E-Drug: Trust & Ethical Laws (cont)
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E-Druggers,
Tim Dodd, Training Advisor, Ghana National Drugs Programme wrote with
regard to pharmaceutical care and professional obligations:-
Mechanisms such as peer review, education and information, defined and
published standards of practice, and development of laws and sanctions
are all available to effect such changes.
The S African Pharmacy Council is in the process of amending two of its
ethical rules to enable and achieve better therapeutic outcomes. Any
failure to comply with the ethical rules can lead to disciplinary
steps. The first, which is causing quite a fuss amongst some of my
Pharmacy colleagues is:-
"Failure in the interest of the patient to:-
(a) furnish advice or information for the safe and effective use of
medicines supplied by him/her.
(b) counsel personally a patient or the person whom the medicine is
supplied on behalf of the patient on any matter which in the
pharmacist's judgement, will enhance or optimise the medicine therapy
prescribed:
Provided that such counselling should be done face to face."
It has been argued that it is impractical to do "face to face"
counselling. Reading the whole rule in its proper context, the
pharmacist's judgement and the caregiver do feature prominently in this
ethical rule. The caregiver can be the doctor, nurse, other healthcare
personnel or one's kin. To claim that this is impractical, I ask then,
if Pharmacists are not relinquishing their responsibility especially
when claims are made that Pharmacists are in fact the caretakers of the
special commodity called medicines? Presently in SA even the PHC nurse
and Pharmacist's assistant are being taught that the patient or
caregiver has to be counselled "face to face". Why then should the
Pharmacist be exempt from doing the same?
Is it not the patient's right to be counselled on his/her medicines?
It may be difficult to change entrenched habits around but change for
the better is necessary if the desired outcomes are to be achieved. The
entire health process collapses at the level of the Pharmacy refuting
the purpose of having being correctly diagnosed and seeking help, if
this element of care is lacking. And waste of monies are incurred -
patients don't do well, return for more of the same treatment and the
cycle continues!
The second amendment takes the form of additions to an existing ethical
rule. These read:
"failure when supplying medicines:-
(i) to ensure that medicine is packaged in a manner that will
guarantee the safety, quality and efficacy of the medicine throughout
the delivery process;
(ii) to implement a control system that enable the pharmacist to detect
any problems or a delay in the process of the delivery of medicine to
the patients;
(iii) to take adequate steps to correct and identify delay in the
process of delivery of medicine to patients;
(iv) to implement an effective report back system to ensure that
problems with medicine supply are detected timeously;
(v) to. in addition to complying with rule 1 above, furnish
comprehensive written instructions regarding the correct use of
medicine;
(vi) to ensure that appropriate cold chain management procedures are
maintained in respect of thermolabile medicines"
Comments from e-druggers are welcome to enable S A to get onto the right
road to pharmaceutical care.
Mariam Cassimjee