Community Pharmacy Case
Case 1
Note - this case and case discussion have been adapted from Case Studies in Pharmacy Ethics (1).
You are a relief pharmacist at an independent pharmacy. A patient walks into the pharmacy and asks for Robitussin Cough and Cold. You can not find the Robitussin Cough and Cold in the OTC section of the pharmacy. While scanning the OTC shelves, you realize there are no products containing dextromethorphan available. You call the pharmacy manager to ask where the dextromethorphan-containing products are. The manager states that dextromethorphan is a potentially harmful medication and should not be available to patients without counselling from the pharmacist. The manager stresses to only give the Robitussin to the patient if he really needs it, to counsel him on the risks, and to sell him just one bottle.
Your task:
Tip: Consider using the Documentation Tool to help you navigate through the case
Note - this case and case discussion have been adapted from Case Studies in Pharmacy Ethics (1).
You are a relief pharmacist at an independent pharmacy. A patient walks into the pharmacy and asks for Robitussin Cough and Cold. You can not find the Robitussin Cough and Cold in the OTC section of the pharmacy. While scanning the OTC shelves, you realize there are no products containing dextromethorphan available. You call the pharmacy manager to ask where the dextromethorphan-containing products are. The manager states that dextromethorphan is a potentially harmful medication and should not be available to patients without counselling from the pharmacist. The manager stresses to only give the Robitussin to the patient if he really needs it, to counsel him on the risks, and to sell him just one bottle.
Your task:
- Consider if this is an ethical dilemma
- If this is an ethical dilemma, what are the key ethical principles involved?
Tip: Consider using the Documentation Tool to help you navigate through the case
Case Discussion
Here we have an ethical dilemma regarding access to over-the-counter medications. Dextromethorphan (DM) was previously a Schedule 1 product, available only by prescription due to the potential for abuse. However, DM has been approved for self-selection by patients in the OTC aisle.
The two main ethical principles involved in this case are those of autonomy and beneficence.
Autonomy:
Beneficence:
Additional questions to consider:
Here we have an ethical dilemma regarding access to over-the-counter medications. Dextromethorphan (DM) was previously a Schedule 1 product, available only by prescription due to the potential for abuse. However, DM has been approved for self-selection by patients in the OTC aisle.
The two main ethical principles involved in this case are those of autonomy and beneficence.
Autonomy:
- Competent and rational patients have the right to freely select and purchase products that are approved for sale in the OTC aisle.
- It may be considered paternalistic to deny patients the right to self-selection of OTC products when it is legally permissible
Beneficence:
- Without adequate counselling, there is the risk for injury and harm to the patient with DM usage
- It may be in the patient's best interest to inhibit access to this medication
- The manager seems to believe he has a duty to protect his patients from potential harm
Additional questions to consider:
- What additional factors would you take into consideration?
- What is the prevalence of DM abuse in the area?
- When two ethical principles are conflicting, how would you decide which one takes precedence?
References
1. Haddad A, Veath RM. Case Studies in Pharmacy Ethics. 2nd ed. New York: Oxford University Press; 2008.
1. Haddad A, Veath RM. Case Studies in Pharmacy Ethics. 2nd ed. New York: Oxford University Press; 2008.