Adoption of a pharmacist concience clause by professional associations and boards of pharmacy in the United States

OBJECTIVE: To determine the number of professional associations and boards of pharmacy in the United States that have adopted or are considering to adopt a conscience clause as part of their codes of ethics, rules, laws or regulations. BACKGROUND: Pharmacists are often exposed to ethical dilemmas in their day-to-day practice and their response depends on a number of factors, including the personal beliefs and values of those involved. This has lead some professional associations to address whether their members have the right to refuse to participate in procedures which are contrary to their conscience or moral convictions. The outcome of these discussions is usually the development and adoption of a conscience clause. METHODS: A one-page self-administered questionnaire was sent by Fax to the highest ranking officer of 108 pharmacy organizations in the United States. RESULTS: Thirty-five completed questionnaires were received for a 32.4 percent response rate. In general, it was found that there is a lack of knowledge as to what a conscience clause is. Only two state associations and one board of pharmacy responded that they have a conscience clause as part of their code of ethics or regulations. Reasons given for not having a conscience clause included lack of interest and low priority. Nevertheless, four state associations, one national association and one board of pharmacy responded that they are considering developing a pharmacist conscience clause. More professional associations than boards of pharmacy expressed interest to obtain information about conscience clauses. CONCLUSION: Although many state associations and boards of pharmacy that responded do not have a conscience clause as part of their codes of ethics, laws or regulations, this survey shows an increasing interest to learn about it. This is expected as the pharmacist assumes increasing responsibility in patient care.

Bioethics committees: a health communication approach

The modern health care system is being transformed as a consequence of scarce resources and better informed consumers. In this transformed health care system human communication has become a crucially important process. This essay examines the health communication functions performed by bioethics committees in health care delivery and makes recommendations for promoting the effective use of these groups within the modern health care system. The essay describes how bioethics committee can help establish a climate in which physicians and other committee members can share relevant health information, learn about patient and family concerns, promote health education and informed consent, and facilitate effective decision making about complex health care practice issues. It is argued that clear recognition and attention to the central role of effective communication within the bioethics committee is essential for the survival of the modern health care system since ethics committees depend on sharing relevant information to diagnose health problems, provide health care, promote health education, help in the formulation of new health care policies, and provide much-needed decision-making support to health care providers and consumers. The role that health communication expertise can perform in the effective operation and utilization of bioethics committees is described. We conclude that in order to provide needed support in addressing the many complexities of modern health care, bioethics committees must develop clear communication processes, norms, and roles