The peak professional body for working pharmacists has come out with a new code of ethics for the profession, but information on how to handle conflicts of interest when the pharmacist is both prescriber and dispenser is still scarce.
The Pharmaceutical Society of Australia – not to be confused with pharmacy owner organisation the Pharmacy Guild of Australia – launched the updated code on Wednesday. It applies to all pharmacists and pharmacy students registered with AHPRA.
It came just as the Pharmacy Board of Australia considered creating an endorsement for pharmacist prescribers and as the guild pushed for scope of practice to expand even further.
“With greater responsibility from the increasing breadth of scope of practice comes greater accountability,” code of ethics co-author Dr Ayomide Ogundipe said.
“Pharmacists must be familiar with these ethical obligations as our role in the health system continues to grow.”
The document did make reference to scope of practice at several points, but perhaps not in the way that doctors may have expected.
For instance, one care-related principle was that a pharmacist “does not place pressure on staff or colleagues to undertake tasks that are unlawful, unethical or beyond their … scope”, while a competency-based principle is that a pharmacist is “accountable for practising safely and providing care within their own scope” and identifying areas where they cannot practice safely.
The section on “conflicts and dualities of interest” was where prescribing, more specifically, was addressed.
“All registered healthcare practitioners practise within systems where professional responsibilities may coexist with personal, financial or commercial dualities of interest,” the code of ethics read.
“This duality of interest is not, of itself, unethical. Dualities of interest are common in practice.”
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But where two interests may be reasonably seen to “compromise” professional judgement, the code of ethics said, this did constitute a conflict of interest.
In a recent submission to the aforementioned Pharmacy Board of Australia consultation, the AMA made it clear that it, at least, considered one person sharing the role of prescriber and dispenser to be a conflict of interest.
It also wrote that it would consider a pharmacist prescriber writing a prescription and having it dispensed by a colleague working in the same premise would have financial incentive to prescribe greater amounts of medicine or more expensive medicine.
For its part, the PSA code of ethics said that conflicts of interest required “judicious consideration and appropriate management”.
“Pharmacists must not make an unjustifiable profit from products or services they prescribe, recommend or supply,” the code read.
“The person or organisation that may be impacted by the practitioner’s conflict of interest needs to be made aware of any conflict.
“Where an actual conflict exists, disclosure alone is often insufficient and active steps to manage the conflict are usually necessary.”
Strategies suggested in the document included seeking oversight from an independent third party, relinquishing the secondary interest and delegating functions to another individual or group.
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