Arnold R M, Nissen J C, Campbell N A
School of Medicine, University of Pennsylvania, Philadelphia 19104.
Drug Intell Clin Pharm. 1987 Dec;21(12):1008-11. doi: 10.1177/106002808702101218.
The frequency and nature of ethical issues faced by pharmacists have not been well documented. To address these issues a retrospective study of the potential ethical problems encountered by pharmacists in a drug information center was conducted. Of the 744 calls received over a 13-month period, 50 raised ethical issues. Consumer calls were more likely to raise ethical issues than were health-provider calls. The calls mainly fell into five categories: drug identification, assessment of a physician's recommendations for consumers, conflict between callers' needs and legal or public-health considerations, therapeutic issues in the pharmacist-patient relationship, and paternalistic treatment of "difficult" callers. These questions raised ethical issues related to confidentiality, truth telling, and pharmacists' societal obligations. Pharmacists may confront an increased number of ethical issues as more drug information centers provide consumer services. Although there is no empirical evidence regarding pharmacists' ability to deal with ethical issues, there are reasons to believe that training in medical ethics will better equip pharmacists to recognize, analyze, and resolve ethical dilemmas.
药剂师所面临的伦理问题的频率和性质尚未得到充分记录。为解决这些问题，对一家药物信息中心的药剂师遇到的潜在伦理问题进行了一项回顾性研究。在13个月期间接到的744个电话中，有50个提出了伦理问题。消费者打来的电话比医疗服务提供者打来的电话更有可能提出伦理问题。这些电话主要分为五类：药物识别、对医生给消费者的建议的评估、来电者的需求与法律或公共卫生考虑之间的冲突、药剂师与患者关系中的治疗问题以及对“难缠”来电者的家长式处理。这些问题引发了与保密、讲真话以及药剂师的社会义务相关的伦理问题。随着越来越多的药物信息中心提供消费者服务，药剂师可能会面临越来越多的伦理问题。虽然没有关于药剂师处理伦理问题能力的实证证据，但有理由相信，医学伦理学培训将更好地使药剂师具备识别、分析和解决伦理困境的能力。
