E thic a l Issue s in Pha rma c y Pra c tic e Mic ha e l Ma nola - - PowerPoint PPT Presentation

E thic a l Issue s in Pha rma c y Pra c tic e

Mic ha e l Ma nola kis, Pha rmD, PhD

2015 CPF I ANNUAL ME E T ING F L AT ROCK, NC

 I

ha ve no c o nflic ts o f inte re st to disc lo se .

Ob je c tive s

 De sc rib e a stra te g y fo r ma king a n e thic a lly-

b a se d de c isio n.

 Diffe re ntia te wa ys tha t individua ls c a n suffe r  Asse s the diffe re nc e b e twe e n the b io me dic a l

g o o d o f a pa tie nt a nd the sub je c tive g o o d o f tha t sa me pa tie nt

I ma g ine , if yo u will…

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I ma g ine , if yo u will…

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I ma g ine , if yo u will…

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Wha t do yo u do ?

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Wha t sho uld yo u do ?

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Wha t sho uld yo u do ?

Yo u c a n g e t it do ne .

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Wha t sho uld yo u do ?

Yo u c a n g e t it do ne . I t is yo ur jo b !

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Wha t sho uld yo u do ?

Yo u c a n g e t it do ne . I t is yo ur jo b ! T he a c tio n is le g a l.

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Wha t sho uld yo u do ?

Yo u c a n g e t it do ne . I t is yo ur jo b ! We a re do ing a g o o d thing b y he lping . T he a c tio n is le g a l. 12

Wha t sho uld yo u do ?

Yo u c a n g e t it do ne . I t is yo ur jo b ! We a re do ing a g o o d thing b y he lping . T he a c tio n is le g a l. Duty to Ca re

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Ge ne ra l Princ iple s o f Bio me dic a l E thic s

Re spe c t fo r Auto no my Justic e Be ne fic e nc e No n- ma le fic e nc e

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An E thic a l De c isio n Ma king Mo de l

Cla rify the F a c ts Cla rify the Va lue s De te rmine the Optio ns

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Cho o se a n Optio n E thic a lly De fe nsib le Cho ic e Bruc e We inste in, PhD & Alvin Mo ss, MD

But, wha t if so me thing g e ts in the wa y?

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Mo ra l Distre ss

 First defined by Andrew Jameton in 1984  Moral distress: the inability of a moral agent to act

according to his or her core values and perceived

• bligations due to internal and external constraints.*

 Causes, Factors and Effects **

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• Gra dy, C. Mo ra l Distre ss: a g ro wing pro b le m in he a lth pro fe ssio ns.

T he Ha sting s Ce nte r Re po rt. Ja nua ry-F e b rua ry 2010: p 20.

• Ga lla g he r A. Mo ra l Distre ss a nd Mo ra l Co ura g e in E

ve ryda y Nursing Pra c tic e . T he Online Jo urna l o f I ssue s in Nursing . Vo l. 16 No . 2 (Ma rc h 21, 2010)

L

• o king a t E

ve ryda y Nursing *

Ca use s: po o r q ua lity a nd futile c a re , unsuc c e ssful a dvo c a c y, ra ising unre a listic ho pe F a c to rs: sta ff e duc a tio n le ve l, pe e r suppo rt, e duc a tio na l le ve l / e xpe rie nc e E ffe c ts: mixe d with re spe c t to po sitive

• r ne g a tive impa c t o n c a re ,

re duc e d jo b sa tisfa c tio n

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*Ga lla g he r, A. Mo ra l Distre ss a nd Mo ra l Co ura g e in E ve ryda y Nursing Pra c tic e . T he Online Jo urna l o f I ssue s in Nursing . Vo l. 16, No . 2.

E xpe rie nc e d a t le a st o nc e within the pa st 6 mo nths –

10 20 30 40 50 60 70 E thic a lly tro ub ling inte ra c tio n with pro fe ssio na l fro m a no the r disc ipline Any situtio n tha t didn't se e m q uite rig ht fro m e thic a l pe rspe c tive Co nflic t with po lic y tha t pre ve nte d do ing the rig ht thing Dire c tive fro m supe rviso r tha t ra ise d e thic a l c o nc e rn

Pe rc e nta g e of Re sponde nts

Ca n yo u na me this philo so phe r?

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Aristo tle

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F

• o lha rdine ss

Co wa rdic e

Co ura g e

“T he ma n who shuns a nd fe a rs e ve rything a nd ne ve r sta nds his g ro und b e c o me s a c o wa rd, whe re a s a ma n who kno ws no fe a r a t a ll a nd g o e s to me e t e ve ry da ng e r b e c o me s re c kle ss.”

• Aristo tle , Nic o mac he an E

thic s, I

I

• 2. 1104a 20-23

One De finitio n o f Mo ra l Co ura g e *

Pre se nc e a nd re c o g nitio n

• f a mo ra l

situa tio n Mo ra l c ho ic e Be ha vio r I ndividua lity F e a r

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Mille r, R. Mo ra l Co ura g e : De finitio n a nd De ve lo pme nt. E thic s Re so urc e Ce nte r Ma rc h 2005. http:/ / e thic s.o rg / file s/ u5/ Mo ra l_Co ura g e _De finitio n_a nd_ De ve lo pme nt.pdf. Ac c e sse d 5/ 28/ 15.

Attrib ute s o f the mo ra lly c o ura g e o us le a de r

Gre a te r c o nfide nc e in princ iple s tha n in pe rso na lity Hig he r to le ra nc e fo r a mb ig uity, e xpo sure a nd pe rso na l lo ss Ac c e pta nc e o f de fe rre d g ra tific a tio n & simple re wa rds I nde pe nde nc e

• f tho ug ht

F

• rmida b le

pe rsiste nc e a nd de te rmina tio n

T he c a se o f Judy

Our E thic a l De c isio n Ma king Mo de l: Wha t a re the fa c ts a nd va lue s a t pla y?

Cla rify the F a c ts Cla rify the Va lue s

De te rmine the Optio ns

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Cho o se a n Optio n E thic a lly De fe nsib le Cho ic e

Suffe ring

Pa tho physio lo g y- b a se d

• Ac ute c a re
• Chro nic c a re
• L
• ng te rm c a re

Suffe ring

Pa tho physio lo g y- b a se d Spiritua l-b a se d

• Ac ute c a re
• Chro nic c a re
• L
• ng te rm c a re
• Our b ro ke n, fra c ture d

se lf

• Our b ro ke n sta te in a

spiritua l se nse

Suffe ring

Pa tho physio lo g y- b a se d Spiritua l-b a se d

• Ac ute c a re
• Chro nic c a re
• L
• ng te rm c a re
• Our b ro ke n, fra c ture d

se lf

• Our b ro ke n sta te in a

spiritua l se nse

“…we suffe r with him in o rde r tha t we ma y a lso b e g lo rifie d with him.” Ro ma ns 8:17 (E SV)

Ho w sho uld a pha rma c ist a c t?

Po lic y Ma nda te s L e g a l Ma nda te s E thic a l Ma nda te s F a ith Ma nda te s

T he b a la nc e re q uire d b y the Christia n Pha rma c ist.

I nte rna l E xte rna l

So , le t’ s re vise o ur q ue stio n…ho w sho uld a Christia n pha rma c ist a c t?

Po lic y Ma nda te s L e g a l Ma nda te s E thic a l Ma nda te s F a ith Ma nda te s

2 T imo thy 1:7 (E SV)

…fo r Go d g a ve us a spirit no t o f fe a r b ut

• f po we r a nd lo ve a nd se lf-c o ntro l.

I sa ia h 58:10 (E SV)

 …if yo u po ur yo urse lf o ut fo r the hung ry

a nd sa tisfy the de sire o f the a fflic te d, the n sha ll yo ur lig ht rise in the da rkne ss a nd yo ur g lo o m b e a s the no o nda y.

So , we re turn a g a in to the q ue stio n…ho w sho uld a Christia n pha rma c ist a c t?

Po lic y Ma nda te s L e g a l Ma nda te s E thic a l Ma nda te s F a ith Ma nda te s

T ha nk yo u!