Pharmacists – personal values and professional obligations

Pharmacy professionals in the UK will know that the General Pharmaceutical Council (GPhC) have recently published revised Standards for Pharmacy Professionals (2017) and In practice: Guidance on religion, personal values and beliefs (2017). There was some controversy surrounding the consultation on the drafts of these documents, since the drafts – and indeed the published versions of the documents – introduce new obligations for pharmacists whose personal beliefs conflict with elements of their professional roles, and seem to create a strong presumption in favour of the interests of pharmacy service-users.

Under published Standard 1, pharmacy professionals must provide ‘person-centred care’, and pharmacists must ‘take responsibility for ensuring that person-centred care is not compromised because of personal values and beliefs’. According to the Standards, ‘people receive safe and effective care when pharmacy professionals recognise their own values and beliefs but do not impose them on other people’, (GPhC, Standards (2017), emphasis added). In the specific guidance on religion, personal values and beliefs, the GPhC states: ‘Pharmacy professionals have the right to practise in line with their religion, personal values or beliefs as long as they act in accordance with equalities and human rights law and make sure that person-centred care is not compromised.’ (GPhC, Guidance on religion (2017)).

At the same time that this shift is happening in the profession’s codes of ethics, there are a number of debates taking place that could lead to pharmacy professionals being increasingly exposed to morally-controversial practices. For example, there are repeated and ongoing efforts to legalise assisted suicide, both in Parliament and through the courts, and if any of these efforts succeeds, pharmacists may find that an expectation develops that they will dispense lethal prescriptions for use in assisted suicides. In addition, the current campaign to decriminalise abortion seeks (among other things) to remove the requirement, under the Abortion Act 1967, that abortions take place only in hospitals and ‘approved places’. This would open up the possibility that women may be able to self-abort at home using mifepristone and misoprostol obtained on prescription, or even sold over-the-counter in pharmacies. Either way, pharmacists and pharmacy staff would obviously be directly involved in buying, stocking and providing the pills. At first glance, then, it seems that accommodation of individual conscience within the profession is being de-prioritised just as pharmacists roles are being re-negotiated in ways that may bring them into increasing and more direct contact with practices that some members of the profession may regard as morally problematic or even impermissible.

Against this background, we want to explore how pharmacists experience conflict between their professional roles and their personal values in their everyday practice. We have been awarded funding under the British Academy/Leverhulme Small Research Grants Scheme for a pilot study in which we will interview pharmacists working around the UK. We will ask pharmacy professionals about their experiences of, and views on, conflict between personal values and professional expectations, about their engagement with professional ethics guidance generally, and about their perceptions of the GPhC Standards and Guidance.

We will interview up to 40 pharmacists.  The interviews will either be face-to-face in six locations across the UK (Birmingham, Edinburgh, Glasgow, London, Manchester, and Newcastle), or over the telephone, or via Skype. We will ask pharmacists about:

(i) their general impressions, thoughts and feelings about the revised GPhC’s Standards,

(ii) their perceptions of, and involvement in, the processes by which professional ethical guidance is created (including any factors making involvement less likely),

(iii) their sense of the role of values in their practice and the place of ethics guidance as a source of key values, and

(iv) their experiences of, and views about, conflict between their personal ethical commitments and the expectations associated with their professional roles.

Our intention is that this initial investigation will form a pilot study for a larger project exploring the authority of professional guidance, particularly when it comes into conflict with the individual consciences of professionals.