Wong L S, Scahill S L, Barton E, Lim X Y, Hikaka J, Boey J, Exeter D J, Hudson M, Nu'u A, Ram Sanyogita Sanya
M&HS Building 505 - Bldg 505, 85 Park Rd, Grafton, Auckland 1023, New Zealand.
Explor Res Clin Soc Pharm. 2025 Apr 30;18:100609. doi: 10.1016/j.rcsop.2025.100609. eCollection 2025 Jun.
Conscientious objection (CO) in pharmacy refers to the refusal to provide certain services based on moral or religious beliefs. Person-centred care helps to carve a way forward in balancing the duality of private conscience and public role expectations of the pharmacist. While individual conscience is a factor, pharmacists must also adhere to professional, legal, and regulatory standards. This interplay highlights the need for clear, context-sensitive guidance for both pharmacists and patients to ensure equitable access to services.
This review aimed to explore and understand the similarities, differences, and limits across international pharmacist codes of ethics in relation to CO clauses.
The document search focused on a list of OECD member countries. The International Federation of Pharmacists (FIP) website assisted with the identification of relevant regulatory pharmacist organisations (POs) within OECD countries. Information on Codes of Ethics and CO clauses published in English were gathered from POs' websites using specific keywords. Document analysis was employed to qualitatively examine individual Codes of Ethics.
A survey of OECD countries ( = 38) identified 96 relevant documents pertaining to pharmacist Codes of Ethics or legislation on CO. Of these, 24 Codes of Ethics in English were identified, 12 of which explicitly mentioned CO. Among these, nine explicitly permitted CO, while six inferred it through moral, religious, or personal grounds. Most ( = 11) emphasized the importance of maintaining continuity of care to ensure patient access to services.
There are similarities and differences in Codes of Ethics governing pharmacists' CO worldwide, suggesting variability in practice norms. Consistent guidance across jurisdictions is needed to safeguard patients' rights to access treatment. Future studies on how pharmacists apply ethical codes in CO scenarios could provide valuable insights for updating professional regulatory standards.
药学领域的良心拒付（CO）是指基于道德或宗教信仰拒绝提供某些服务。以患者为中心的护理有助于在平衡药剂师个人良心与公众角色期望的二元性方面开辟一条前进的道路。虽然个人良心是一个因素，但药剂师也必须遵守专业、法律和监管标准。这种相互作用凸显了为药剂师和患者提供明确的、因地制宜的指导的必要性，以确保公平获得服务。
本综述旨在探讨和理解国际药剂师道德准则中与良心拒付条款相关的异同及局限性。
文献检索聚焦于经合组织成员国列表。国际药剂师联合会（FIP）网站协助识别经合组织国家内相关的药剂师监管组织（POs）。使用特定关键词从POs网站收集以英文发布的道德准则和良心拒付条款的信息。采用文献分析对各道德准则进行定性研究。
对38个经合组织国家的调查确定了96份与药剂师道德准则或良心拒付立法相关的文件。其中，识别出24份英文道德准则，其中12份明确提及良心拒付。其中，9份明确允许良心拒付，6份通过道德、宗教或个人理由推断允许。大多数（11份）强调维持护理连续性以确保患者获得服务的重要性。
全球范围内管理药剂师良心拒付的道德准则存在异同，表明实践规范存在差异。需要跨司法管辖区的一致指导以保障患者获得治疗的权利。未来关于药剂师在良心拒付情形中如何应用道德准则的研究可为更新专业监管标准提供有价值的见解。
