Law, discretion and the pharmacist
In these difficult and challenging times, many are finding it hard to revisit their doctors to obtain a prescription for well-needed medications, and this is understandable. Some persons are pensioners, others live far away from the nearest doctor or clinic, still others are either unemployed or are unemployable.
How can such ones still be afforded the right to quality health care despite these extenuating circumstances?
For years, our pharmacists have served as a valuable and functional link between doctors and patients, so much so that in years gone by, the pharmacy was not only referred to as a drug store but also as 'doctor shop'. Back then, and today, our pharmacists play a pivotal role in accessing, supplying, dispensing and even the manufacturing of our medication. At times our pharmacist may even be at liberty to substitute if need be and to suggest suitable alternatives in the absence or shortage of some drugs.
As a result of this reputation, some may be tempted to approach our pharmacists not just for advice, but at times may request medications without a prescription. It is certainly a pleasure to know that we engender the trust and confidence of those not well. However, in such a situation the pharmacist needs to be there not only for the patient, but also will need to exercise balance, discretion, good judgement and caution. This is not only in his/her interest but also in the interest of the patient.
IN THE PATIENT'S INTEREST
At times, a patient may have forgotten to take their usual morning medication and may only need one or two tablets to suffice them for the day. This is of particular importance to persons with life-threatening disorders, such as epileptics, asthmatics, sicklers and even diabetics and hypertensives.
As pharmacists, we can and have rendered meaningful community service to our customers, especially if our patient profile record reveals that the medications have been taken over the years and present prescriptions indicate that the patient is currently on the same medication.
Reason would or should dictate that in the event of an emergency, some discretion should be used in deciding whether to sell. Even in such a situation, good customer service would involve going the extra mile by calling the doctor if need be.
IN THE PHARMACIST'S
In any pharmacy, drugs are basically classified as over-the-counter or prescription drugs, and with good reason. There are times when ethically and professionally, the pharmacists need to say 'no, you will need to see your doctor'. Situations have arisen where a customer decides for themself that they want to take certain drugs again and again and will present empty containers requesting such without the doctor's knowledge. This is an unwise practice and should be discouraged. Certainly, we do not wish to be caught up in the process of making monetary gain at the expense of ruining the ethical standards or the profession.
Unscrupulous and underhanded individuals may be able to access sedatives, antibiotics, hallucinogenic drugs, abortive agents and even narcotic drugs without a prescription. Such a practice is strongly discouraged and is a contravention of the law.
Despite the challenging economic times, patients should be reminded of the importance of being reaccessed by their practitioner to establish:
1. If a stronger dosage is needed;
2. If the dosage needs to be reduced;
3. If combinations would work better; or
4. If the drug needs to be discontinued altogether.
In recent times, there has also been the trend of sharing medications with other family members or friends based on the pretext that they have the same or similar symptoms as we did then, but please be reminded that every individual responds differently to medications. Some are allergic to sulphur or derivatives of sulphur; still others adversely respond to penicillin and penicillin-related compounds. Still, others respond negatively to aspirin or other salycilates and even to steroids.
As members of the health-care team, I hope we all had a meaningful Pharmacy Week. May we continue to offer service, advice and counsel at the highest level, and continue to serve and assist within the ambits of the law.
If we keep this balanced mental attitude, not only will we gain the respect and trust of other health-care professionals, but most important, we will maintain the respect and confidence of the public at large to whom we have an accounting.
n Patrick LaMont is a practising pharmacist and a past president of the western branch of the Pharmaceutical Society of Jamaica; email: firstname.lastname@example.org