Pharmacy Ethics

Question 1

What are the 4 bioethical principles set out by Beauchamp and Childress?

Answer 1

• Respect for Autonomy
• Non-maleficence
• Beneficence
• Justice

Question 2

Define the Principle surrounding the Respect for Autonomy

Answer 2

• The right of competent adults to make informed decisions regarding their healthcare
• Underlies the requirement to seek consent of the patient before any investigation or treatment takes place

Question 3

Define the Principle of Non-maleficence

Answer 3

• To not intentionally cause harm or injury to patients, either by acts of omission or commission
• Fundamental commitment by HCPs to protect their patients from harm

Question 4

Define the Principle of Beneficence

Answer 4

• HCPs have a duty to be of benefit to patients, as well as take positive steps to prevent and remove harm form the patient
• The goal of providing benefit can be applied at an individual patient level, or to society as a whole

Question 5

Define the Principle of Justice

Answer 5

• A form of fairness which implies the fair distribution of goods in society and requires looking at the role of entitlement
• Hinges on the fact that some goods and supplies are in short supply, thus some fair means of allocating them must be determined

Question 6

What are the segments of the 4-box model for ethical decision making?

Answer 6

• Medical indications
• Patient Preferences
• Quality of Life
• Contextual Features

Question 7

What information may be present in the ‘Medical Indications’ box?

What bioethical principle(s) are at play here?

Answer 7

• Principle(s) = Non-maleficence & Beneficence
• Diagnosis, prognosis, treatment options
• Assessment of goals of care
• Probabilities of success of treatment
• How can this patient benefit from care and how can harm be avoided?

Question 8

What information may be present in the ‘Patient Preferences’ box?

What bioethical principle(s) are at play here?

Answer 8

• Principle(s) = Respect for Autonomy
• Has patient been informed of risks and benefits, and given consent?
• Is the patient mentally capable and legally competent? Any evidence of incapacity?
• If mentally capable, what preferences are they stating?
• Is the patient unwilling or unable to cooperate with treatment? If so, why?

Question 9

What information may be present in the ‘Quality of Life’ box?

What bioethical principle(s) are at play here?

Answer 9

• Principle(s) = Beneficence, Non-maleficence & Respect for Autonomy
• What are the prospects of return to ‘normal life’ and what physical, mental, social deficits might the patient experience?
• Are there any biases that might prejudice the provider’s evaluation of the patient’s quality of life
• What ethical issues arise concerning improving a patient’s quality of life?
• What are the plans and rationale to forgo life-sustaining treatment?

Question 10

What information may be present in the ‘Contextual Information’ box?

What bioethical principle(s) are at play here?

Answer 10

• Principle(s) = Justice and Fairness
• Are there professional or business interests that might create conflict?
• Other parties (e.g. family members) with interest in the clinical decisions?
• Limits imposed on confidentiality by the interest of third parties?
• Financial factors
• Religious issues
• Legal issues
• Considerations for clinical research and education affecting care?
• Public health and safety
• Conflicts of interest within institutions e.g. hospitals that may affect clinical decision making and patient welfare