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Code of Ethics for Pharmacists     Sept 2011




                                 PSA Your voice.
Code of Ethics for Pharmacists


                            Background                                                 Pharmacists nominated by PSA Branches; PSA
                                                                                       members; and external stakeholders including
                            The Pharmaceutical Society of Australia’s Code of
                            Professional Conduct (from 1998) has been revised          pharmacy, consumer and other health professional
                            to reflect:                                                organisations and government bodies. The revised
                                                                                       code will be known as the PSA Code of Ethics for
                            ››   changes in legislation, changes to the health care
                                                                                       Pharmacists (the ‘PSA Code’).
                                 landscape and evolution of professional pharmacy
                                 practice;                                             Status of this Code
                            ››   the implementation of national registration for       All pharmacists registered with the Pharmacy Board
                                 pharmacists including the overarching Code of         of Australia (PBA) under the National Registration
                                 Conduct for Registered Health Practitioners;
                                                                                       and Accreditation Scheme need to comply with
                            ››   the reviews and subsequent release of PSA’s           a common code of conduct that applies to all
                                 Professional Practice Standards and the pharmacy      registered health practitioners. The Code of Conduct
                                 profession’s National Competency Standards
                                                                                       for Registered Health Practitioners provides guidance
                                 Framework for Pharmacists in Australia 2010; and
                                                                                       on the ethical framework through which effective
                            ››   consistency with contemporary pharmacy practice       health services should be delivered. It contains
                                 in Australia.                                         important standards for practitioner behaviour
                            The review and revision of the previous Code               on: working professionally with all members
                            was conducted through a rigorous, multi-stage              of the health care team and system; sharing
                            process involving: the PSA Board and Branches; a           decision-making and providing good care in a
                            Code Review Working Group and panel of Expert              professional and ethical manner; minimising risk;

2   Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.
ensuring healthy and competent professionals; and                the principles are intended to promote a better
contributing to the development of other health                  understanding of the context and application of
practitioners.                                                   the principles to everyday practice. Although the
                                                                 principles are numbered and associated with a
The PBA has indicated that the PSA Code would
                                                                 specific area of focus, they are of equal importance.
be implemented as the pharmacy profession-
specific code in addition to the overarching code                Following the Summary of Principles, the main
for registered health practitioners. The PSA Code                section of the document further articulates each
will, most likely, form an appendix to the health                of the principles. A set of more detailed statements
practitioners’ code. The PBA, in its role of public              (Obligations) outline the standards of professional
protection, may use or refer to the PSA Code in cases            behaviour expected of a pharmacist.
involving the conduct or behaviour of pharmacists.
                                                                 Where warranted, the PSA Code will also be
Purpose and scope of this Code                                   supported by separate documents providing
                                                                 additional detail and which can be updated as
The PSA Code must be read in conjunction with
                                                                 required. These will be referenced in the Additional
other relevant documents such as: Federal and state/
                                                                 guidance section.
territory legislation; standards, codes and guidelines
issued by the PBA; and guidelines and standards                  Application of this Code
issued by professional organisations. Nothing in the
                                                                 The principles contained in this Code apply to every
PSA Code is to be construed as permitting breach
                                                                 pharmacist irrespective of the role, scope, level or
of any law, or interpreted in any way which would
                                                                 location of practice. Clearly there will be instances
discourage any pharmacist from complying with any
                                                                 where some principles may not be directly relevant
legal obligation.
                                                                 to an individual pharmacist’s usual practice, for
The PSA Code articulates the values of the pharmacy              example, where the area of focus is on business
profession and expected standards of behaviour                   practices. However, it is expected that all pharmacists
of pharmacists to consumers and society. It is                   will embrace the underlying tenet of each principle
designed to guide and support professional practice              and be responsible for propagating the profession’s
of all pharmacists. Note that the PBA’s definition of            core values.
“practice” (adapted below) applies here.
                                                                 Intern pharmacists and pharmacy students will be
   To practise as a pharmacist means undertaking                 exposed to the PSA Code and learn about various
   any role, whether remunerated or not, in which                ‘codes’ of ethics relevant to their chosen profession.
   the individual uses their skills and knowledge as a           It is expected that intern pharmacists and pharmacy
   pharmacist. Practice is not restricted to the provision       students comply with the PSA Code during periods
   of direct clinical care. It also includes working in          of supervised practice (clinical placements).
   a direct nonclinical relationship with consumers;
                                                                 All non-pharmacist personnel engaged in the
   working in management, administration,
                                                                 pharmacy profession are strongly encouraged
   education, research, advisory, regulatory or policy
                                                                 to comply with the principles of the PSA Code.
   development roles; and any other roles that
                                                                 Employers are encouraged to include the PSA Code
   impact on safe, effective delivery of services in the
                                                                 as part of the employee induction process and
   profession and/or use their professional skills.
                                                                 regularly promote aspects of the Code. This will
Structure and content of this Code                               enhance rigour and promote confidence in
                                                                 the profession.
The PSA Code consists of nine principles covering
five main areas of focus which are core to                       Additional guidance
pharmacists and pharmacy practice. The principles
                                                                 The PSA will provide additional guidance to
capture philosophical concepts and form the
                                                                 pharmacists on an ongoing basis to cover specific
foundation of the Code.
                                                                 principles, areas of practice or issues as they arise
The Summary of Principles (p. 4) provides an                     or are identified. These may be provided as points
overview of the entire Code, the nine principles                 or referenced (if substantial documents) in the
aligned to areas of focus, and sub-text supporting               Additional guidance section.
each principle. The areas of focus associated with


                                                      Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.   3
Code of Ethics for Pharmacists –
Summary of Principles


                              Area of focus                  Principle and supporting text

                              The consumer                   1.	A pharmacist recognises the health and wellbeing of the consumer as their
                                                                first priority.
                                                             	 A pharmacist will utilise expert knowledge and provide care in a compassionate and
                                                               professional manner.
                                                             2.	A pharmacist pays due respect for the autonomy and rights of consumers and
                                                                encourages consumers to actively participate in decision-making.
                                                             	 A pharmacist will, through informed consent, pay due respect to the dignity and privacy of
                                                               the consumer including: respecting the consumer’s individuality; respecting their right to
                                                               refuse advice or treatment; and ensuring the privacy and confidentiality of the consumer
                                                               and information provided.

                              The                            3.	A pharmacist upholds the reputation and public trust of the profession.
                              community                      	 A pharmacist will not abuse the trust and respect of individuals and society.
                                                             4.	A pharmacist acknowledges the professional roles in and responsibilities to the
                                                                wider community.
                                                             	 A pharmacist will ensure responsible and accountable control and supply of therapeutic
                                                               goods and contribute to public health and enhancing the quality use of medicines.

                              The pharmacy                   5.	A pharmacist demonstrates a commitment to the development and enhancement
                              profession                        of the profession.
                                                             	 A pharmacist will commit to advancing the profession through involvement in activities
                                                               including: training staff; engaging in teaching; acting as a preceptor; mentoring students,
                                                               interns and colleagues; engaging in discussions and participating in initiatives to develop
                                                               the profession; and showing professional leadership.
                                                             6.	A pharmacist maintains a contemporary knowledge of pharmacy practice and
                                                                ensures health and competence to practise.
                                                             	 A pharmacist will recognise the importance of lifelong learning and self-development and
                                                               their impact on professional competence. Further, a pharmacist is responsible for ensuring
                                                               personal health to practise and supporting health professional colleagues in this regard.
                                                             7.	A pharmacist agrees to practise only under conditions which uphold the
                                                                professional independence, judgement and integrity of themselves or others.
                                                             	 A pharmacist will exercise professional autonomy, objectivity and independence and
                                                               manage actual and potential situations of conflict of interest.

                              Business                       8.	A pharmacist conducts the business of pharmacy in an ethical and
                              practices                         professional manner.
                                                             	 A pharmacist will ensure business practices are conducted primarily in the best interest of
                                                               the consumer, paying due respect to colleagues, while upholding the reputation of the
                                                               profession.

                              Other                          9.	A pharmacist works collaboratively with other health professionals to optimise the
                              health care                       health outcomes of consumers.
                              professionals
                                                             	 A pharmacist will consult and work cooperatively with other health care professionals to
                                                               achieve expected or optimal health outcomes for the consumer.




4   Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.
Principles, obligations and
additional guidance


        In this section, each Principle is further articulated              In addition, points to guide the application of
        through Obligation statements which outline the                     the PSA Code to everyday practice are provided.
        standards of professional behaviour expected                        This Additional guidance section will be developed
        of a pharmacist.                                                    further over time as issues arise or are identified.




        Principle 1 – Consumer First Priority
         A pharmacist recognises the health and wellbeing of the consumer as their first priority.

         It is important to reiterate that this principle applies to all pharmacists, even when not involved in providing direct
         care to consumers.

         Obligations                                    Additional guidance

         A pharmacist must:                             ››   When recommending a therapeutic product, any new evidence or
                                                             lack of rigorous information must be carefully balanced with the
         1.1	 Consider their duty of care to the
                                                             consumer’s choice and health status.
              consumer first and foremost.
                                                        ››   Professional judgement must be exercised to prevent the supply of
         1.2	 Utilise expert knowledge and                   products likely to constitute an unacceptable hazard to health or
              provide care in a compassionate                the supply of unnecessary and/or excessive quantities of medicines
              and professional manner.                       or products, particularly those which have a potential for abuse or
         1.3	 Recognise consumers who are                    dependency.
              particularly vulnerable and tailor        ››   It is important to ensure consumers understand both risks and
              the provision of care accordingly.             benefits associated with the chosen options of medication
                                                             management and care. Clear directions and contacts should be
         1.4	 Act to prevent harm to the
                                                             provided for actions to be taken in the event of an adverse event or
              consumer.
                                                             outcome.
         1.5	 Promote good health and                   ››   As the consumer’s health care management may extend over more
              wellbeing.                                     than one health/pharmacy sector/provider, it is important that
                                                             pharmacists consider their liaison role and appropriately facilitate
                                                             continuity of care for the consumer.




                                                                 Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.   5
Principle 2 – Informed Consent
                              A pharmacist pays due respect for the autonomy and rights of consumers and encourages consumers to
                              actively participate in decision‑making.

                              Participation by consumers in health care decisions is a core principle of the Australian Charter of Healthcare Rights.
                              Consumers have the right to be informed about the choices available in health care and to be involved in making
                              decisions based on these choices. Optimal health outcomes will depend on consumers being made aware of
                              available options and expected outcomes (both positive and negative).

                              Obligations                                              Additional guidance

                              A pharmacist must:                                       ››   Informed consent is based on provision of sufficient information
                                                                                            to enable the consumer to make an informed decision about
                              2.1	 Respect the dignity of the
                                                                                            the medication or service. Coercion or lack of transparency
                                   consumer.
                                                                                            are unacceptable.
                              2.2	 Recognise and respect consumer                      ››   Provision of information must be tailored to the consumer’s needs
                                   diversity, culture, beliefs, values and                  and purpose and in non-judgemental language.
                                   characteristics, and not discriminate
                                                                                       ››   The consumer has a right to be offered and to acquire all relevant
                                   on any grounds.
                                                                                            information regarding their medication. However there may be
                              2.3	 Through informed consent,                                exceptions to this consumer right; any legislative requirements and
                                   encourage consumers to                                   professional privilege represent two examples.
                                   participate in shared decision-                     ››   Protecting the consumer’s right to privacy and confidentiality
                                   making and assist by providing                           must occur not only in any interaction with the consumer but
                                   information and advice relevant                          also in all communication between health practitioners regarding
                                   to the consumer’s clinical needs in                      the consumer.
                                   appropriate language and detail.
                                                                                       ››   A pharmacist has a right to decline provision of care based on a
                              2.4	 Respect the consumer’s choice                            conscientious objection. However, this right should not prevent
                                   including the right to refuse                            the consumer from accessing health care that they are entitled to.
                                   treatment, care or advice, or to                         Therefore in these circumstances the pharmacist should inform the
                                   withdraw consent at any time.                            consumer of the objection and appropriately facilitate continuity of
                                                                                            care for the consumer.
                              2.5	 Ensure compliance with the
                                   consumer’s right to privacy.                        ››   Australian Commission on Safety and Quality in Health Care.
                                                                                            Australian Charter of Healthcare Rights.
                              2.6	 Ensure confidentiality of the
                                   consumer’s information.




6   Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.
Principle 3 – Public Trust
 A pharmacist upholds the reputation and public trust of the profession.

 Pharmacists are regarded as role models and are granted certain professional privileges. In return, individual
 members of the community and the whole of society expect professional behaviour which warrants trust and
 respect.

 Obligations                                  Additional guidance

 A pharmacist must:                           ››   Consumers place a high level of trust in pharmacists and expect
                                                   sound and objective advice. Pharmacists should ensure they and
 3.1	 Demonstrate accepted standards
                                                   their staff are not susceptible to inappropriate marketing influence
      of professional and personal
                                                   that may adversely impact on their primary obligation to provide
      behaviour.
                                                   the most appropriate product, care or advice to meet consumer
 3.2	 Respect the trust that individuals           needs.
      and society place in the profession.    ››   Pharmacists should carefully consider how information provided
 3.3	 Provide accurate, truthful, relevant         to consumers has been received and interpreted. Information
      and independent information in a             provided should not exploit a person’s lack of knowledge or
      form that is appropriate for and not         understanding.
      misleading to consumers.



Principle 4 – Quality Use of Medicines
 A pharmacist acknowledges the professional roles in and responsibilities to the wider community.

 Pharmacists commit to responsible and accountable control and supply of therapeutic goods and to contribute to
 public health and enhancing the quality use of medicines in partnership with individuals and the wider community.
 All aspects of pharmacy practice are underpinned by quality use of medicines principles and evidence-based
 practice.

 Obligations                                  Additional guidance

 A pharmacist must:                           ››   All reasonable care must be taken when disposing of medicinal
                                                   products and chemicals. Medicines awaiting disposal must be
 4.1	 Ensure responsibility and
                                                   securely stored.
      accountability in the control,
      procurement, manufacture,               ››   Timely reporting of suspected adverse events or reactions
      handling and supply of therapeutic           to therapeutic goods is also a professional responsibility and
      goods.                                       expectation.
                                              ››   Pharmacists must be cognisant of the nature and level of
 4.2	 Promote the roles and
                                                   responsibility the community expects of the pharmacy profession.
      responsibilities of pharmacists to
      the community.                          ››   Pharmacists have a responsibility to contribute to the achievement
                                                   of the objectives of Australia’s National Medicines Policy which are:
 4.3	 Consider the use of and access               timely access to the medicines that Australians need, at a cost
      to health resources in a fair and            individuals and the community can afford; medicines meeting
      equitable manner.                            appropriate standards of quality, safety and efficacy; quality use of
                                                   medicines; and maintaining a responsible and viable medicines
                                                   industry.




                                                       Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.   7
Principle 5 – Enhance the Profession
                              A pharmacist demonstrates a commitment to the development and enhancement of the profession.

                              All members of a respected and privileged profession have a role in the development, advancement and evolution
                              of that profession. There are a range of activities and opportunities available to fulfil this responsibility which
                              pharmacists may undertake to different extents at different stages of a professional career.

                              Obligations                                              Additional guidance

                              A pharmacist must:                                       ››   Examples of activities to be involved in include: professional
                                                                                            development and training of staff; engaging in teaching; acting as a
                              5.1	 Commit to advancing the
                                                                                            preceptor; mentoring students, interns and colleagues; engaging in
                                   profession through involvement in
                                                                                            discussions and participating in initiatives to develop the profession;
                                   appropriate activities.
                                                                                            developing and promoting professional roles and responsibilities
                              5.2	 Encourage and support the                                to consumers, other health professionals and governments; and
                                   ongoing development of staff and                         showing professional leadership.
                                   colleagues.                                         ››   A preceptor pharmacist must act as a role model and actively
                                                                                            engage in teaching and mentoring intern pharmacists and
                                                                                            pharmacy students, not leaving these responsibilities solely to other
                                                                                            staff members.
                                                                                       ››   A preceptor pharmacist must not compromise or manipulate time,
                                                                                            effort or vulnerability of intern pharmacists.
                                                                                       ››   A preceptor pharmacist must demonstrate fairness in the
                                                                                            interaction between preceptor and intern, and in the allocation of
                                                                                            learning opportunities.



                            Principle 6 – Lifelong Learning
                              A pharmacist maintains a contemporary knowledge of pharmacy practice and ensures health and
                              competence to practise.

                              All pharmacists should understand and accept the concept of lifelong learning and must commit to continuous
                              learning and professional development as a means of advancing their practice and professional role in the
                              community. Pharmacists also have a responsibility to identify impairment and ways to address the issues and seek
                              or provide support.

                              Obligations                                                                              Additional guidance

                              A pharmacist must:                                                                       ››   Pharmacy Board of Australia. Guidelines
                              6.1	 Recognise the importance of lifelong learning and self-                                  on continuing professional development.
                                   development and their impact on professional competence, and                             1 July 2010.
                                   commit to this concept in their current role, responsibility and                    ››   Pharmacy Board of Australia. Guidelines
                                   scope of practice.                                                                       for mandatory notifications. 1 July 2010.
                              6.2	 Recognise the benefits of self-assessment, or appraisal or
                                   review by others, of professional performance and respond
                                   appropriately to the outcomes.
                              6.3	 Be responsible for ensuring personal health to practise and
                                   supporting health professional colleagues in this regard.
                              6.4	 Recognise signs and behaviour in self and colleagues which
                                   may indicate a need for intervention in professional practice and
                                   referral for advice and support.




8   Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.
Principle 7 – Professional Accountability
 A pharmacist agrees to practise only under conditions which uphold the professional independence,
 judgement and integrity of themselves or others.

 A pharmacist is responsible for the professional decisions and contributions he or she makes in professional
 practice. Most practice settings involve working as part of a health care team which involves a pharmacist: working
 alongside professional pharmacist colleagues; supervising and being accountable for interns, students and support
 staff; or reporting to managers. Professional service delivery depends on successful team work derived from respect,
 good communication and cooperation.

 Obligations                                   Additional guidance

 A pharmacist must:                            ››   A pharmacist must not override the professional autonomy of
                                                    pharmacists in his or her employ unless consumer safety may be
 7.1	 Exercise professional autonomy,
                                                    compromised.
      objectivity and independence,
      and manage actual and potential          ››   It is advisable to refuse employment where a pharmacist’s
      situations of conflict of interest.           professional autonomy or judgement is denied or integrity is
                                                    compromised in any way.
 7.2	 Behave in a manner which makes
                                               ››   Pharmacists engaged in research must appropriately consider
      it clear that he or she is responsible
                                                    responsible research practices and research ethics principles
      and accountable for all decisions
                                                    including any declaration or disclosure of interests (eg. grants from
      made and actions taken in
                                                    industry or shareholdings).
      professional practice.
                                               ››   National Health and Medical Research Council, the Australian
 7.3	 Communicate with team members                 Research Council and Universities Australia. Australian code for the
      regarding each person’s sphere of             responsible conduct of research. 2007.
      responsibility and line of reporting.
                                               ››   National Health and Medical Research Council, the Australian
 7.4	 Ensure that the working                       Research Council and Australian Vice-Chancellors’ Committee.
      environment and conditions are                National statement on ethical conduct in human research. Updated
      conducive to the optimal delivery             September 2009.
      of health care services and do not       ››   Pharmacists who employ other health practitioners should sight
      present a risk to the safety and care         and authenticate credentials and be confident the activities and
      of consumers or colleagues.                   services provided complement the role of the pharmacist. The
                                                    pharmacist shall maintain the professional role in the provision
                                                    of quality use of medicines, dispensing of medications and
                                                    counselling.
                                               ››   Pharmacists are responsible for actions of staff under their
                                                    supervision and arrangements must be made to ensure appropriate
                                                    professional indemnity insurance coverage.
                                               ››   It is recognised that sub-optimal working conditions may be
                                                    unavoidable in some emergency situations (eg. following floods,
                                                    fires or cyclones). Pharmacists should make their best efforts to
                                                    safeguard consumers and colleagues under such circumstances.




                                                        Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.   9
Principle 8 – Ethical Business Practices
                               A pharmacist conducts the business of pharmacy in an ethical and professional manner.

                               Pharmacists are part of a diverse profession where contribution to health care service delivery occurs in many ways
                               and through a variety of settings. In many cases, the contribution of professional expertise occurs in a health care
                               setting involving business practices.

                               Obligations                                              Additional guidance

                               A pharmacist must:                                       ››   Examples of ‘pharmacy health care service’ models include (but are
                                                                                             not limited to): operating a hospital pharmacy department; running
                               8.1	 Ensure business practices are
                                                                                             a community pharmacy in a retail environment; or providing
                                    conducted primarily in the best
                                                                                             a consultant pharmacist service through the delivery of Home
                                    interest of the consumer.
                                                                                             Medicines Reviews.
                               8.2	 Consider and recognise when                         ››   The premises or location from which pharmacy health care services
                                    potential conflicts of interest                          are delivered to consumers should reflect the professional character
                                    should be declared.                                      and health-related nature of the profession.
                                                                                        ››   When considering service or product availability from a pharmacy,
                                                                                             the pharmacist will need to carefully balance issues such as
                                                                                             consumer demand and commercial factors with quality, safety
                                                                                             and efficacy.
                                                                                        ››   Vigilance over business practices may be particularly warranted by
                                                                                             pharmacists in community pharmacies due to their existence in the
                                                                                             retail environment where factors such as competitive prices and
                                                                                             volume are key business drivers.
                                                                                        ››   Irrespective of the setting or model through which pharmacists
                                                                                             practise, it is important to reiterate that the consumer’s interests
                                                                                             are always paramount while recognising the duality of interest of a
                                                                                             pharmacist who may conduct a pharmacy business in the provision
                                                                                             of a health care service.
                                                                                        ››   Parameters which guide any competitive marketing of therapeutic
                                                                                             goods or health care services are: having the best interest of the
                                                                                             consumer (Principle 1); upholding the reputation of the profession
                                                                                             (Principle 3); and respecting colleagues (Principles 7 and 9).
                                                                                        ››   A pharmacist must refrain from inappropriate advertising, cognisant
                                                                                             of the fact that pharmacy is a health care profession.
                                                                                        ››   Pharmacy Board of Australia. Guidelines for advertising of regulated
                                                                                             health services. 1 July 2010.
                                                                                        ››   Therapeutic Goods Advertising Code 2007 provides that the marketing
                                                                                             and advertising of therapeutic goods to consumers is conducted
                                                                                             in a manner that promotes the quality use of therapeutic goods, is
                                                                                             socially responsible and does not mislead or deceive the consumer.




10   Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.
Principle 9 – Collaboration
 A pharmacist works collaboratively with other health professionals to optimise the health outcomes
 of consumers.

 The provision of care by means of multidisciplinary teams aims to produce synergies and efficiencies through the
 contribution of respective health professional skills and expertise. Collaborative care implemented through good
 communication and cooperation can deliver enhanced efficiencies and better health outcomes for consumers,
 particularly in the context of an increasing demand for and complexity of health care.

 Obligations                                 Additional guidance

 A pharmacist must:                          ››   A pharmacist must ensure no conflict of interest encroaches on
                                                  the relationship with any other health care provider (eg. sharing of
 9.1	 Exercise professional independence
                                                  financial gain from a referral or sale of a product or medication).
      and judgement and be cognisant
      of own scope of professional           ››   A pharmacist must at all times refrain from expressing defamatory
      practice when providing support             or unprofessional complimentary remarks in public about any
      and advice to other health                  consumers, colleagues or other health care providers.
      professionals.                         ››   Working within your own scope of pharmacy practice and
                                                  recognising the expertise of others should also facilitate appropriate
 9.2	 Respect and understand the
                                                  referral processes thereby enhancing the multidisciplinary approach
      expertise of other health
                                                  to optimising health outcomes for consumers.
      professionals.

 9.3	 Consult and work cooperatively
      with other health professionals to
      achieve expected health outcomes
      for the consumer.

 9.4	 Establish good working
      relationships and promote agreed
      communication paths with other
      health professionals to enable the
      delivery of best possible outcomes.




                        Endorsed by PSA Board September 2011

                         Scheduled for review September 2016

                                                      Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.   11
PSA3307
pharmaceutical Society   Branch Contact Details     New South Wales            South Australia
of Australia Ltd.        P: 1300 369 772            82 Christie Street         Suite 7/102
ABN 49 008 532 072       F: 1300 369 771            St Leonards NSW 2065       Greenhill Road
                                                    PO Box 162                 Unley SA 5061
National Office
                                                    St Leonards NSW 1590       E: sa.branch@psa.org.au
Pharmacy House           Australian
44 Thesiger Court        Capital Territory          E: nsw.branch@psa.org.au
                                                                               Tasmania
Deakin ACT 2600          Pharmacy House                                        161 Campbell Street
                                                    Queensland
PO Box 42                44 Thesiger Court                                     Hobart TAS 7000
                                                    PACE
Deakin West ACT 2600     Deakin ACT 2600                                       E: tas.branch@psa.org.au
                                                    Level 3, West Wing
P: 02 6283 4777          PO Box 42                  20 Cornwall Street
                         Deakin West ACT 2600                                  Victoria
F: 02 6285 2869                                     Dutton Park QLD 4102
                         E: act.branch@psa.org.au                              Level 1, 381 Royal Parade
E: psa.nat@psa.org.au                               PO Box 6120                Parkville VIC 3052
                                                    Buranda QLD 4102           E: vic.branch@psa.org.au
www.psa.org.au                                      E: qld.branch@psa.org.au

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Code of-ethics-2011

  • 1. Code of Ethics for Pharmacists Sept 2011 PSA Your voice.
  • 2. Code of Ethics for Pharmacists Background Pharmacists nominated by PSA Branches; PSA members; and external stakeholders including The Pharmaceutical Society of Australia’s Code of Professional Conduct (from 1998) has been revised pharmacy, consumer and other health professional to reflect: organisations and government bodies. The revised code will be known as the PSA Code of Ethics for ›› changes in legislation, changes to the health care Pharmacists (the ‘PSA Code’). landscape and evolution of professional pharmacy practice; Status of this Code ›› the implementation of national registration for All pharmacists registered with the Pharmacy Board pharmacists including the overarching Code of of Australia (PBA) under the National Registration Conduct for Registered Health Practitioners; and Accreditation Scheme need to comply with ›› the reviews and subsequent release of PSA’s a common code of conduct that applies to all Professional Practice Standards and the pharmacy registered health practitioners. The Code of Conduct profession’s National Competency Standards for Registered Health Practitioners provides guidance Framework for Pharmacists in Australia 2010; and on the ethical framework through which effective ›› consistency with contemporary pharmacy practice health services should be delivered. It contains in Australia. important standards for practitioner behaviour The review and revision of the previous Code on: working professionally with all members was conducted through a rigorous, multi-stage of the health care team and system; sharing process involving: the PSA Board and Branches; a decision-making and providing good care in a Code Review Working Group and panel of Expert professional and ethical manner; minimising risk; 2 Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.
  • 3. ensuring healthy and competent professionals; and the principles are intended to promote a better contributing to the development of other health understanding of the context and application of practitioners. the principles to everyday practice. Although the principles are numbered and associated with a The PBA has indicated that the PSA Code would specific area of focus, they are of equal importance. be implemented as the pharmacy profession- specific code in addition to the overarching code Following the Summary of Principles, the main for registered health practitioners. The PSA Code section of the document further articulates each will, most likely, form an appendix to the health of the principles. A set of more detailed statements practitioners’ code. The PBA, in its role of public (Obligations) outline the standards of professional protection, may use or refer to the PSA Code in cases behaviour expected of a pharmacist. involving the conduct or behaviour of pharmacists. Where warranted, the PSA Code will also be Purpose and scope of this Code supported by separate documents providing additional detail and which can be updated as The PSA Code must be read in conjunction with required. These will be referenced in the Additional other relevant documents such as: Federal and state/ guidance section. territory legislation; standards, codes and guidelines issued by the PBA; and guidelines and standards Application of this Code issued by professional organisations. Nothing in the The principles contained in this Code apply to every PSA Code is to be construed as permitting breach pharmacist irrespective of the role, scope, level or of any law, or interpreted in any way which would location of practice. Clearly there will be instances discourage any pharmacist from complying with any where some principles may not be directly relevant legal obligation. to an individual pharmacist’s usual practice, for The PSA Code articulates the values of the pharmacy example, where the area of focus is on business profession and expected standards of behaviour practices. However, it is expected that all pharmacists of pharmacists to consumers and society. It is will embrace the underlying tenet of each principle designed to guide and support professional practice and be responsible for propagating the profession’s of all pharmacists. Note that the PBA’s definition of core values. “practice” (adapted below) applies here. Intern pharmacists and pharmacy students will be To practise as a pharmacist means undertaking exposed to the PSA Code and learn about various any role, whether remunerated or not, in which ‘codes’ of ethics relevant to their chosen profession. the individual uses their skills and knowledge as a It is expected that intern pharmacists and pharmacy pharmacist. Practice is not restricted to the provision students comply with the PSA Code during periods of direct clinical care. It also includes working in of supervised practice (clinical placements). a direct nonclinical relationship with consumers; All non-pharmacist personnel engaged in the working in management, administration, pharmacy profession are strongly encouraged education, research, advisory, regulatory or policy to comply with the principles of the PSA Code. development roles; and any other roles that Employers are encouraged to include the PSA Code impact on safe, effective delivery of services in the as part of the employee induction process and profession and/or use their professional skills. regularly promote aspects of the Code. This will Structure and content of this Code enhance rigour and promote confidence in the profession. The PSA Code consists of nine principles covering five main areas of focus which are core to Additional guidance pharmacists and pharmacy practice. The principles The PSA will provide additional guidance to capture philosophical concepts and form the pharmacists on an ongoing basis to cover specific foundation of the Code. principles, areas of practice or issues as they arise The Summary of Principles (p. 4) provides an or are identified. These may be provided as points overview of the entire Code, the nine principles or referenced (if substantial documents) in the aligned to areas of focus, and sub-text supporting Additional guidance section. each principle. The areas of focus associated with Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd. 3
  • 4. Code of Ethics for Pharmacists – Summary of Principles Area of focus Principle and supporting text The consumer 1. A pharmacist recognises the health and wellbeing of the consumer as their first priority. A pharmacist will utilise expert knowledge and provide care in a compassionate and professional manner. 2. A pharmacist pays due respect for the autonomy and rights of consumers and encourages consumers to actively participate in decision-making. A pharmacist will, through informed consent, pay due respect to the dignity and privacy of the consumer including: respecting the consumer’s individuality; respecting their right to refuse advice or treatment; and ensuring the privacy and confidentiality of the consumer and information provided. The 3. A pharmacist upholds the reputation and public trust of the profession. community A pharmacist will not abuse the trust and respect of individuals and society. 4. A pharmacist acknowledges the professional roles in and responsibilities to the wider community. A pharmacist will ensure responsible and accountable control and supply of therapeutic goods and contribute to public health and enhancing the quality use of medicines. The pharmacy 5. A pharmacist demonstrates a commitment to the development and enhancement profession of the profession. A pharmacist will commit to advancing the profession through involvement in activities including: training staff; engaging in teaching; acting as a preceptor; mentoring students, interns and colleagues; engaging in discussions and participating in initiatives to develop the profession; and showing professional leadership. 6. A pharmacist maintains a contemporary knowledge of pharmacy practice and ensures health and competence to practise. A pharmacist will recognise the importance of lifelong learning and self-development and their impact on professional competence. Further, a pharmacist is responsible for ensuring personal health to practise and supporting health professional colleagues in this regard. 7. A pharmacist agrees to practise only under conditions which uphold the professional independence, judgement and integrity of themselves or others. A pharmacist will exercise professional autonomy, objectivity and independence and manage actual and potential situations of conflict of interest. Business 8. A pharmacist conducts the business of pharmacy in an ethical and practices professional manner. A pharmacist will ensure business practices are conducted primarily in the best interest of the consumer, paying due respect to colleagues, while upholding the reputation of the profession. Other 9. A pharmacist works collaboratively with other health professionals to optimise the health care health outcomes of consumers. professionals A pharmacist will consult and work cooperatively with other health care professionals to achieve expected or optimal health outcomes for the consumer. 4 Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.
  • 5. Principles, obligations and additional guidance In this section, each Principle is further articulated In addition, points to guide the application of through Obligation statements which outline the the PSA Code to everyday practice are provided. standards of professional behaviour expected This Additional guidance section will be developed of a pharmacist. further over time as issues arise or are identified. Principle 1 – Consumer First Priority A pharmacist recognises the health and wellbeing of the consumer as their first priority. It is important to reiterate that this principle applies to all pharmacists, even when not involved in providing direct care to consumers. Obligations Additional guidance A pharmacist must: ›› When recommending a therapeutic product, any new evidence or lack of rigorous information must be carefully balanced with the 1.1 Consider their duty of care to the consumer’s choice and health status. consumer first and foremost. ›› Professional judgement must be exercised to prevent the supply of 1.2 Utilise expert knowledge and products likely to constitute an unacceptable hazard to health or provide care in a compassionate the supply of unnecessary and/or excessive quantities of medicines and professional manner. or products, particularly those which have a potential for abuse or 1.3 Recognise consumers who are dependency. particularly vulnerable and tailor ›› It is important to ensure consumers understand both risks and the provision of care accordingly. benefits associated with the chosen options of medication management and care. Clear directions and contacts should be 1.4 Act to prevent harm to the provided for actions to be taken in the event of an adverse event or consumer. outcome. 1.5 Promote good health and ›› As the consumer’s health care management may extend over more wellbeing. than one health/pharmacy sector/provider, it is important that pharmacists consider their liaison role and appropriately facilitate continuity of care for the consumer. Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd. 5
  • 6. Principle 2 – Informed Consent A pharmacist pays due respect for the autonomy and rights of consumers and encourages consumers to actively participate in decision‑making. Participation by consumers in health care decisions is a core principle of the Australian Charter of Healthcare Rights. Consumers have the right to be informed about the choices available in health care and to be involved in making decisions based on these choices. Optimal health outcomes will depend on consumers being made aware of available options and expected outcomes (both positive and negative). Obligations Additional guidance A pharmacist must: ›› Informed consent is based on provision of sufficient information to enable the consumer to make an informed decision about 2.1 Respect the dignity of the the medication or service. Coercion or lack of transparency consumer. are unacceptable. 2.2 Recognise and respect consumer ›› Provision of information must be tailored to the consumer’s needs diversity, culture, beliefs, values and and purpose and in non-judgemental language. characteristics, and not discriminate ›› The consumer has a right to be offered and to acquire all relevant on any grounds. information regarding their medication. However there may be 2.3 Through informed consent, exceptions to this consumer right; any legislative requirements and encourage consumers to professional privilege represent two examples. participate in shared decision- ›› Protecting the consumer’s right to privacy and confidentiality making and assist by providing must occur not only in any interaction with the consumer but information and advice relevant also in all communication between health practitioners regarding to the consumer’s clinical needs in the consumer. appropriate language and detail. ›› A pharmacist has a right to decline provision of care based on a 2.4 Respect the consumer’s choice conscientious objection. However, this right should not prevent including the right to refuse the consumer from accessing health care that they are entitled to. treatment, care or advice, or to Therefore in these circumstances the pharmacist should inform the withdraw consent at any time. consumer of the objection and appropriately facilitate continuity of care for the consumer. 2.5 Ensure compliance with the consumer’s right to privacy. ›› Australian Commission on Safety and Quality in Health Care. Australian Charter of Healthcare Rights. 2.6 Ensure confidentiality of the consumer’s information. 6 Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.
  • 7. Principle 3 – Public Trust A pharmacist upholds the reputation and public trust of the profession. Pharmacists are regarded as role models and are granted certain professional privileges. In return, individual members of the community and the whole of society expect professional behaviour which warrants trust and respect. Obligations Additional guidance A pharmacist must: ›› Consumers place a high level of trust in pharmacists and expect sound and objective advice. Pharmacists should ensure they and 3.1 Demonstrate accepted standards their staff are not susceptible to inappropriate marketing influence of professional and personal that may adversely impact on their primary obligation to provide behaviour. the most appropriate product, care or advice to meet consumer 3.2 Respect the trust that individuals needs. and society place in the profession. ›› Pharmacists should carefully consider how information provided 3.3 Provide accurate, truthful, relevant to consumers has been received and interpreted. Information and independent information in a provided should not exploit a person’s lack of knowledge or form that is appropriate for and not understanding. misleading to consumers. Principle 4 – Quality Use of Medicines A pharmacist acknowledges the professional roles in and responsibilities to the wider community. Pharmacists commit to responsible and accountable control and supply of therapeutic goods and to contribute to public health and enhancing the quality use of medicines in partnership with individuals and the wider community. All aspects of pharmacy practice are underpinned by quality use of medicines principles and evidence-based practice. Obligations Additional guidance A pharmacist must: ›› All reasonable care must be taken when disposing of medicinal products and chemicals. Medicines awaiting disposal must be 4.1 Ensure responsibility and securely stored. accountability in the control, procurement, manufacture, ›› Timely reporting of suspected adverse events or reactions handling and supply of therapeutic to therapeutic goods is also a professional responsibility and goods. expectation. ›› Pharmacists must be cognisant of the nature and level of 4.2 Promote the roles and responsibility the community expects of the pharmacy profession. responsibilities of pharmacists to the community. ›› Pharmacists have a responsibility to contribute to the achievement of the objectives of Australia’s National Medicines Policy which are: 4.3 Consider the use of and access timely access to the medicines that Australians need, at a cost to health resources in a fair and individuals and the community can afford; medicines meeting equitable manner. appropriate standards of quality, safety and efficacy; quality use of medicines; and maintaining a responsible and viable medicines industry. Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd. 7
  • 8. Principle 5 – Enhance the Profession A pharmacist demonstrates a commitment to the development and enhancement of the profession. All members of a respected and privileged profession have a role in the development, advancement and evolution of that profession. There are a range of activities and opportunities available to fulfil this responsibility which pharmacists may undertake to different extents at different stages of a professional career. Obligations Additional guidance A pharmacist must: ›› Examples of activities to be involved in include: professional development and training of staff; engaging in teaching; acting as a 5.1 Commit to advancing the preceptor; mentoring students, interns and colleagues; engaging in profession through involvement in discussions and participating in initiatives to develop the profession; appropriate activities. developing and promoting professional roles and responsibilities 5.2 Encourage and support the to consumers, other health professionals and governments; and ongoing development of staff and showing professional leadership. colleagues. ›› A preceptor pharmacist must act as a role model and actively engage in teaching and mentoring intern pharmacists and pharmacy students, not leaving these responsibilities solely to other staff members. ›› A preceptor pharmacist must not compromise or manipulate time, effort or vulnerability of intern pharmacists. ›› A preceptor pharmacist must demonstrate fairness in the interaction between preceptor and intern, and in the allocation of learning opportunities. Principle 6 – Lifelong Learning A pharmacist maintains a contemporary knowledge of pharmacy practice and ensures health and competence to practise. All pharmacists should understand and accept the concept of lifelong learning and must commit to continuous learning and professional development as a means of advancing their practice and professional role in the community. Pharmacists also have a responsibility to identify impairment and ways to address the issues and seek or provide support. Obligations Additional guidance A pharmacist must: ›› Pharmacy Board of Australia. Guidelines 6.1 Recognise the importance of lifelong learning and self- on continuing professional development. development and their impact on professional competence, and 1 July 2010. commit to this concept in their current role, responsibility and ›› Pharmacy Board of Australia. Guidelines scope of practice. for mandatory notifications. 1 July 2010. 6.2 Recognise the benefits of self-assessment, or appraisal or review by others, of professional performance and respond appropriately to the outcomes. 6.3 Be responsible for ensuring personal health to practise and supporting health professional colleagues in this regard. 6.4 Recognise signs and behaviour in self and colleagues which may indicate a need for intervention in professional practice and referral for advice and support. 8 Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.
  • 9. Principle 7 – Professional Accountability A pharmacist agrees to practise only under conditions which uphold the professional independence, judgement and integrity of themselves or others. A pharmacist is responsible for the professional decisions and contributions he or she makes in professional practice. Most practice settings involve working as part of a health care team which involves a pharmacist: working alongside professional pharmacist colleagues; supervising and being accountable for interns, students and support staff; or reporting to managers. Professional service delivery depends on successful team work derived from respect, good communication and cooperation. Obligations Additional guidance A pharmacist must: ›› A pharmacist must not override the professional autonomy of pharmacists in his or her employ unless consumer safety may be 7.1 Exercise professional autonomy, compromised. objectivity and independence, and manage actual and potential ›› It is advisable to refuse employment where a pharmacist’s situations of conflict of interest. professional autonomy or judgement is denied or integrity is compromised in any way. 7.2 Behave in a manner which makes ›› Pharmacists engaged in research must appropriately consider it clear that he or she is responsible responsible research practices and research ethics principles and accountable for all decisions including any declaration or disclosure of interests (eg. grants from made and actions taken in industry or shareholdings). professional practice. ›› National Health and Medical Research Council, the Australian 7.3 Communicate with team members Research Council and Universities Australia. Australian code for the regarding each person’s sphere of responsible conduct of research. 2007. responsibility and line of reporting. ›› National Health and Medical Research Council, the Australian 7.4 Ensure that the working Research Council and Australian Vice-Chancellors’ Committee. environment and conditions are National statement on ethical conduct in human research. Updated conducive to the optimal delivery September 2009. of health care services and do not ›› Pharmacists who employ other health practitioners should sight present a risk to the safety and care and authenticate credentials and be confident the activities and of consumers or colleagues. services provided complement the role of the pharmacist. The pharmacist shall maintain the professional role in the provision of quality use of medicines, dispensing of medications and counselling. ›› Pharmacists are responsible for actions of staff under their supervision and arrangements must be made to ensure appropriate professional indemnity insurance coverage. ›› It is recognised that sub-optimal working conditions may be unavoidable in some emergency situations (eg. following floods, fires or cyclones). Pharmacists should make their best efforts to safeguard consumers and colleagues under such circumstances. Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd. 9
  • 10. Principle 8 – Ethical Business Practices A pharmacist conducts the business of pharmacy in an ethical and professional manner. Pharmacists are part of a diverse profession where contribution to health care service delivery occurs in many ways and through a variety of settings. In many cases, the contribution of professional expertise occurs in a health care setting involving business practices. Obligations Additional guidance A pharmacist must: ›› Examples of ‘pharmacy health care service’ models include (but are not limited to): operating a hospital pharmacy department; running 8.1 Ensure business practices are a community pharmacy in a retail environment; or providing conducted primarily in the best a consultant pharmacist service through the delivery of Home interest of the consumer. Medicines Reviews. 8.2 Consider and recognise when ›› The premises or location from which pharmacy health care services potential conflicts of interest are delivered to consumers should reflect the professional character should be declared. and health-related nature of the profession. ›› When considering service or product availability from a pharmacy, the pharmacist will need to carefully balance issues such as consumer demand and commercial factors with quality, safety and efficacy. ›› Vigilance over business practices may be particularly warranted by pharmacists in community pharmacies due to their existence in the retail environment where factors such as competitive prices and volume are key business drivers. ›› Irrespective of the setting or model through which pharmacists practise, it is important to reiterate that the consumer’s interests are always paramount while recognising the duality of interest of a pharmacist who may conduct a pharmacy business in the provision of a health care service. ›› Parameters which guide any competitive marketing of therapeutic goods or health care services are: having the best interest of the consumer (Principle 1); upholding the reputation of the profession (Principle 3); and respecting colleagues (Principles 7 and 9). ›› A pharmacist must refrain from inappropriate advertising, cognisant of the fact that pharmacy is a health care profession. ›› Pharmacy Board of Australia. Guidelines for advertising of regulated health services. 1 July 2010. ›› Therapeutic Goods Advertising Code 2007 provides that the marketing and advertising of therapeutic goods to consumers is conducted in a manner that promotes the quality use of therapeutic goods, is socially responsible and does not mislead or deceive the consumer. 10 Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd.
  • 11. Principle 9 – Collaboration A pharmacist works collaboratively with other health professionals to optimise the health outcomes of consumers. The provision of care by means of multidisciplinary teams aims to produce synergies and efficiencies through the contribution of respective health professional skills and expertise. Collaborative care implemented through good communication and cooperation can deliver enhanced efficiencies and better health outcomes for consumers, particularly in the context of an increasing demand for and complexity of health care. Obligations Additional guidance A pharmacist must: ›› A pharmacist must ensure no conflict of interest encroaches on the relationship with any other health care provider (eg. sharing of 9.1 Exercise professional independence financial gain from a referral or sale of a product or medication). and judgement and be cognisant of own scope of professional ›› A pharmacist must at all times refrain from expressing defamatory practice when providing support or unprofessional complimentary remarks in public about any and advice to other health consumers, colleagues or other health care providers. professionals. ›› Working within your own scope of pharmacy practice and recognising the expertise of others should also facilitate appropriate 9.2 Respect and understand the referral processes thereby enhancing the multidisciplinary approach expertise of other health to optimising health outcomes for consumers. professionals. 9.3 Consult and work cooperatively with other health professionals to achieve expected health outcomes for the consumer. 9.4 Establish good working relationships and promote agreed communication paths with other health professionals to enable the delivery of best possible outcomes. Endorsed by PSA Board September 2011 Scheduled for review September 2016 Code of Ethics for Pharmacists 2011 I © Pharmaceutical Society of Australia Ltd. 11
  • 12. PSA3307 pharmaceutical Society Branch Contact Details New South Wales South Australia of Australia Ltd. P: 1300 369 772 82 Christie Street Suite 7/102 ABN 49 008 532 072 F: 1300 369 771 St Leonards NSW 2065 Greenhill Road PO Box 162 Unley SA 5061 National Office St Leonards NSW 1590 E: sa.branch@psa.org.au Pharmacy House Australian 44 Thesiger Court Capital Territory E: nsw.branch@psa.org.au Tasmania Deakin ACT 2600 Pharmacy House 161 Campbell Street Queensland PO Box 42 44 Thesiger Court Hobart TAS 7000 PACE Deakin West ACT 2600 Deakin ACT 2600 E: tas.branch@psa.org.au Level 3, West Wing P: 02 6283 4777 PO Box 42 20 Cornwall Street Deakin West ACT 2600 Victoria F: 02 6285 2869 Dutton Park QLD 4102 E: act.branch@psa.org.au Level 1, 381 Royal Parade E: psa.nat@psa.org.au PO Box 6120 Parkville VIC 3052 Buranda QLD 4102 E: vic.branch@psa.org.au www.psa.org.au E: qld.branch@psa.org.au