# Code of Pharmaceutical Ethics

## Introduction

Code of Pharmaceutical Ethics is the meaning of ethics are moral principles. It is also a science of moral duty. The code of ethics is a carefully formulated system of principles or rules of practice for the guidance of a particular group of individuals like the members of a profession. The development of this code of ethics is the indication of the evolution and the growth of moral consciousness. Ethics are different from laws. Law is defined as ‘Rules of human conduct binding on all persons in a state or nation’. Ethics is defined as ‘Rules by which a profession regulates actions and sets standards for all its members. The major difference involving both of them is in the method of enforcing compliance with the rules. When a law is broken, the violator may be subjected to punishment, a fine or imprisonment, or both, or the violator may be subjected to considerable monetary penalties in civic action. But when rules are broken, the professional body may subject the violator to loss of professional privileges. Law may prevent one from causing injury to another, but it cannot force him to help his neighbor in the hours of need. Helping the neighbor is the function of ethics.

## Pharmaceutical Code of Ethics

The profession of pharmacy is noble in its ideals and pious in its character. In handling, selling, distribution, compounding, and dispensing medical substances, including poisons and potent drugs, a pharmacist, in collaboration with medical men and others, is charged with the onerous responsibility of safeguarding the health of people. It is the duty of all those involved in the pharmacy field to be sure that the pharmacist in training knows the standards of professional conduct and understands that, deviation from those standards cannot maintain the status of the pharmacy profession.

The Government restricts the practice of pharmacy to those, who qualify under regulatory requirements and grants them privileges necessarily denied to others. In return, the Government expects the pharmacists to recognize their responsibilities and fulfill their professional obligations honorably and with due regard for the well-being of the society. Every pharmacist should, not only be willing to play his part in giving service but should also avoid any act or omission which would prejudice the giving of the services or impart confidence for the pharmacist as a body. A pharmacist must, above all, be a good citizen and must uphold and defend the laws of the state and the nation.

### Ethics of Pharmacist in Relation to his Job:

Scope of Pharmaceutical Services:

• When the premises are registered under statutory requirements and opened as a pharmacy, reasonably comprehensive pharmaceutical services should be provided.
• This involves a willingness to furnish emergency supplies at all times.

Conduct of the Pharmacy:

• The conditions in a pharmacy should be such that it should preclude avoidable risk or error of accidental contamination in the preparation, dispensing, and supply of medicines.
• The appearance of the pharmacy should reflect the professional character of the pharmacy.
• It should be clear to the public that the practice of pharmacy is being carried out in the establishment.
• Signs, notices, descriptions, wordings on business, stationary and related indications, should be restrained in size, design, and terms.
• A notice, stating that dispensing under E.S.I.S (Employees State Insurance Scheme) or any such other scheme sponsored by the government is carried out, may be exhibited at the premises.
• In every pharmacy, there should be a pharmacist, in personal control of the pharmacy who will be regarded as primarily responsible for the observance of proper standards of conduct in connection to it.
• Any obstruction of the pharmacist in the execution of his duty by the owner will be regarded as a failure on the part of the owner to observe the standards in question.

Handling of Prescriptions:

• When a prescription is presented for dispensing, it should be received by a pharmacist without any discussion or comment over it, regarding the merits and demerits of its therapeutic efficacy.
• The pharmacist should not even show any physiognomic expression of alarm or astonishment upon the receipt of a prescription; as such things may cause anxiety in patients or their agents and may even shake faith in their physician.
• Any questions that are raised related to the prescription should be answered with every caution and care, it should neither offend a patron nor should it disclose any information which might have been intentionally withheld from him.
• A pharmacist is not given the privilege to add, omit or substitute any ingredient or alter the composition of a prescription, without the consent of the prescriber, unless the change is emergent or is demanded purely by the technique of the pharmaceutical art and does not cause any alteration in the therapeutic action of the recipe.
• In case of any obvious error in it, due to any omission, incompatibility, or overdosage, the prescription should be referred back to the prescriber for correction or approval of the change suggested.
• In matters related to the refilling of prescription, a pharmacist should solely be guided by the instructions of the prescriber and he should advise patients to use medicines or remedies, strictly in accordance with the intention of the physician, as noted on the prescription.

Handling of Drugs:

• All possible care should be taken to dispense a prescription correctly, by weighing and measuring all ingredients, in correct proportions, with the help of scales and measures; visual estimations must be avoided.
• A pharmacist should always use drugs and medicinal preparations of standard quality. He should never fill his prescription with spurious, substandard, and unethical preparations.
• A pharmacist should be judicious in dealing with drugs and medicinal preparations known to be poisonous or to be used for addiction or another abusive purpose.
• Such drugs and preparations should not be supplied to anyone, if there is a reason to suppose that, it is required for such purpose.

Apprentice Pharmacist:

• While in charge of a dispensary, drug store, or hospital pharmacy, where apprentice pharmacists are admitted for practical training, a pharmacist should see that the trainees are given full facilities for their work so that on the completion of their training they acquired sufficient technique and skill to make themselves dependable pharmacists.
• No certificate or credentials should be granted unless the above criterion is attained and the recipient has proved himself worthy of the same.

## Pharmacists in relation to trade

Price Structure:

• Price charged from the customers, should be fair and in keeping with the quality and quantity of commodity supplied, and the labor and the skill that is required in making it ready for use, so as to ensure an adequate remuneration to the pharmacist, taking into consideration his knowledge, skill, time consumed and the great responsibility involved, but at the same time without unduly taxing the purchaser.

• No attempts should be made to capture the business of a contemporary by cut-throat competitions, i.e., by offering any sort of prizes or gifts or any kind of allurement to patronizers or by knowingly charging lower prices for medical commodities than those charged by a fellow pharmacist, if they are reasonable.
• In case, if any order or prescription, genuinely intended to be served by some dispensary, is brought by mistake to another, then the latter must refuse to accept it and must direct the customer to the right place.
• Labels, trademarks, and other signs and symbols of the contemporary should not be imitated or copied.

Purchase of Drugs:

Drugs should always be purchased from genuine and reputable sources and a pharmacist should always be on his guard not to aid or abet, directly or indirectly, the manufacture, possession, distribution, and sale of spurious or substituted drugs.

Hawking of Drugs:

• Hawking of drugs and medicinals should not be encouraged nor should any attempt be made to solicit orders for such substances from door to door.
• ‘Self-service’ method of operating pharmacies and drug-stores should not be used as this practice may lead to the distribution of therapeutic substances without expert supervision and thus would encourage self-medication, which is highly undesirable.

No display material either on the premises, in the press, or elsewhere should be used by a pharmacist in connection with the sale to the public of medicines or medical appliances which is undignified in style or which contains:-

1. Any wording design or illustration reflecting unfavorably on pharmacist collectively or upon any group or individual.
2. A disparaging reference, direct or by implication to other suppliers, products, remedies, or treatments.
3. Misleading, or exaggerated statements or claims.
4. The word “Cure” is in reference to an ailment or symptoms of ill health.
5. A guarantee of therapeutic efficacy.
6. An appeal to fear,
7. An offer to refund the money paid.
8. A prize, competition, or similar scheme.
9. Any reference to a medical practitioner or a hospital or the use of the terms “Doctor” or “Dr.” or “Nurse” in connection with the name of preparation not already established.
10. A reference to sexual weakness, premature aging, or loss of virility.
11. A reference to complaints of sexual nature in terms that lack the reticence proper to the subject.

No article or preparation, advertised to the public by means of display material of the kind mentioned above should be exhibited in a pharmacy if it is known or could reasonably be known that the article or preparation is so advertised.

## Pharmacists in relation to the medical profession

Limitation of Professional Activity:

• Whereas it is expected that medical practitioners, in general, would not take to the practice of pharmacy by owning drug stores, as this ultimately leads to coded prescriptions and monopolistic practices detrimental to the pharmaceutical profession and also to the interest of patients.
• It should be made a general rule that pharmacists under no circumstances take to medical practice that is to diagnosing diseases and prescribing remedies therefore even if requested by patrons to do so.
• In cases of accidents and emergencies, a pharmacist may, however, render First Aid to the victim.
• No pharmacist should recommend a particular medical practitioner unless specifically asked to do so.

Clandestine Arrangements:

• No pharmacist should enter into any secret arrangements or contract with a physician to offer him any commission or any advantage of any description in return for his favor of patronage by recommending his dispensary or drug store or even himself to patients.

Liaison with the Public:

• Being a liaison between the medical profession and people, a pharmacist should always keep himself abreast with the modern developments in pharmacy and other allied sciences by regularly reading books, journals, magazines, and other periodicals, so that on the one hand he may be in a position to advise the physician on pharmaceutical matters like those of colors, flavors, vehicles and newer forms of administration of medicines, on the other hand, he may be able to educate the people for maintaining healthy and sanitary conditions of living
• Thus, a pharmacist can contribute his share to the nation-building activities of the country.
• A pharmacist should at all times endeavor to promote knowledge and contribute his quota to the advancement of learning. A pharmacist should never disclose any information which he has acquired during his professional activities to any third party or person unless required by law to do so.
• He should never betray the confidence that his patrons repose in him or which he has won by virtue of his eminent character and conduct.

## Pharmacist in relation to His profession

Professional Vigilance:

• It is not only sufficient for a pharmacist to be law-abiding and to deter from doing things derogatory to Society and his profession, but it should be his bounden duty to make others also fulfill the provisions of the pharmaceutical and other laws and regulations.
• He should not be afraid of bringing or causing a miscreant to be brought to book, who may be a member of his own profession.
• Whereas it is obligatory for a pharmacist to extend help and co-operation to a fellow member in his legitimate needs, scientific, technical or otherwise, he is to be, at the same time, vigilant to weed the undesirable out of the profession and thus help to maintain its fair name and traditions.

Law-abiding Citizens:

• A pharmacist engaged in the profession has to be an enlightened citizen endowed with a fair knowledge of the land and he should strive to countenance and defend them. He should be particularly conversant with the enactments pertaining to food, drug, pharmacy, health, sanitation, and the like and endeavor to abide by them in every phase of his life.
• A pharmacist is a unified whole and his life cannot be divided into compartments.

Relationship with Professional Organisations:

• In order to inculcate a corporate life in his own professional colleagues, a pharmacist should join and advance the cause of all such organizations, the aims and objects of which are conducive to the scientific moral, and cultural well-being of pharmacists and at the same time is in no way contrary to the code of pharmaceutical ethics.

Decorum and Propriety:

• A pharmacist should always refrain from doing all such acts and deeds which are not in consonance with the decorum and propriety of the pharmaceutical profession or which are likely to bring discredit or upgrade to the profession or to himself.

## Pharmacists OATH

A young prospective pharmacist should feel no hesitation in assuming the following Pharmacist’s Oath:

“I swear by the Code of Ethics of Pharmacy Council of India in relation to the community and shall act as an integral part of the health care team. I shall uphold the laws and standards governing my profession. I shall strive to perfect and enlarge my knowledge to contribute to the advancement of pharmacy and public health.

I shall follow the system, which I consider best for pharmaceutical care and counseling of the patient. I shall endeavor to discover and manufacture drugs of quality to alleviate the sufferings of humanity. I shall hold in confidence, the knowledge gained about the patients in connection with my professional practice and never divulge it unless compelled to do so by the law.

I shall associate with organizations having their objectives for the betterment of the profession of Pharmacy and make a contribution to carrying out the work of these organizations.

While I continue to keep this oath inviolate, may it be granted to me to enjoy life and practice of pharmacy respected by all, at all times? Should I trespass and violate the oath, the reverse be my lot.”

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