Redman B K
School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA.
Am J Health Syst Pharm. 1995 Oct 1;52(19):2099-104. doi: 10.1093/ajhp/52.19.2099.
The pharmacy profession's responsibility to provide ethical leadership to its members is explained, and areas where pharmacy should take a leadership role are described. Changes taking place in health care offer many opportunities for pharmacy in its transformation into a fully clinical discipline. The profession needs to address the ethical issues that will affect it as part of this revolution. The role pharmacy is taking to eliminate medication misadventuring will be a test case for the profession's ability to exert the leadership it must, as part of its new definition of itself. Pharmacy needs to define the structure, process, and outcomes necessary to improve its own practice to avoid drug misadventuring, with a clear set of practice and ethical standards, and engage medicine and nursing to adopt similar standards. Pharmacy should also take a leadership role in health care reform, working with other clinicians to ensure that the changes provide better outcomes for patients. Health care professionals are bound together by a common moral purpose: to act in the patient's best interest. Thus, each health profession is a moral community, which must determine and promote ethical behavior among its members. Pharmacy must practice ethical leadership: it must define and prove its contribution to patient outcomes, further develop legal and ethical standards, and examine its responsibilities for vulnerable patient groups such as children. It must work to overcome the traditional dominance of medicine; pharmacy, nursing, and medicine must come together in service of the patient and develop a cross-professional conception of ethics. Pharmacy also must participate in the broader debate about health care. Pharmacy has begun to take a leadership role among the health professions through its efforts to eliminate medication misadventuring. Additional leadership challenges for the profession are suggested.
文中解释了药学专业对其成员提供道德引领的责任，并描述了药学应发挥领导作用的领域。医疗保健领域正在发生的变革为药学向完全临床学科的转型提供了诸多机遇。作为这场变革的一部分，该专业需要应对将影响自身的伦理问题。药学在消除用药差错方面所发挥的作用，将成为对该专业发挥其必须具备的领导力能力的一个测试案例，这也是其对自身新定义的一部分。药学需要明确为改进自身实践以避免用药差错所需的结构、流程和结果，制定一套清晰的实践和道德标准，并促使医学和护理专业采用类似标准。药学还应在医疗保健改革中发挥领导作用，与其他临床医生合作，确保变革能为患者带来更好的结果。医疗保健专业人员因一个共同的道德目标而紧密相连：即从患者的最大利益出发行事。因此，每个医疗专业都是一个道德共同体，必须确定并促进其成员的道德行为。药学必须践行道德引领：它必须明确并证明其对患者治疗结果的贡献，进一步制定法律和道德标准，并审视其对儿童等弱势患者群体的责任。它必须努力克服医学的传统主导地位；药学、护理和医学必须携手为患者服务，并形成一种跨专业的伦理观念。药学还必须参与关于医疗保健的更广泛辩论。药学已通过努力消除用药差错，在医疗专业中开始发挥领导作用。文中还提出了该专业面临的其他领导挑战。
