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PubMed2003

A longitudinal study of United Kingdom pharmacists' misdemeanours--trials, tribulations and trends.

BACKGROUND: Standards of UK pharmacy practice are maintained by the Royal Pharmaceutical Society of Great Britain, which has the power to take a range of sanctions, including removal of the right to practice, against those found guilty of malpractice. This function is currently under review. OBJECTIVE: To conduct a longitudinal study in order to define trends and identify areas where remedial or preventative support could be focused. METHOD: Case analysis of reports of individuals' misdemeanours published in the British Pharmaceutical Journal over a 12-year period (September 1988-October 2000). Professional and personal misdemeanours were considered. MAIN OUTCOME MEASURE: Nature of misdemeanour, conviction or disciplinary proceedings against individual, practising pharmacists in the study period. Reasons offered for committing the misdemeanour and penalties applied. RESULTS: 344 cases, involving a wide range of personal (162) and professional (590) misdemeanours were found. On an annual basis, the maximum incidence of pharmacists found guilty of any misdemeanour was extremely low (< 0.1 of 1% on the pharmaceutical register). The most common professional misdemeanour was failure to keep adequate written records. The most common personal misdemeanour was fraud. The most common reason cited for committing any misdemeanour was financial gain. Numbers in individual offence categories were persistent but low and there were few obvious trends with time. The odds of involvement ratio for male versus female pharmacists was 7.36 (CI: 5.23-10.35) and for ethnic minority versus Caucasian pharmacists was 3.8 (CI: 3.06-4.72). The most stringent penalties (either imprisonment or removal of the right to practice and frequently both) were applied to cases involving personal use or trafficking of drugs subject to abuse. CONCLUSIONS: The current self-regulation of pharmacy practice in the UK involves a wide range of misdemeanours of varying severity; but the incidence of reports of pharmacists found guilty of malpractice was extremely low. The nature of misdemeanours appeared to change little over the period of the study; this study therefore indicates the spectrum of misdemeanours likely to be encountered by a regulating board in the immediate to medium-term future. If regulatory changes such as competence-based practice rights are introduced, the spectrum may change.

Codes of Ethics↗
PubMed2003

[The directions of the activity of the Society of Lithuanian Pharmacists in 1922-1940].

The aim of this work is to examine the directions of the activity of the Society of Lithuanian Pharmacists in 1922-1940. When preparing this work archive documents, the publications of the magazine "Pharmaceutical News" and other periodical press was investigated. In the independent Republic of Lithuania (1918-1940) four professional pharmaceutical organizations were active. The most influential one was the Society of Lithuanian Pharmacists, established on September 18, 1922, where only owners of pharmacies could become its real members. This organization united about 80% of owners of pharmacies in all the country. The main directions of the activity of the Society were the following: active participation in the creation of a legitimate basis of pharmacy, concern for the interests and ethics of its members, publication, participation in an international activity. The Society of Lithuanian Pharmacists belonged to the International Pharmaceutical Federation (IPF), and established the Society of Baltic Pharmacists together with societies of Latvian and Estonian pharmacists in 1938. The Society of Lithuanian Pharmacists paid great attention to the problems of professional ethics and it used to fight with the so called "soiled competition". The Court of Honour was established for this purpose which tried the violations of ethics by the members of the society. The magazine "Pharmaceutical News" was being published in common with the Union of Lithuanian Pharmacists in 1923-1940. It was the main professional pharmaceutical magazine in Lithuania which reflected pharmaceutical problems of that time, was concerned with the ways to solve them and the activity of organizations. The Society of Lithuanian Pharmacists became stronger and stronger gradually, gained bigger and bigger authority and extended the directions of its activity. Moreover, it started to take care of the heritage of pharmaceutical history and charity as well. In particular, the Society of Lithuanian Pharmacists established the museum of an ancient Lithuanian pharmacy, financially supported the Society of Lithuanian Pharmacy Students and other organizations. When Lithuanian was occupied by the Soviet Union, the activity of all societies was ceased, societies of Lithuanian pharmacists stopped functioning on September 13, 1940 as well.

History of Pharmacy↗
PubMed2002

Ethical assessment of industry-sponsored clinical trials: a case analysis.

The rapid growth of clinical trials sponsored by the pharmaceutical industry and conducted by community physicians raises concerns about the scientific quality of this research and the adequacy of protections for research participants. In this article, we present an in-depth ethical analysis of a recent industry-sponsored placebo-controlled study for treatment of asthma. The ethical analysis uses a proposed ethical framework for evaluating clinical research focusing on seven ethical requirements: (1) scientific value, (2) scientific validity, (3) fair subject selection, (4) favorable risk/benefit ratio, (5) independent review, (6) informed consent, and (7) respect for enrolled subjects.

Administration, Inhalation↗
PubMed2004

[A 30-year history of the change in package insert for Japanese pharmaceutical medicines].

Package inserts are very important in the medical field. They are full of useful and fundamental information. We have edited two books, named 'Drugs in Japan - Ethical Drugs' and 'Drugs in Japan - Over-the-Counter Drugs' based on the review of package inserts provided for pharmaceutical medicine for more 30 years. We tried to analyze the change in package insert contents; in particular, information quality and quantity.The quality of the information provided in package inserts has improved year by year, with drastic improvements being seen three times. The information quantity has also increased in proportion to the improvement in quality. We created a graph based on package inserts, Warfarin; Eisai, chronologically. It shows that improvement in information quality is supported by the amount of text in the package insert.

Drug Labeling↗
PubMed1991

Reply to Boyle's "Who is entitled to double effect?

I have only minor quibbles with Boyle's presentation of my version of the Doctrine of Double Effect (DDE) (Boyle, 1991). On my view, the extra morally problematic element in cases of direct intention is the subordination of a victim to purposes that he or she either rightfully rejects or (and this is something that I should now wish to add in light of Boyle's criticisms) cannot rightfully accept. In cases of indirect intention the victim is incidentally affected by an agent's strategy, but in cases of direct intention the victim is made part of the strategy. Boyle suggests at one point that this amounts to using the person.... But I do not think the "using" metaphor is always apt in these cases, although it is perhaps helpful in pointing to the objectionable element in direct intention, which in its perfectly general form can be put only more abstractly.... My only other concern with Boyle's exposition of my view involves his use of the expression "intentionally harming"....The discussion there tends to suggest, in contrast to what Boyle has said earlier, that I represent DDE as discriminating between cases of incidental and intentional harming. But this is precisely what I tried to avoid....

Bioethical Issues↗
PubMed2000

Office dispensing: a responsible approach.

Office dispensing is a value added service in the dermatologist's office. As dermatologists we can recommend products with known scientific validity that will enhance patient care and provide reliable therapeutic results. Patients enjoy the convenience of being able to purchase products in the office and appreciate the dermatologist who spends time outlining a daily skin care regimen. Office dispensing benefits the physician by forcing him or her to keep current on new innovations in skin care and serves as an effective way to develop your cosmetic practice. Antiaging products, moisturizers and sunscreens, cleansers, and acne products are the basics for any in-office dispensing operation. The addition of hair and nail care products constitutes more advanced dispensing. Despite the mutual benefits for both the patient and physician, office dispensing continues to be controversial. The American Medical Association is concerned that selling health-related goods in the office may compromise the patient-physician relationship. The American Academy of Dermatology continues to support the right of dermatologists to dispense products in their office as long as it is in the best interest of the patient, as it is with all other dermatologic care. Dermatologists must preserve the right to dispense by conducting themselves in a highly professional and ethical manner.

Commerce↗
PubMed2004

Health technology assessment and its influence on health-care priority setting.

In this article, we review the development of health technology assessment (HTA) in England and Wales, France, The Netherlands, and Sweden, and we summarize the reaction to these developments from a variety of different disciplinary and stakeholder perspectives (political science, sociology, economics, ethics, public health, general practice, clinical medicine, patients, and the pharmaceutical industry). We conclude that translating HTA into policy is a highly complex business and that, despite the growth of HTA over the past two decades, its influence on policy making, and its perceived relevance for people from a broad range of different perspectives, remains marginal.

Europe↗