Exploring pharmacy ethics in developing countries: a scoping review

Ethics and Business in Community Pharmacies – A Framework for an Ethical Dialogue

“…Some authors also emphasized that pharmacists perceived these practices as a threat to their professional dignity and, even more, in the pharmacies in which "the culture of the organization was one where the pressure to meet targets was perceived as excessive or as prioritizing profit over meeting patient needs, this was viewed as detrimental to service quality" [10]. On the one hand, we consider that professional associations should facilitate pharmacists' access to special training in the ethical field with reflective exercises and case studies, which, as demonstrated by other authors, could help them better handle current constraints in community pharmacies [2,8,12,19]. On the other hand, pharmacists' employers should develop organizational cultures that support team development to ensure a good working environment and quality of pharmaceutical services [10].…”

“…Consequently, we totally agree with the necessity of developing an ethical framework for training pharmacists for dispensing complementary medicines because, unlike the salespersons in convenience stores and supermarkets, pharmacists in the community pharmacies have "professional responsibilities regarding evidence-based practice and supporting positive health outcomes" [16]. Several authors have underlined the importance of patients' autonomy to be observed by pharmacists, but also the obligation to provide correct information about the effectiveness of complementary medicines they requested, to enable patients to make an informed decision to buy and use these products [8,[16][17][18]24]. We consider that adequate ethical training becomes even more important in the context of maintaining sales targets, which makes patients even more vulnerable if not properly informed.…”

“…In fact, the extent to which pharmaceutical companies will assume their social and environmental responsibilities will also reflect the success of the ethical dialogue between the stakeholders [20]. The agreement of common training programs and the commitment to implement common actions have also been recommended by other authors, who emphasized the necessity of continuous efforts for ethical professional development of pharmacists, namely the creation of a framework of persuasion and resilience in the context of financial pressures, both in developing countries [4,8,9,11,22,24] and in more advanced countries, especially where pharmacists' roles in community pharmacies are expanding [1,5,18,19,26]. In the process of establishing the content of common training, providing them in an experiential context, and assessing their results based on the skills and abilities acquired, collaboration with academic institutions could be useful [1,5,8,16,26], which would constitute a long-term beneficial partnership for everyone involved, as well as for the future of pharmaceutical education.…”

“…Ethical competencies acquired by pharmacists during their education are heavily challenged by the business environment in which they work, even in the community pharmacy, "particularly where there are corporate values and reward systems in operation" [26]. Moreover, sometimes insufficient training for ethical decision-making in practice [1] makes them even more vulnerable to financial pressure, some of them being pushed into "moral distress" [8,11] or suffering a "crisis of professional identity" [9]. Indeed, a very competitive environment, such as that of community pharmacies, may exacerbate the pressure and conflicts between professional pharmaceutical ethics and employers' business interests [9,10,16,18,24,26].…”

Assessment of Community Pharmacy Professionals’ Attitude and Perception Towards Ethical Issues in Amhara Region, Ethiopia: A Cross-Sectional Survey 2020

“…18 Community pharmacy professionals in different countries are experiencing frequent and complex ethical dilemmas which compromise ethical pharmacy practice. 6,8,15,[19][20][21] They often run a commercial matter nearby their work sites which further augment the dilemmas. 22,23 Community pharmacy practice results many ethical conflicts because of the advertisement flora and fauna of pharmacy, 23 arising from conflicting personal, professional, institutional or societal values of the different parties involved.…”