Discussion
The present essay provides an insight on the core ethical issues in the pharmaceutical industry. The pharmaceutical enterprise have crucial role for the widespread recovery of effectiveness in the healthcare industry. The international institutions intervened with the framework of ethical code that mainly represent minimum standards the enterprise respect to attain good ethical practices. At present, most of the pharmaceutical companies maintain ethics in its business operations. Ethical values of pharmaceutics are directly related to professional responsibilities of the pharmacists (Publications.parliament 2018). The major ethical values of pharmaceutics involve- respect for the patient’s dignity, non-maleficence, beneficence, honesty, empathy, cooperation. Over the years, as the role of pharmacists have changed considerably, numerous ethical issues occurs relating to varied aspects of discipline. The pharmacists being one of the health –care providers face ethical problems in form of pharmaceutical care, cooperation with health- care team and relationship with the patients. In few nations, especially in US and UK, the pharmacies are involved in primary care service industry and few have special prescription rights. However, they are faced with issues regarding requirement of technical skills and consideration of ethical values. Due to such ethical issues, the pharmacists use code of ethics for safeguarding their profession The National Board of Registration of Pharmacists provide the code of conduct for assuring highest level of ethical as well as moral practice by the pharmacists (Schenker, Arnold and London 2014). In fact, these bodies also monitor the pharmacists for assuring that they meet standard of ethics and consumers attain highest quality medicine products with safety. The code of ethics takes into account values of CSR (corporate Social Responsibility) and protection of the stakeholder’s interest with whom the enterprise interacts. The CSR policies that the companies in pharmaceutical sector have pursued are critically assessed in this study.
Ethical issues in the pharmaceutical industry
Clinical pharmacy practice
Pharmaceutical care
Ethical issues might occur in regular clinical pharmacy practice. Pharmaceutical care relates to pharmacists responsibility for the drug therapy to achieve best result that promote patient’s quality of life. Few ethical issues that occur in pharmaceutical care practice involve – patient’s privacy, confidentiality, duty to warn, autonomy, competencies to decide about procurement of best medication. Lack of confidentiality assurance might cause unwillingness to disclose data by the patient, which in turn creates numerous obstacles to pharmaceutical care. Another crucial role played by pharmacists is to select best medications for the patients. The pharmacists are required to balance varied objectives that include- reduction of drug cost, cost utility of drugs, cost – benefit and total cost of illness (Cdn.intechopen 2018). However, the decisive position of pharmacists might lead to ethical questions relating to this sector. As a result, problems might result from advertising activity and other medical relating activities.
Ethical issues in the pharmaceutical industry
Ethical issue might also arise in certain situation when the pharmacists assists physician in the therapy but has not been permitted to comment on the shortcomings of professionals.
Another ethical issue might occur in professionally dispensing of medicine by the pharmacists. This requires provision of proper information on drug dosage depending on several factors, warnings, contraindications and few precautions. There are some legal regulations that permit the pharmacists to refuse selling of medicine, which in turn might put patient’s life at risk. Few countries especially UK permit the pharmacists to decline dispensing of drug due to their individual belief (Allen and Ansel 2013). In these circumstances, ethical values of pharmacists mainly remains in clash with patient autonomy and dignity. Nevertheless, numerous cases occur such as- cyberdoctors creating potential harms, selling drugs without any prescriptions (Cdn.intechopen 2018).
Based on the nation’s regulation, the pharmacists are permitted to sell drugs without prescription from physician. This involves setting of proper regulations by the authority for ensuring public safety. In this situation, pharmacists has to take decision regarding selling of medicines to the youngsters. However, non- prescription of medicine and self-medication creates ethical challenge to the pharmacists as improper dosing might lead to death of patient (Braithwaite 2013). Thus, serious ethical issue lies on the pharmacists decision of selling drugs without any prescription and proper information about the drug.
Extemporaneous pharmaceutical preparations are basically unlicensed medicine. Some of the country‘s regulation do not need these to be concerned with efficacy, bioavailability, quality and safety (Publications.parliament 2018). However, ethical problem occurs with assurance of drug quality in the extemporaneous preparations due to no need for medicine registration. In this situation, the pharmacists face challenges in preparing such medicines based on their basic knowledge and giving proper data for avoiding unintended harms. Nevertheless, stability issues can occur from extemporaneous preparations, which may involve- loss of uniformity, variation of bioavailability, degradation of drugs causing toxicity (Darrow et al. 2015).
The Pharmaceutical producers are not only producer of drugs as well as dosage forms but also develop and produce medicine licensed for medical use. Since the pharmacists are subjected to different rules and regulations with regard to production, testing and assuring quality of drugs, ethical issues might occur due to improper nations law (Light, Lexchin and Darrow 2013).
Assurance of medicine quality include varied aspects such as- production, control of quality, distribution and monitoring. However, ethical issues might occur while producing quality medicine as it needs effectual management of the company. If the management of the pharmaceutical organization does not integrate preventive measures then it might adversely impact on the drug quality. Thus, quality assurance of drugs requires high ethical conduct from the pharmacists for integrating quality into the pharmaceutical commodities.
Clinical pharmacy practice
The quality of medicine might be influenced by lack of proper control over several activities that arise during storage as well as distribution practice. Proper guidelines to storage as well as distribution of drugs helps to ensure quality of such pharmaceutical products. For maintaining quality and safety, each activity in storage as well as distribution of drugs is carried out based on principles of GSP, GDP and GMP. As storage as well as distribution of drugs are different in different nations, ethical issues occur for the pharmacists operating in that nation. Another ethical issue in GDP and GSP is cold chain system in handling of pharmaceuticals that need vaccines. Moreover, disruption of cold chain might result in non- effectiveness of vaccination. Nevertheless, there might be breach of ethics if the pharmacy product is reinstalled with new tag when cold chain system disrupts.
Import and export relates to the actions on drug distribution that are mainly controlled by licenses. The pharmacists having such licenses are required to have high ethics level as medicines are often diverted to illegal channels. The pharmacists having less ethics might create issues because dangerous drugs might lead to death of patients or their stake can be at stake.
There are few code of ethics for the pharmacists that include- respect for the patients dignity, empathy, honesty, beneficence, cooperation and so on. Proper ethical relation between patients, pharmacists and physicians is necessary as it helps them to meet their own needs. These code of ethics are explained below-
Patients require detail information regarding their medications and also prefer to discuss health issues with their healthcare provider. However, it is the responsibility of the pharmacists to fulfill information gap but could not due to lack of proper knowledge (Salari et al. 2013). For instance, recent studies on UK has reflected that few pharmacists provided proper drug information, which in turn lowers their treatment costs. Therefore, pharmacists should build their relationship with the patients for attracting their trust on the pharmacy system. As patient consultation has been the most crucial ethical issue in pharmacy practice, the pharmacists should comply with this ethical code of conduct.
Showing empathy with the patients by cooperating with physicians is another major concern of the pharmacists. The pharmacists can provide patient oriented service according to the patients interest and thus build better relationship with them. Few evidences in UK reflects that faults occurred from pharmacists that include dispensing drugs, improper self- trafficking and improper self- medication might lead to loss of confidence to the pharmacists.
Pharmaceutical care
Honest pharmacists do not sell any kind of harmful pharmaceutical products that provide adverse impact on the patients. There are some pharmacies in UK or other nations that sell alcohol, cigarettes that are totally banned for the patients. This raises ethical problems for the pharmacists if consumption of such products adversely affects the health of patients.
Beneficence to patients has been provided at the target of optimizing drug therapy as per interest of patients. One of the vital issues in this ethical code is pharmacists responsibility of selling drug. Pharmacists are identified as eligible healthcare experts to give advice to the patients on the heath products and more information on drug. Their responsibility is to counsel customers about the benefits of pharmacy products. If there is informed objection, then this ethical code indicates that the pharmacists must redirect patient to other substitute sources.
The pharmacists are motivated to cooperate with other health- care providers in order to provide better healthcare service to the patients. At present, the pharmacist in most of the developed nations maintains this ethical code of conduct in order to avoid any kind of risk regarding patient’s health (Youtie and Bozeman 2014).
In face of ethical issues, it is necessary for the pharmaceutical industry to address these issues through strategic Corporate Social Responsibility (CSR) actions. CSR relates to the commitment provided by the business to improve well- being of the community through proper business practices as well as huge contribution of the corporate resources (Salton and Jones 2015). It is the concept where the companies adopt social as well as environmental concerns in the business operations and also in interaction with its stakeholders. Now-a- days the pharmaceutical company integrate CSR programs that mainly focus on health and well- being of people. These pharmaceutical companies also give fund, equipment and medicines to the non- profit enterprise that mainly work towards enhancing health of under- served communities (Filatotchev and Stahl 2015). The CSR policy that the companies in the pharmaceutical sector across the globe pursues are given below-
- Serving the whole community of the respective nations. This means that every company has the key priority to address the needs of the patients and give back to community.
- The Pharmaceutical company concentrate on quality support for meeting the requirements of the society of respective countries (Turcsanyi and Sisaye 2013).
- Leveraging Pharmaceutical companies resources that involves- marketing, human resources, research and other products for maximizing effect on social initiatives.
- The companies under this pharmaceutical sector ensure sustainability by introducing interventions in communities that address vital requirements and become sustainable over the period of time (Salton and Jones 2015).
Overall, the CSR activities of the pharmaceutical companies include- education and livelihood, preventive healthcare, water management, disaster relief and so on.
Examples of CSR policies adopted by the pharmaceutical companies operating in UK
Ethical issues in pharmaceutical industry is primarily based on the rules and regulations followed by the company. The key ethical issues faced by the pharmaceutical industry is the drug pricing issues faced by the company operating in the United Kingdom. The consumers of the Pharmaceutical products in the United Kingdom are significantly affected by the rise in the price of the Pharmaceutical product as they play a significant role in the demand and supply functions of the products and services provided. The rise in the price of the pharmaceutical product has not been in proportionate basis for the industry (Mehralian et al. 2016). The policies followed by the government in the regulation of the pharmaceutical industry is the rules and regulation followed by the govermnet. Companies operating in the pharmaceutical industry needs to act ethically and be transparent in the field of development and invention of new products of the pharmaceutical industry. Patent laws and monopolistic pricing is some of the key ethical issues faced by the pharmaceutical industry (Mehralian et al. 2016). Pharmaceutical companies have to obtain and meet certain regulatory rules and regulations and acquire patent rights for the products innovated and developed by the company. In the United Kingdom the pharmaceutical industry is being regulated by the MHRA body. The Regulatory body MHRA is an key executive agency for the department of health. The MHRA or Medicine and HealthCare products regulatory Agency is the key regulator in the United Kingdom which approves and guides all the rules and the regulations in the United Kingdom (Darrow et al. 2015).
Dispensing of drugs
Pharmaceutical Industry in UK has shown key interest in there idea for supporting the various type of Corporate Social Responsibility as the same helps the company in involvement in various types of activities which are for the wellbeing of the society in general along with the business of the companies (Das 2016). The CSR activities followed by the firms like Novartis Pharmacy Services (UK) Ltd, Integrated Pharmacy Services Ltd, and Novartis Medical are some of the few companies following there CSR activities regularly and in the best interest of the society. The company’s serves the society by developing public infrastructures, donating medicine and providing services in the healthcare industry are some of the common services and features provided by the company in the field of healthcare. The CSR policies followed by the companies helps the company and the society on an overall basis provide a better place to work. It is important for the company to follow policies and action which acts in the best of interest for all the stakeholders of the company from shareholders to society which are directly and indirectly related for the overall growth and prosperity of the company. Reducing Carbon Emissions, Reducing water consumption and providing better and safe workplace for the employees of the company and a sustainable environment for the society is some of the key CSR policies followed by the companies operating in the pharmaceutical industry. The application of CSR policies followed by the company help the government and the society build public capacities like infrastructure development, better public policies and deliver quality products and services to the consumers of the society at large (Aggarwal and Angrish 2017).
Conclusion
From the above discussion, it can be concluded that several ethical issues arise within the pharmaceutical companies. In order to mitigate these ethical issues, most of the pharmaceutical companies across the globe are complying with the ethical code of conduct. Few evidences in UK exemplifies that code of practice owes to secure acceptance as well as integration of high standards of conduct especially in marketing medicines. The CSR policies of the companies operating in the pharmaceutical sector also reflects that they are mainly committed in providing proper and affordable medication to the community especially to the poor people. In addition to this, the CSR policies also helps the companies to avoid risk arising due to patient medication. The requirement of CSR programs in business strategy of pharmaceutical sector helps to bring about new CSR experts in pharmaceutical sector.
Prescribing of POM (Pharmacy only Medicines)
References
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