Tag: pharmacists

Bioethics Blogs

Mandatory Reporting of Pharmacy Prescription Errors?

Following the widely-reported 2014 case of a Cincinnati pharmacist incorrectly filling a prescription which led to a serious patient injury, the Ohio State Board of Pharmacy is now poised to promulgate a new regulation requiring pharmacists to report errors and to the board. This may be the first attempt by a US state board of pharmacy to require dispensing error reporting. (However, about six years ago, the Canadian province of Nova Scotia instituted a required reporting system that has resulted in over 20,000 reports of errors and “near-misses” each year.)

The facts of the 2014 case are direct: A pharmacist was responsible for mistakenly filling a prescription written to supply labetalol but instead dispensed lamotrigine. As a result, the patient suffered permanent kidney damage requiring long-term dialysis. However, because of more in-depth news reporting, an investigator for a local television station made the claim that pharmacists deal with mistakes in “secrecy” and recommended that prescription errors reporting be mandated.

Regrettably, dispensing errors are an unfortunately fact of a pharmacist’s life. In a 2003 observational study attempting to assess prescription dispensing accuracy in 50 pharmacies in six US cities, pharmacy researchers Elizabeth Flynn, Kenneth Barker, and Brian Carnahan showed that the error rate was 1.7% for the 4481 prescriptions reviewed. Of the 77 identified mistakes, the team considered five to “clinically important.” (J Am Pharm Assoc. 2003;43:191-200). Interestingly, the accuracy rate did not vary significantly by pharmacy type or city.

In a 1998 report, a national pharmacist liability carrier provided information to authors Walter Fitzgerald and Dennis Wilson that 85% of its claims resulted from “mechanical errors,” including dispensing the wrong drug or dose, or labeling the prescription incorrectly.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Mandatory Reporting of Pharmacy Prescription Errors?

Following the widely-reported 2014 case of a Cincinnati pharmacist incorrectly filling a prescription which led to a serious patient injury, the Ohio State Board of Pharmacy is now poised to promulgate a new regulation requiring pharmacists to report errors and to the board. This may be the first attempt by a US state board of pharmacy to require dispensing error reporting. (However, about six years ago, the Canadian province of Nova Scotia instituted a required reporting system that has resulted in over 20,000 reports of errors and “near-misses” each year.)

The facts of the 2014 case are direct: A pharmacist was responsible for mistakenly filling a prescription written to supply labetalol but instead dispensed lamotrigine. As a result, the patient suffered permanent kidney damage requiring long-term dialysis. However, because of more in-depth news reporting, an investigator for a local television station made the claim that pharmacists deal with mistakes in “secrecy” and recommended that prescription errors reporting be mandated.

Regrettably, dispensing errors are an unfortunately fact of a pharmacist’s life. In a 2003 observational study attempting to assess prescription dispensing accuracy in 50 pharmacies in six US cities, pharmacy researchers Elizabeth Flynn, Kenneth Barker, and Brian Carnahan showed that the error rate was 1.7% for the 4481 prescriptions reviewed. Of the 77 identified mistakes, the team considered five to “clinically important.” (J Am Pharm Assoc. 2003;43:191-200). Interestingly, the accuracy rate did not vary significantly by pharmacy type or city.

In a 1998 report, a national pharmacist liability carrier provided information to authors Walter Fitzgerald and Dennis Wilson that 85% of its claims resulted from “mechanical errors,” including dispensing the wrong drug or dose, or labeling the prescription incorrectly.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Kenya’s Public Doctors to End 100-Day Strike That Saw Deaths

March 14, 2017

(ABC News) – Thousands of doctors at Kenya’s public hospitals have agreed to end a 100-day strike that saw people dying from lack of care, an official with the doctors’ union said Tuesday. The strike was blamed for dozens of deaths, as the majority of Kenyans cannot afford private health care. The government and union officials signed a deal to address pay and other issues in dispute, said Dr. Ouma Oluga, the secretary-general of the Kenya Medical Practitioners, Pharmacists and Dentists Union.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

End of ‘Conscience Clause’: Pharmacists Are Stripped of Their Right to Refuse Drugs on Religious Grounds

March 13, 2017

(Daily Mail) – Pharmacists will no longer be able to refuse to dispense contraception or certain drugs because of a moral objection. The so-called ‘conscience clause’ that allows them to refer a patient to a colleague has now been ruled incompatible with requirements that pharmacists deliver ‘person-centred care’. The General Pharmaceutical Council (GPhC) says the new system means they will be required to ensure the treatment of their client ‘is not compromised because of personal values and beliefs’.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Cultural crisis? Moral breakdown? Or a glimpse of the transhumanist future?

Over on the Commentary website, Nick Eberstadt has a brilliant and disturbing piece called “Our Miserable 21st Century.” Among its many haunting points is the following concerning the unemployed and opioid-addicted men of “fly-over” America:

We already knew from other sources … that the overwhelming majority of the prime-age men in this un-working army generally don’t “do civil society” (charitable work, religious activities, volunteering), or for that matter much in the way of child care or help for others in the home either, despite the abundance of time on their hands. Their routine, instead, typically centers on watching — watching TV, DVDs, Internet, hand-held devices, etc. — and indeed watching for an average of 2,000 hours a year, as if it were a full-time job. But Krueger’s study adds a poignant and immensely sad detail to this portrait of daily life in 21st-century America: In our mind’s eye we can now picture many millions of un-working men in the prime of life, out of work and not looking for jobs, sitting in front of screens — stoned.

And yet, are these men not on the transhumanist cutting edge? Freed from the tyranny of their bodily ills by drugs, they occupy long stretches of the day with (admittedly crude) virtual realities that allow them to escape the tyranny of circumstances beyond their control. Imagine how much happier they will be when able to immerse themselves in the more sophisticated virtual worlds that are just around the corner! Imagine how much better off they will be when our current medications are replaced with what will doubtless be far superior, safe, effective, and naturally non-addictive tools of pain relief and mood control.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Doctors and Patients Reel after Trump’s Immigration Ban

January 31, 2017

(Wired) – By one estimate, a quarter of all doctors in the US were not born in this country. Across the healthcare industry, from medical students to doctors to pharmacists to orderlies, lives were changed in an instant last Friday. Some, like Tourkamani, because they were separated from family. Others because they were prevented from even doing their work. According to the American of American Medical Colleges, 260 doctors from the banned nations—Iraq, Iran, Libya, Somalia, Syria, Sudan, Yemen—applied for residencies like Tourkamani’s this year. The AAMA believes these doctors may not be able to practice in the US because of the timing of the order.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Alberta Nurse Practitioners Authorized to Provide Medical Assistance in Dying

January 10, 2017

(Edmonton Journal) – Nurse practitioners are registered nurses, with graduate education, who can order and interpret screening and diagnostic tests, perform procedures and prescribe medications and therapeutic interventions. There are 450 nurse practitioners in Alberta. The provincial cabinet approved last week the Medical Assistance in Dying Standards of Practice for Nurse Practitioners as standards of practice for CARNA. The regulations were developed in collaboration with Alberta Health, Alberta Health Services, the College of Physicians and Surgeons of Alberta and the Alberta College of Pharmacists.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Pharmacist Vaccination Laws, 1990-2016

Since the 1990s, there has been a growing movement to improve access to immunization services by giving pharmacists the authority to administer vaccines. The newest map on LawAtlas.org explores state laws from 1990 to 2016 that give pharmacists authority to … Continue reading

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Crossing the Line: When Doctors’ Beliefs Endanger Patients’ Autonomy and Health

by Craig M. Klugman, Ph.D.

In 2016 the Illinois legislature passed and Governor Bruce Rauner signed into law Public Act 099-690 (SB 1564), an amendment to the Health Care Right of Conscience Act. This change states “It is also the public policy of the State of Illinois to ensure that patients receive timely access to information and medically appropriate care.” The change requires physicians to inform patients about legal treatment options including their factual risks and benefits, but does not require the physician to perform such services. If the hospital or physician has a conscientious objection to performing a procedure, then the patient must be referred to or transferred to someone or some facility that will.

For this effort, state officers have been sued in both state and federal courts by the Alliance Defending Freedom on behalf of a group of “pregnancy centers,” a doctor and her medical practice in Rockford, IL. Their complaint is that this law “forces them to promote abortion regardless of their ethical of moral views.” In other words, because the law requires doctors to allow patients to know all of their legal options indicated under standard of care and to be transferred elsewhere for services a physician or facility will not perform, this violates their religious freedom. The plaintiffs want it to be legal to lie, obfuscate, and keep information from patients and to keep patients away from legal and safe, medically indicated procedures. Specifically, this suit cites abortion.

Most surprisingly, a judge in a rural county has issued an injunction against the law going into effect (only) for the named plaintiffs.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Nursing Is Seen as the Most Ethical Profession in America and Congress Ranks the Least

December 23, 2016

(Health IT News) – Nurses rank, by far, the top profession for honest and ethics in the U.S. in the 2016 version of the annual Gallup poll on ethics in professions, Americans Rate Healthcare Providers High on Honest, Ethics, published this week. Since 1999, nurses have been #1 in this survey except for the year 2001, when firefighters scored the top spot in light of the 9/11 attack. Another consistency in this survey among U.S. consumers is that pharmacists and physicians top the list once again, after nurses, and the most-trusted professions in America.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.