Abstract
In daily practice, pharmacists are regularly confronted with moral problems in which deciding what to do is not always a straightforward decision. In this contribution we show how the use of a specific method for moral deliberation can (in retrospect or prospective) aid moral judgements. We use the case of dispensing isotretinoin to demonstrate one ethical reflection method, namely the Utrecht Method.
Notes
The Centre for Bioethics and Health Law is currently the Ethics Institute.
For a justification of this standard, see Den Hartogh who argues that a physician is involved in a specific project, and it is contrary to the project to facilitate the birth of a life marred by serious defects. These considerations relate to the quality of life of any future child whomever that may be [14].
References
Cooper RJ, Bissell P, Wingfield J. Ethical decision-making, passivity, and pharmacy. J Med Ethics. 2008;34:441–5.
Charter Professionalism of the Pharmacist. Royal Dutch Pharmacist Association. Dec 2012. http://www.knmp.nl/praktijkvoering/professionaliteit/handvest-van-de-apotheker. Accessed 14 Dec 2014.
Steinkamp N, Gordijn B. Ethical case deliberation on the ward. A comparison of four methods. Med Health Care Philos. 2003;6:235–46.
Rutgers B, Heeger R. The reflective equilibrium method of moral reasoning in teaching animal and veterinary ethics. In: Marie M, Edwards S, et al. editors. Animal bioethics, principles and teaching methods. Wageningen University Press, Wageningen; 2005. pp. 329–42.
Bolt LLE, Verweij MF, van Delden JJM. Ethiek in praktijk. Assen: Van Gorcum; 2010.
European Medicines Agency (EMAE). EMEA/CPMP/2811/03. http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Isotretinoin_29/WC500010881.pdf. Accessed 19 Jan 2015.
Zomerdijk IM, Ruiter R, Houweling LMA, Herings RMC, Sturkenboom MCJM, Straus SMJM, et al. Isotretinoin exposure during pregnancy: a population-based study in The Netherlands. BMJ. 2014. BMJ Open 2014; 4:e005602. doi:10.1136/bmjopen-2014-005602.
Lammer E, Chen D, Hoar R, Agnish N, Benke P, Braun L, et al. Retinoic acid embryopathy. NEJM. 1985;313:837–41.
Schaefer C, Meister R, Weber-Schoendorfer C. Isotretinoin exposure and pregnancy outcome: an observational study of the Berlin Institute for Clinical Teratology and Drug Risk Assessment in Pregnancy. Arch Gynecol Obstet. 2010;281:221–7.
Crijns HJMJ, van Rein N. Gispen-de Wied CC, Straus SM, de Jong-van den Berg LTW. Prescriptive contraceptive use among isotretinoin users in the Netherlands in comparison with non-users: a drug utilisation study. Pharmacoepidemiol Drug Saf. 2012;21:1060–6.
Crijns I, Straus S, Luteijn M, Gispen-de Wied C, Raine J, de Jong-van den Berg L. Implementation of the Harmonized EU Isotretinoin Pregnancy Prevention Programme. A Questionnaire Survey among European Regulatory Agencies. Drug Saf. 2012;35(1):27–32.
Hope T, McMillan J. Physicians’ duties and the non-identity problem. Am J Bioeth. 2012;12(8):21–9.
NVOG (Nederlandse Vereniging voor Obstetrie & Gynaecologie). Modelprotocol Mogelijke morele contra-indicaties bij vruchtbaarheidsbehandelingen. Utrecht. 2010. http://www.nvog.nl/Sites/Files/0000000935_NVOGModelprotocolMogelijkeMoreleContraindicatiesVruchtbaarheidsbehandelingen2010.pdf. Accessed 26 Apr 2015.
den Hartogh G. Het filosofisch gehalte van de medische ethiek. De casus “wrongful life”. In: Braeckman J, de Reuver B, Vervisch T, editors. Ethiek van DA tot 9/11. Amsterdam; 2005. pp. 15–40.
Schermer M. Health, happiness and human enhancement—dealing with unexpected effects of deep brain stimulation. Neuroethics. 2013;6:435–45.
Hoven M van den, Kole J. Distance, dialogue and reflection: interpersonal reflective equilibrium as method for professional ethics education. J Moral Educ. 2015;44:145–64.
Acknowledgments
We thank the anonymous reviewers for their constructive comments.
Funding
None.
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bolt, I., van den Hoven, M., Blom, L. et al. To dispense or not to dispense? Ethical case decision-making in pharmacy practice. Int J Clin Pharm 37, 978–981 (2015). https://doi.org/10.1007/s11096-015-0170-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11096-015-0170-8