Case Studies in Pharmacy Ethics

by Veatch, Robert; Haddad, Amy

• ISBN13: 9780195308129
• ISBN10: 0195308123
• Edition: 2nd
• Format: Paperback
• Copyright: 2008-03-26
• Publisher: Oxford University Press

Summary

Georgetown Univ., Washington, DC. Focuses on ethical choices faced by pharmacists. Presents a new model for analyzing cases and ethics of new drug distribution systems, such as hospitals, where formularies limit drug choices on basis of cost and efficacy, and Internet-based pharmacies. Previous edition: c1999. Softcover. DNLM: Ethics, Pharmacy.

Table of Contents

List of Cases	p. xv
Introduction: Four Questions of Ethics	p. 3
What Are the Source, Meaning, and Justification of Ethical Claims?	p. 4
Distinguish Between Evaluative Statements and Statements Presenting Nonevaluative Facts	p. 4
Distinguish Between Moral and Nonmoral Evaluations	p. 5
Determine Who Ought to Decide	p. 7
What Kinds of Acts Are Right?	p. 9
Consequentialism	p. 9
Deontological or "Duty-Based" Ethics	p. 10
Other Issues of Normative Ethics	p. 12
How Do Rules Apply to Specific Situations?	p. 13
What Ought to Be Done in Specific Cases?	p. 15
Notes	p. 17
Ethics and Values in Pharmacy
A Model for Ethical Problem Solving	p. 21
The Five-Step Model	p. 21
Application of the Model	p. 22
Respond to the Sense That Something Is Wrong	p. 23
Gather Information	p. 24
Identify the Ethical Problem/Moral Diagnosis	p. 25
Seek a Resolution	p. 26
Work with Others to Choose a Course of Action	p. 27
Notes	p. 28
Values in Health and Illness	p. 29
Identifying Value Judgments in Pharmacy	p. 30
Separating Ethical and Other Evaluations	p. 35
What Is the Source of Moral Judgments?	p. 41
Grounding Ethics in the Professional Code	p. 42
Grounding Ethics in the Physician's Orders	p. 46
Grounding Ethics in Hospital Policy	p. 49
Grounding Ethics in the Patient's Values	p. 51
Grounding Ethics in Religious or Philosophical Perspectives	p. 52
Notes	p. 54
Ethical Principles in Pharmacy Ethics
Benefiting the Patient and Others: The Duty to Do Good and Avoid Harm	p. 57
Benefiting the Patient	p. 58
Health in Conflict with Other Goods	p. 58
Relating Benefits and Harms	p. 61
Benefits of Rules and Benefits in Specific Cases	p. 63
Benefiting Society and Individuals Who Are Not Patients	p. 65
Benefits to Society	p. 65
Benefits to Specific Nonpatients	p. 68
Benefits to the Profession	p. 69
Benefits to the Pharmacist and the Pharmacist's Family	p. 71
Notes	p. 72
Justice: The Allocation of Health Resources	p. 73
Justice Among Patients	p. 74
Justice Between Patients and Others	p. 77
Justice in Public Policy	p. 79
Justice and Other Ethical Principles	p. 83
Notes	p. 85
Autonomy	p. 86
Determining Whether a Patient Is Autonomous	p. 89
External Constraints on Autonomy	p. 93
Overriding the Choices of Autonomous Persons	p. 95
Notes	p. 100
Veracity: Dealing Honestly with Patients	p. 102
The Condition of Doubt	p. 104
Lying in Order to Benefit	p. 106
Protecting the Patient by Lying	p. 106
Protecting the Welfare of Others	p. 108
Special Cases of Truth Telling	p. 111
Patients Who Don't Want to Be Told	p. 111
Family Members Who Insist That the Patient Not Be Told	p. 113
The Right of Access to Medical Records	p. 114
Notes	p. 116
Fidelity: Promise-Keeping and Confidentiality	p. 118
The Ethics of Promises: Explicit and Implicit	p. 119
The Limits on the Promise of Confidentiality	p. 122
Breaking Confidence to Benefit the Patient	p. 123
Breaking Confidence to Benefit Others	p. 126
Incompetent, Impaired, and Dishonest Colleagues	p. 128
Notes	p. 133
Avoidance of Killing	p. 134
Active Killing Versus Letting One Die	p. 137
Withholding Versus Withdrawing Treatment	p. 142
Direct Versus Indirect Killing	p. 144
Justifiable Omissions	p. 148
Voluntary and Involuntary Killing	p. 150
Killing as Punishment	p. 152
Notes	p. 155
Special Problem Areas
Abortion, Sterilization, and Contraception	p. 159
Abortion	p. 159
Abortion for Medical Problems of the Fetus	p. 161
Abortion Following Sexual Assault	p. 164
Abortion to Save the Life of the Pregnant Woman	p. 167
Abortion and the Mentally Incapacitated Woman	p. 169
Abortion for Socioeconomic Reasons	p. 171
Sterilization	p. 172
Contraception	p. 174
Notes	p. 179
Genetics, Birth, and the Biological Revolution	p. 181
Genetic Counseling	p. 183
Genetic Screening	p. 187
In Vitro Fertilization	p. 189
Surrogate Motherhood	p. 192
Genetic Engineering	p. 194
Notes	p. 196
Mental Health and Behavior Control	p. 199
The Concept of Mental Health	p. 200
Mental Illness and Autonomous Behavior	p. 203
Mental Illness and Third-Party Interests	p. 207
Other Behavior-Controlling Therapies	p. 209
Notes	p. 213
Formularies and Drug Distribution Systems	p. 215
Formularies	p. 216
Eliminating Unproven Therapies	p. 217
Eliminating Proven but Marginally Beneficial Therapies	p. 220
Eliminating Proven but Cost-Ineffective Therapies	p. 222
Appeals to Override Formularies	p. 224
Physician Behavior with Drug Company Influence	p. 226
Drug Distribution Systems	p. 229
Mail-Order Pharmacies	p. 229
Drugs from Canada	p. 231
Notes	p. 234
Experimentation on Human Subjects	p. 236
Calculating Risks and Benefits	p. 239
Privacy and Confidentiality	p. 242
Equity in Research	p. 245
Conflicts of Interest in Research	p. 248
Informed Consent in Research	p. 250
Notes	p. 253
Consent and the Right to Refuse Treatment	p. 255
The Elements of a Consent	p. 256
The Standards for Consent	p. 259
Comprehension and Voluntariness	p. 263
Notes	p. 272
Death and Dying	p. 274
The Definition of Death	p. 275
Competent and Formerly Competent Patients	p. 278
Never-Competent Patients	p. 281
Limits Based on Interests of Others	p. 285
Notes	p. 289
Appendix	p. 293
The Hippocratic Oath	p. 293
Code of Ethics for Pharmacists	p. 294
Index	p. 297
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