Zilz D A
Respiratory Care Services, University of Wisconsin Hospital and Clinics.
Am J Hosp Pharm. 1990 Aug;47(8):1759-65.
The importance of interdependence in the future of the pharmacy profession is discussed. In politics, economics, business, and health care, the pursuit of individual independence is giving way to the realization that interdependence is necessary for future success. Communication technology and the accelerated growth of new knowledge foster interdependence. When one sector of society creates large and interdependent structures, other sectors with which it interacts must do likewise to retain a balance of power or influence. Interdependence--sharing ideas and information--has helped institutional pharmacists to gain influence in health care; with this influence have come responsibilities and risks. Pharmacists' contribution to clinical research is increasingly respected and needed by the pharmaceutical industry. However, compromised ethical standards are at risk when drug companies reward pharmacists for research or presentations involving their products or for influencing prescribing of these products. Industry is also dependent on pharmacists making purchasing decisions. Biotechnology products in particular set the stage for potential conflict of interest. Pharmacy should formulate guidelines defining standards of conduct; ASHP is encouraged to establish a commission on ethics. Guidelines might require (1) that pharmacy and therapeutics committee members fully disclose any relationship with manufacturers of drugs considered for the formulary and (2) that pharmacists' publications in industry-sponsored literature and presentations at industry-supported educational programs be objective and scientifically sound. Successful organizational leadership will require the ability to identify opportunities for interdependence.
讨论了相互依存关系在药学专业未来发展中的重要性。在政治、经济、商业和医疗保健领域，对个人独立性的追求正在让位于一种认识，即相互依存是未来取得成功的必要条件。通信技术和新知识的加速增长促进了相互依存关系。当社会的一个部门创建庞大且相互依存的结构时，与之互动的其他部门也必须如此，以保持权力或影响力的平衡。相互依存——分享想法和信息——帮助机构药师在医疗保健领域获得影响力；伴随着这种影响力而来的是责任和风险。药师对临床研究的贡献越来越受到制药行业的尊重和需要。然而，当制药公司因药师参与涉及他们产品的研究或报告，或因影响这些产品的处方而给予奖励时，道德标准就有受到损害的风险。行业也依赖药师做出采购决策。特别是生物技术产品为潜在的利益冲突埋下了伏笔。药学专业应制定界定行为标准的指导方针；鼓励美国卫生系统药师协会成立一个伦理委员会。指导方针可能要求：（1）药学与治疗学委员会成员充分披露与列入处方集考虑范围的药品制造商的任何关系；（2）药师在行业资助的文献上发表的文章以及在行业支持的教育项目上的报告应客观且科学合理。成功的组织领导将需要具备识别相互依存机会的能力。
