School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
Faculty of Pharmacy, Applied Science Private University, Amman, 11931, Jordan.
Int J Clin Pharm. 2020 Apr;42(2):418-435. doi: 10.1007/s11096-020-01021-4. Epub 2020 Apr 10.
Background Healthcare ethics have been profoundly influenced by principles of bioethics that emerged post-World War II in the Declaration of Geneva 1948. 'Beneficence' (to do good), 'Non-Maleficence' (to do no harm), 'Justice' (fairness and justice in access) and 'Respect for Autonomy' (respect for patient individuality, including decision making, privacy, and right to refuse), have become foundational principles of contemporary medical codes of ethics. These principles are well reflected in most professional pharmacy code of ethics globally. This domain remains relatively unexplored in most developing countries and the majority of what has been published in this area relates to western cultures. There have been no attempts to pool findings from a similar scope of research emanating in developing countries. Aim of the review This study aims to explore the scope of pharmacy ethics in the literature pertaining to developing countries. Methods An extensive search of three relevant (Scopus, CINAHL, IPA) databases was conducted from Jan 2000 to Feb 2020, in order to identify relevant studies conducted in or focussed on ethics in pharmacy in developing countries. A separate Google Scholar search was carried out in an effort to locate supplementary articles, hand-searched articles were also included to achieve an exhaustive investigation of all current relevant studies. Results The full text of 20 relevant articles that met inclusion criteria were critically analysed and qualitatively categorised into three emerging themes; Ethical challenges in pharmacy practice, Approaches used in teaching pharmacy ethics, and Code of ethics analysis and implementation. Conclusions: Findings of this literature review illuminated a gap in pharmacy ethics literacy in developing countries and variances in pharmacists' ethical attitudes in handling ethical dilemmas, as well as a lack of familiarity with ethical principles and codes of ethics. Pharmacists' lack of respect for patients' autonomy and pharmacists being prone to financial pressure were found to have a significant impact on pharmacy practice in most of developing countries. However, attempts are being made to rectify this gap by efforts to incorporate ethical and professional education in undergraduate curricula, and by studies in which new codes of ethics are being implemented.
自 1948 年《日内瓦宣言》发布以来，生物伦理学的原则对医疗保健伦理产生了深远的影响。“善行”（做好事）、“不伤害”（不造成伤害）、“公正”（公平和公正地获得）和“尊重自主权”（尊重患者的个性，包括决策、隐私和拒绝的权利）已成为当代医学伦理规范的基本原则。这些原则在全球大多数专业药房道德规范中都有很好的体现。在大多数发展中国家，这个领域相对没有得到探索，而且这一领域发表的大多数内容都与西方文化有关。没有尝试从发展中国家类似的研究范围内汇集发现。
本研究旨在探讨发展中国家文献中与药房伦理相关的范围。
从 2000 年 1 月至 2020 年 2 月，对三个相关数据库（Scopus、CINAHL、IPA）进行了广泛搜索，以确定在发展中国家进行或专注于药房伦理的相关研究。还进行了单独的 Google Scholar 搜索，以寻找补充文章，并进行手工搜索，以彻底调查所有当前相关研究。
20 篇符合纳入标准的相关文章的全文进行了批判性分析，并分为三个新兴主题进行定性分类；药房实践中的伦理挑战、药房伦理教学中使用的方法以及道德规范分析和实施。
本文献综述的结果表明，发展中国家的药房伦理素养存在差距，药剂师在处理伦理困境时的道德态度存在差异，并且对伦理原则和道德规范不熟悉。发现药剂师对患者自主权的不尊重以及药剂师容易受到财务压力的影响，对大多数发展中国家的药房实践产生了重大影响。然而，正在通过努力将道德和专业教育纳入本科课程以及研究实施新道德规范来努力纠正这一差距。
