Pharmacy Ethics in Pharmacy 5 — Questions and Answers
Question 1: A pharmacist is asked to compound a medication that lacks FDA approval for any indication. The most ethical approach is to:
- Refuse all compounding not specifically FDA-approved
- Compound only when there is a legitimate medical need that cannot be met by a commercially available product (Correct answer)
- Compound it freely since compounding pharmacies are exempt from FDA oversight
- Require the patient to sign a waiver and then compound it
Correct answer: Compound only when there is a legitimate medical need that cannot be met by a commercially available product
Compounding is ethically justified when it addresses a genuine, individualized patient need unmet by commercially available products, per FDAMA guidelines.
Question 2: A pharmacist who is also a part-owner of a specialty pharmacy refers patients to that pharmacy without disclosure. This is an example of:
- Appropriate entrepreneurship
- A conflict of interest that must be disclosed (Correct answer)
- Standard integrated pharmacy practice
- Illegal kickback under all circumstances regardless of disclosure
Correct answer: A conflict of interest that must be disclosed
Financial relationships that could influence clinical recommendations must be disclosed to patients to maintain transparency and trust.
Question 3: When a minor seeks emergency contraception without parental consent, the pharmacist should:
- Refuse without parental consent in all states
- Know the applicable state law, as many states allow minors to consent to emergency contraception independently (Correct answer)
- Always require a prescription from a physician
- Dispense freely since it is an OTC product in all states
Correct answer: Know the applicable state law, as many states allow minors to consent to emergency contraception independently
Minor consent laws vary by state; many permit minors to independently consent to emergency contraception and other reproductive health services.
Question 4: An error occurs in which the wrong drug is dispensed but is caught before patient harm. Ethically, the pharmacist should:
- Quietly correct the error and move on
- Disclose the error to the patient and document it in the pharmacy's error reporting system (Correct answer)
- Blame the technician who filled the prescription
- Only report the error if state law specifically requires it
Correct answer: Disclose the error to the patient and document it in the pharmacy's error reporting system
Ethical practice requires transparency about errors — patients deserve to know, and system reporting promotes safety improvement.
Question 5: A patient with schizophrenia refuses their antipsychotic medication. After confirming they are legally competent, the pharmacist's ethical duty is to:
- Force compliance because the medication is clearly needed
- Respect the refusal, provide counseling on the risks, and communicate with the prescriber (Correct answer)
- Dispense the medication without the patient's knowledge in another form
- Report the patient to psychiatric authorities immediately
Correct answer: Respect the refusal, provide counseling on the risks, and communicate with the prescriber
Competent patients have an absolute right to refuse medication; the pharmacist's role is to educate and communicate, not override the decision.
Question 6: Which of the following represents an ethically appropriate relationship between a pharmacist and a pharmaceutical manufacturer?
- Accepting significant financial payments to recommend a product to patients
- Participating in unbiased continuing education sponsored by a manufacturer with full disclosure (Correct answer)
- Exclusively stocking a manufacturer's products in exchange for personal compensation
- Sharing patient data with a manufacturer to help them target marketing
Correct answer: Participating in unbiased continuing education sponsored by a manufacturer with full disclosure
Pharmacists may participate in industry-sponsored education when it is unbiased, scientifically accurate, and relationships are fully disclosed.
Question 7: A pharmacist working at a chain pharmacy is pressured by management to reduce counseling time to improve throughput. The most ethical response is to:
- Comply fully — employers have authority over work practices
- Maintain professional counseling standards and escalate concerns through appropriate channels (Correct answer)
- Quit immediately
- Counsel patients only when they specifically ask
Correct answer: Maintain professional counseling standards and escalate concerns through appropriate channels
Professional obligations to patient care cannot be overridden by employer productivity pressures; pharmacists must advocate for conditions that allow safe practice.
Pharmacy Ethics in Pharmacy 5
A pharmacist is asked to compound a medication that lacks FDA approval for any indication.
The most ethical approach is to: