Therefore, experts from the Research Center for Medical Ethics and History of Medicine (MEHMRC) and the Research Center for Pharmaceutical Sciences of Tehran University of Medical Sciences (TUMS) wanted to provide the Code of Ethics of the National Pharmaceutical System, which contains various workplaces where pharmacists play their role as health professionals. In order to achieve this goal, a working group of experts in the fields of pharmacy, medicine, medical ethics and law was formed. An extensive search was carried out for codes and policies of developed countries using keywords such as pharmacy, ethics, ethical issues, code of conduct, etc. or their combination. The resulting codes and policies were reviewed and the most useful points were extracted, compiled and compared to local rules and context. The draft was submitted to pharmaceutical experts in various workplaces for review, and feedback was collected and discussed at several meetings to reach consensus. The final Code of Ethics consists of five ethical codes and guidelines that are useful to pharmacists working in a variety of fields, including pharmaceuticals, pharmaceutical manufacturers, pharmaceutical importers, pharmaceutical distributors, and political or regulatory decision-making organizations. The Food and Drug Organization (FDO) of Iran`s Ministry of Health and Medical Education is almost the sole policymaker in the pharmaceutical system. The document focuses on patient interests and patient-centred pharmaceutical care, and pharmacists` responsibilities have been aligned with this. The Code consists of 8 articles born from the principles of bioethics and professionalism in pharmacy; Each contains special notes. These articles included respect for the dignity and autonomy of the patient, charity, non-malevolence, justice, empathy, honesty, cooperation and excellence.
In addition, the good ethical relationship between pharmacists and patients, pharmacists and doctors and other healthcare providers was taken into account. The main topics of the code of conduct provided are covered in the following sections. Which supervisory authority – state, federal or tribal – is responsible for issuing at this IHS location? As a state-run distributor, each IHS service unit is responsible for developing local policies and procedures that comply with federal laws, including U.S. Drug Enforcement Administration (DEA)1 regulations and reports on state prescription drug monitoring programs.6 IHS locations also maintain a pharmacy library that contains applicable federal and state laws that prohibit the practice of pharmacy. 1 Because IHS pharmacies operate at the federal level, IHS pharmacists do not need to be licensed in the state in which they operate. However, IHS pharmacists must comply with their state board regulations to obtain their licenses. A statement from the Attorney General of Arizona addressed this issue as part of a question from the Arizona Nursing Council and is helpful in explaining how state and federal jurisdictions are enforced.7 In the event of a discrepancy between federal and state laws, pharmacists must follow the most restrictive law, whether federal or state. Fortunately, federal, IHS and state regulatory language on corresponding liability is consistent (see Additional Table 1 in the Appendix).
When discussing the responsibilities of physicians and pharmacists, all parties must share 3 basic findings: first, pharmacists have a corresponding responsibility to ensure the medical suitability of drugs dispensed; second, that everyone do their best for the patient within their means; and third, this clinical evaluation will always involve some degree of uncertainty. Assuming that all pharmacists who refused to renew Mr. T`s prescription would act in good faith and exercise independent professional judgment in the best interests of the patient, and that pharmacists` judgments would be supported by a chain of command and the appropriate pharmaceutical organizations, Dr. O`s position would become less tenable: since it would be very likely that pharmacists would act reasonably. as any prudent pharmacist should do in similar circumstances, and meets his ethical and legal standards of due diligence towards Mr. T.34 Pharmacists have the same duty as prescribing physicians to prevent the inappropriate use of dangerous drugs. Loperamide, for example, is an over-the-counter drug that could be misused for euphoric effects. Pharmacists and prescribers face challenges when it comes to providing optimal patient care and protecting communities from addiction. These challenges include cognitive biases, an underdeveloped safety culture, and differing expectations about everyone`s responsibility to ensure safe prescribing. This commentary explores the legal, ethical and practical considerations for pharmacists and prescribers who work together to address the uncertainties associated with prescribing. The imbalance between the knowledge and expertise of pharmacists and their role in health care, as well as the lack of involvement of pharmacists in the provision of specialized health services, make it necessary to revolutionize this profession. [1] A systematic review found that in low- and middle-income countries, the lack of standards influences professional services and that, therefore, the effective contribution of pharmacists to health care should be revolutionized.
[42] However, the same is true for Iranian experts who have experience working with the Iranian FDO and who have participated in part in national policy decisions. The shift from pharmaceutical practice to drug dispensing requires pharmacists to be informed of the ethical challenges faced by other health care providers, as well as the ethical challenges of their profession. Of course, we must not forget that the science of pharmacy and pharmaceutical sciences has been widely innovated in the world, and now no one can say that pharmacists only need to know how to work in pharmacy. Today, many pharmacists work in pharmaceutical companies or even in government organizations or insurance companies, etc., Wingfield et al. consider it desirable to systematize pharmaceutical ethics and integrate it into the broader scheme of general health ethics. [43] Assist pharmacists in providing patient-centred health care services; First, pharmacists must be aware of their responsibility, which is defined as the professionalism of the pharmacist. On the other hand, pharmacists face ethical challenges in their daily work just as much as doctors and need a special ethical framework to be able to make decisions. Therefore, we provided the Code of Ethics for the National Pharmaceutical System to inform pharmacists of their role and responsibilities and to assist them in resolving ethical issues in another area of pharmaceutical practice. However, the researchers pointed out that ethical codes could never replace personal moral responsibilities and that there is a complex correlation between an individual`s moral standards and professional codes of ethics. [21] In addition, there may be barriers to meeting the requirements of the Code of Professional Conduct from organizations, interest groups, etc.
Therefore, ethics education is a fundamental means of implementing applied ethics in professions in conjunction with ethical guidelines. While it is true that the moral thinking of health care students can be complemented by education,[44] another study suggests teaching, measuring, and discussing cases as improvements in moral thinking. [45] Bayrami and Abdollahi believe that an ongoing program to inform students about codes of ethics is mandatory and has a positive impact on their future profession. [46] Of course, the most effective timing for ethics courses for pharmacy students, which can influence the outcome, is discussed. Scharr et al. believe that greater exposure to ethics and education may influence greater awareness of ethical issues,[16] but the right time for ethics education is not known. Bumgarner et al. argue that ethics is taught at an early stage, although Latif suggests the second year as the right time for ethics teaching and exposure to the ethical dilemma.
[44,47] Overall, the creation of the Code of Ethics for the National Pharmaceutical System is the first step in implementing ethics in pharmaceutical practice, and further attempts to teach professionalism and the Code of Ethics as necessary and complementary efforts are strongly recommended. Today, the FDO of Iran`s Ministry of Health regulates whole pharmaceutical products from production to consumption. The ODF should ensure the safety and efficacy of all drugs. Since the implementation of regulations and decisions in a high turnover system makes it vulnerable to various types of violations, the FDO should have a code of conduct that provides an ethical framework on the way to solving several ethical challenges. In 2004, Nikfar et al.[39] monitored the National Drug Policy (NDP) and its standardized indicators and consistency with the decisions of the national IDSC in Iran. In order to save lives and improve health, according to this study, it is important to ensure access to medicines, the efficacy, quality and safety of medicines, and the rational use of medicines that are standardized targets of the NDP and useful for assessing the performance of the pharmaceutical system in a country.