, so doing the right thing may not always lead to an increase in what is good
Ethical relativism
morality is relative to the norms of one’s culture
● Actions can be considered right or wrong depending on the
accepted norms of the society
Paternalism
Making decisions for others
Virtue
A virtue describes moral excellence and that which has beneficial quality
-Virtues are habits
Virtue ethics
focuses on the inherent character of a person rather than
on the specific actions he/she performs
A moral theory that focuses on the development of virtuous character.
Situational ethics
Values change as situation changes
Values
the ideas, beliefs, and attitudes about what is important that help guide the way you live
Compare: values vs. morals
Intrinsic values
Something that has value in and of itself
Instrumental values
something that helps give something else it’s value
ex: money
TSBP mission
■ To promote, preserve, and protect the public health, safety, and welfare by fostering the provision of quality pharmaceutical care to the citizens of Texas through the regulation of the practice of pharmacy, the operation of pharmacies, and the distribution of prescription drugs in the public interest
■ Exists to protect the public , NOT pharmacists
First Texas Pharmacy Act
Defined a pharmacist
AS??
Current Texas Pharmacy Act
Originally created a board with 9 members, now 11
Increased authority of TSBP
Created classes A-E pharmacies- can create new classes and remove only the new classes made
TSBP Structure
11 member board and the TSBP agency
TSBP Board Divisions (5)
1- Executive 2- Licensing & Admin Services 3- Enforcement 4- Professional Services 5- Adjudication & Legal Support Services
Pharmacy Ethics
rules that govern how a pharmacist deals with other health care professionals and how they deal with others outside the health care profession
Code of Ethics for Pharmacists (8)
RRRSSAMP
Respects relationship b/w pt and Rph
Respects patient autonomy
Respects the values of peers
Serves individual, community, and societal needs
Seeks justice
Acts with honesty and integrity
Maintains professional competence
Promotes the good of pts
4 Pillars/Principles of Ethics
BANJ
Beneficence- do good
Autonomy- right to make one’s own decisions
Non-maleficence- avoid harm
Justice- be fair
Pillars of Moral Strength (15)
CCC-FFF-TT-HH-RID-WK
Courage, commitment, compassion
Fairness, fidelity, freedom
Temperance, tolerance (+,-)
Honesty, hopefulness
Respect, Integrity, Discernment
Wisdom, Kindness
Positive tolerance
person accepts differences in others
Negative tolerance
simply tolerating another’s beliefs, reluctantly
temperance
orderliness, moderation
wisdom
judicious application of knowledge
courage
moral strength to persevere
commitment
pledge to do something
compassion
empathy, sympathy
discernment
ability to make decisions without personal bias
fairness
ability to make judgement free from discrimination
fidelity
being true to commitment
honesty
confidence a person will act with the right motives
integrity
steadfast adherence to strict moral or ethical codes and a commitment to not break this code
respect
show special regard
hopefulness
looking forward to something with the confidence of success
cooperation
process of working with others
Religion provides a _______ for appropriate behavior
moral code
spirituality
faith in a higher being
state of being concerned with religion
Secular ethics
based on codes developed as a society relying on customs to make their codes
ex: Code of Hammurabi
Atheists believe ethics is a product of _____ and _____
culture, politics
reason
includes the capacity for logical inference and the ability to conduct inquiry, solve problems, evaluate, criticize, and deliberate about how we should act and to reach an understanding of other people, the world, and ourselves
partial reasoning
nvolves bias for or against a person based on one’s relationship with that person
circular reasoning
describes a person who has already made up his or her mind on a particular issue and sees no need for deliberation
consensus building requires
● Parties must reason together
● Identify and consider alternate choices
● Willingness to listen, learn, and make an informed decision
(legal requirement)
informed decision making
■ Determining if a Patient has the Capacity for Making an Informed Decision:
● Given the alternatives, potential benefits of each, and the potential harms of each, can the person express an understanding of the consequences of their choice?
● Apply teach-back method
informed consent
■ Permission that is granted in the knowledge of potential consequences
■ You can give a patient a drug for an indication that is not approved by the
FDA with informed consent
Legal IS/IS NOT necessarily ethical, while illegal is _____
Legal is not
Illegal is almost always unethical
Medication Errors
■ Any error occuring in the medication use process
● Includes events from when the provider decides a medication is needed → the medications effects on the body
To Err is Human suggests …
that the majority of medical errors result from flaws
in the way the health care system is organized, rather than individual
recklessness
3 major elements to reduce medication errors
● The individual professional’s knowledge of Practice
● Resources available to the professional
● Systems designs, problems and failures
developing a high level practice
■ Find your weak spots and watch them closely
■ Find the system’s weak spots and watch them closely
■ Find the weak people and watch them closely
Pill Mills
“Legitimate” clinics that see ~450 - 500 patients/day and write the same
prescription to all the patients
Trinity
○ Hydrocodone containing products (opioid analgesic)
○ Alprazolam (anxiolytic)
○ Carisoprodol (muscle relaxant)
Holy Trinity
○ Oxycodone (opioid analgesic)
○ Alprazolam (anxiolytic)
○ Carisoprodol (muscle relaxant)
Red Flags
● Multiple patients that have the same controlled substance prescription
● Prescriber is at a distant location
● Paying cash for an opioid
● Prescription written by a physician not associated with pain
management
● Multiple Prescriptions and Early Refills
● Multiple prescribers (possible doctor shopping)
● Possible federal or state action against the prescriber
● Unusual behavior
● Use of street slang
State Prescription Drug Monitoring Program
● Detect possible doctor shopping
● Detect possible pharmacy shopping
● Report information to the prescriber
Impaired individuals may/not be pharmacists or pharmacy students
may
ABO
Agreed board order; if RPh cannot show compliance with law and desire to dispose of any pending allegations, they may consent to “Agreed Board Order.”
Licensee must agree to terms and the ABO must be
approved by Board
Public, regardless
BO
If licensee or the Board does not agree to terms of the ABO or if licensee does not want an
informal conference, disciplinary hearing is scheduled before Administrative Law Judge.
The judge will make recommendation to the Board for action to be taken. Board will make decision in the case and document as “Board Order”
Public (unless impaired), but if RPh fails to comply, then a new BO will be issued and it will be public
Standard Rehab Order
Confidential
● 5 year probated suspension as long as the individual receives positive evaluation from Mental Health Professional (MHP)
● $1200 probation fee
● Quarterly reports (self, supervising pharmacist, MHP)
● Personal Recovery Network (PRN) contract
● Drug Screens:
○ Must call daily M-F to see if scheduled for drug screen
○ Must not miss a drug screen
○ Must have an Rx for any + test
○ EtOH test is for ethyl glucuronide (t1/2 = 7 days) → will test
+ for ~ 1 month (even nyquil will cause + test)
○ Other restrictions:
■ Can’t be PIC
■ Can’t be a preceptor for duration of order + 3 years
(total of 8 years)
■ Max 50 hr/week of work allowed
impersonating a pharmacist is a
Class A misdemeanor
Requirements for Licensure
○ A license fee set by the Board
○ A completed application on a form prescribed by the Board
with satisfactory sworn evidence that the applicant:
■ Is at least 18
■ At least 1,000 hour internship
■ Has graduated with a professional degree from an
accredited pharmacy degree program
■ Has passed the examinations required by the board
(NAPLEX and MPJE)
■ Has not had another license granted by another
state restricted, suspended, revoked, or surrendered for any reason
○ Each applicant must obtain practical experience in the practice of pharmacy concurrent with college attendance or after college graduation or both
