Ethical and legal issues arising for a community pharmacist, when a GP requests morphine to be urgently supplied to a patient with cancer who is approaching end of life, but where a legal prescription is not available: What can be done to prevent this ethical/legal dilemma arising?

摘要

Morphine is the cornerstone of treatment for distressing cancer pain in palliative and end of life care. Legal restraints governing the supply of this medicine require that a doctor’s prescription is presented to a pharmacist before morphine may be legally dispensed to a patient. Patient symptoms can deteriorate suddenly at end of life. Situations may arise whereby a pharmacist may be called upon by a GP to urgently dispense morphine to such patients before a legal prescription can be provided. While pharmacists have a duty to ensure medicines are supplied lawfully, they are also ethically bound to ensure that the practice of their profession is at all times directed to maintaining and improving the health, wellbeing, care and safety of the patient in accordance with the statutory Code of Conduct for Pharmacists.This dissertation reviews the legal considerations facing community pharmacists in such scenarios. The ethical considerations for pharmacists are discussed using Beauchamp and Childress’ four principles approach. Recommendations are proposed as to how the incidence of this legal/ethical dilemma might be prevented. The dissertation also includes a review of research findings on the practice of pharmacy ethics and makes recommendations as to how this research may be developed.