Martine Kruijtbosch

179 Gene ra l d i s cu s s i on Moral sensitivity requires a capacity to feel and express relatedness. 26,28 Within situations of moral dilemmas relatedness is shown by respecting and accepting the perspectives and values of others. Through dialogue with others, e.g. patients and health professionals, new perspectives are created 26 that inform the right thing to do in a moral dilemma. 36-38 The importance of moral sensitivity, as a first step to safe and effective patient-centred care, has been described previously for other health professions, such as medicine and nursing. 26,34,39,40 Empirical studies even showed that moral sensitivity improves moral reasoning and ethical decision-making in the best interest of patients. 35,39,41 It is therefore not surprising that the awareness of common professional values is considered important to improve clinical practice. 42-44 Health professions are moral communities with common professional values, that are morally grounded. 45 Similarly, pharmacists make part of a moral community with a collective responsibility to society. In the execution of their social role, pharmacists make use of the professional values that substantiate the pharmacy profession. Only through a common practice and the ability to articulate professional values in clinical decisions, pharmacists will be granted professional autonomy. Moral sensitivity in the pharmacy profession Pharmaceutical care implies that pharmacists take responsibility for patients’ medication- related needs and the achievement of positive health outcomes from drug therapy. Moral sensitivity helps pharmacists to recognise the medication-related needs, concerns and preferences of patients. Moreover, pharmacists need to realise that this patient perspective may change over time due to changes in health status and medication use. Moral sensitivity enables pharmacists to align patients’ medication-related needs with decisions regarding pharmacotherapy. A process of continuous reflection on professional values in the context of these needs enables pharmacists to come to a shared decision about the best care for the patient. Hence, an optimal pharmaceutical care practice involves a combination of both clinical competencies and moral sensitivity. Empirical studies regarding pharmacy ethics showed that pharmacists had problems articulating their moral dilemmas. 10,46,47 Overall pharmacists were not able to articulate professional values beyond the most obvious core value responsibility for the patient’s best interest . 19,46 A reason may be that pharmacists have not been explicitly trained to recognise professional values and moral dilemmas. 19,48,49 The retrospective nature of most previous studies may also have contributed to the inability of pharmacists to describe moral dilemmas. They may have forgotten the frequently occurring cases with relatively low impact on patients and only remembered the ‘high drama’ cases.