PREAMBLE

Proposals

[Change]
...since both share the concern that the conduct of health care professionals should reflect respect for the well-being, dignity and self-determination of all people...

[Add]
A legitimate ethical goal is the maximum accommodation of differing conscientious beliefs of citizens in all walks of life. Nothing in this Code shall be construed in a manner inconsistent with this goal.

Re: Change
Respect for the well being, dignity and self-determination is due to all people, including members of the profession.

"The public" is an abstraction; pharmacists care for individual people. More important, the concepts of well-being, dignity and self-determination are primarily applicable to individuals, not to "the public". It is desirable to avoid language that could cause unintended dichotomies, such as "well-being of the public" vs. "well-being of the individual".

Re: Addition
It is important to ensure that a Code of Ethics does not become an instrument for the suppression of freedom of conscience within the profession.

STATEMENT II:
Guidelines for Interpretation

[Draft model code]
2. Pharmacists determine the patient's needs, values and desired outcomes.
 

[Change]
2. Pharmacists acquaint themselves with the patient=s needs, values and desired outcomes.

Reasons

Re: Change
The change is recommended to avoid any conflict with the notion of self-determination. The present text can be misinterpreted to mean that the pharmacist decides what the patient needs.

[Add]
Guideline for Interpretation
This statement shall not be construed in a manner that places the autonomy, values and dignity of the patient in opposition to the autonomy, values and dignity of the pharmacist.

Re: Addition
In any professional relationship, all parties in the relationship have legitimate spheres of personal and/or professional autonomy, and are entitled to respect for their values and dignity. In its current, unqualified form, the text tends to invite conflict rather than accommodation when disagreements arise. The amendment seeks to avoid such confrontation.

STATEMENT V
Guidelines for Interpretation

Proposals

[Change]
1. Pharmacists who object, as a matter of conscience, to providing a particular pharmacy product or service

d) must not prevent the provision of pharmacy products and services by other pharmacists.

Reasons

Re: Change
Proposed changes (a) and (c) exactly parallel the policy of the Canadian Medical Association with respect to the rights and obligations of physicians in the case of abortion.

Proposed change (b) is consistent with the law on accommodation and with the objectives of the present text (Guideline 2).

Proposed change (d) is consistent with the objectives of the present text (Guideline 2), while avoiding the likelihood that >participation= will be interpreted in a manner prejudicial to freedom of conscience.

Proposals

[Change]
3. Pharmacists abide by the Codes of Ethics in force in their jurisdiction.

[Add]
7. No discrimination should be directed against pharmacists who manifest conscientious convictions by declining to provide pharmacy services or products. Respect for decision in this area must be stressed, particularly for pharmacy students and new practitioners.

Reasons

Re: Change
Guideline 3 in its present form is unacceptably vague, especially since it is contemplated that a pharmacist could be disciplined for a breach of the code. "Ethical principles of the profession" fails to express precisely what those principles are, how they are determined or changed, and by whom.

It is sufficient that pharmacists agree to abide by codes of ethics or conduct, which are, presumably, formulated with ethical principles in mind.

Re: Addition
The additional guideline exactly parallels the policy of the Canadian Medical Association with respect to protection of physicians who have conscientious objections to abortion. (Ref: CMA Statement on Induced abortion, Approved by the CMA Board of Directors, December 15, 1988)