Martine Kruijtbosch

110 Chap t e r 3. 2 end responsibility for drug shortage problems and thereto related decisions, and a lower number of locum pharmacists since 2017. Furthermore, it might be that pharmacists with a more strongly developed sense of professional ethics may have been more likely to respond. Another strength of this study is that we used three scenarios that were very likely to be familiar to all respondents. Moreover, handling options and moral considerations were formulated with the aid of a panel of practicing pharmacists who share the same professional values, practice and language as the participants. 49 The validity of the survey was confirmed by the PCA. The three scenarios were also intentionally chosen for the perceived differences in their potential impact (i.e. perceived relevance) on patients’ health outcomes. However, with these three drug shortages we have not captured all drug shortages and thereto related potential handling options. We therefore cannot generalize pharmacists’ MRPs to all sorts of drug shortages. Insights into moral reasoning can help individual pharmacists to reflect on their motives for handling drug shortages and can also be used for pre- and postgraduate education on professional ethics development. Since drug shortages are still increasing and likely to remain present in the coming years, 6 pharmacists must prepare themselves and develop their professional ethics MRP to professionally act in situations of drug shortages. This ability may improve patient care and protect pharmacists from moral distress. In order to develop pharmacists’ professional ethics MRP more attention should be given to the reflection on and handling of moral dilemmas both in pre- and postgraduate education. The technique of moral case deliberation may be suitable for this. 64,65 CONCLUSION We conclude that pharmacists do consider responsible pharmaceutical care for patients in drug shortage situations. However, this professional ethics moral reasoning perspective can be overruled by a business orientation perspective when the drug shortage may be perceived to have a lower impact on patient outcomes and when alternative drugs or therapy are expensive.