“We are White Coats Whirling Round” – Moral Distress in Swedish Pharmacies
- 249 Downloads
Objective: The extended role of pharmacists has made pharmacy practice more complex and increased the moral responsibility of pharmacy staff. Consequently, ethics has become an important part of their daily work. In health care, ethical dilemmas have been shown to cause distress, usually referred to as “moral distress”. Moral distress among hospital personnel has been well described and discussed in numerous studies. There are very few similar studies in pharmacy settings. This article reports on the results of an investigation concerning whether and in what situations moral distress is present in pharmacy practice.
Method: A questionnaire derived from focus group data, covering ethically troubling situations in pharmacy settings, was distributed to all staff of three pharmacies in Sweden.
Results: The results show that moral distress is experienced in the day-to-day pharmacy practice, and that it is in many ways connected to care providing. For example, prioritizing between customers was reported as very stressful. Younger personnel reported higher moral distress than their older colleagues did. However, there were no differences between pharmacies. A lack of support structures, such as meetings where ethical issues can be discussed, was reported by all the participating pharmacies.
Conclusion: It is reasonable to assume that moral distress is even more present in pharmacy practice than in other health care areas as it is, in general, much more sensitive and exposed to the modern, demanding customer. The meeting with the customer is on a more neutral ground than in, for example, a hospital setting. Allthough there are ethical codes for pharmacists, they are not enough. Moral distress is experienced anyway; general codes and personal coping strategies must be supplemented with support from the management and work organization. There is a need to look more closely at specific factors related to the degree and extension of moral distress, going beyond individual coping strategies.
KeywordsEthical competence Ethical dilemmas Moral distress Pharmacy practice Sweden Work organization
Unable to display preview. Download preview PDF.
- Claesson C. (1989). Apotekaryrke i förändring. En socialfarmaceutisk studie av apotekarnas yrkesutveckling och professionella status (Dissertation). [The change in the pharmaceutical profession. A social pharmaceutical study of the evolution of the pharmaceutical profession and the professional status of the pharmacist.] Uppsala University, Uppsala ISBN 91-506-0732-4Google Scholar
- Mobach, MP. 1999Thought and action. Change to the customer in community pharmacy practice (dissertation)University of GroningenGroningenISBN 90-72591-70-4Google Scholar
- O’Neill, R. 2001Professional judgement and ethical dilemmasTaylor, KMG.Harding, G. eds. Pharmacy practice.Taylor & FrancisLondon & New YorkISBN 0-415-27159-2Google Scholar
- Habermas, J. 1984The Theory of Communicative Action, Vol. IBeacon PressNew YorkISBN 0-7456-0386-6Google Scholar
- Benhabib, S. 1992Situating the Self Gender, community and postmodernism in contemporary EthicsRoutledgeNew YorkISBN 0-415-90546-XGoogle Scholar
- Beauchamp, TL, Childress, JF. 2001Principles of biomedical ethics5Oxford University PressNew YorkISBN 0-19-514331-0Google Scholar
- Bäckman, G. 2002Vårdetisk kompetens Begrepp i teori och praktik. (Dissertation) [Health care ethical competence – concept in theory and practice.]Uppsala UniversityUppsalaGoogle Scholar
- FIP Statement of Professional Standards. Code of ethics for pharmacists. 5 September 1997. http: //www.fip.org/pdf/codeeth.pdf (11 March 2004)Google Scholar
- Etiska riktlinjer för farmacevter 2004 (Ethical guidelines for pharmacists 2004). In: Sveriges Farmacevtförbundet [The Swedish pharmaceutical association]. http://www. farmacevtforbundet.se/default.asp?SelSidID=10056 (11 March 2004)Google Scholar
- Silfverberg G. Praktisk klokhet. Om dialogens och dygdens betydelse för yrkesskicklighet och socialpolitik. [Practical wisdom. The significance of dialogue and virtue in professional skill and social policy.] Stockholm/Stehag: Brutus Östlings Bokförlag Symposion, 1999. ISBN 91-7139-464-8Google Scholar
- Jameton, A. 1984Nursing Practice: The Ethical IssuesPrentice-HallEnglewood Cliffs, NJISBN 0-13-627448-XGoogle Scholar
- Jameton, A. 1992Nursing ethics and the moral situation of the nurseFriedman, E. eds. Choices and conflict.American Hospital AssociationChicago, ILISBN 1-55648-082-2Google Scholar
- Jameton, A. 1993Dilemmas of moral distress: moral responsibility and nursing practiceAWHONNS Clin Issues454251Google Scholar
- Gaither, CA. 1998An investigation of pharmacists’ role stress and the work/nonwork interfaceJ Social Admin Pharm1592103Google Scholar