Martine Kruijtbosch

188 Chap t e r 5 Recommendations for education It has been suggested that pharmacists especially struggle with moral dilemmas due to a lack of professional ethics training throughout their academic training. Professional ethics training should therefore be an integral part of all phases of academic education and should continue during postacademic training. In the Netherlands, educators from both the Bachelor’s and the Master’s pharmacy degree programs, alongwith representatives from the Royal Dutch Pharmacists Association (KNMP), (re)formulated a pharmacy-specific frame of reference and competence standards framework for pharmacists. 101 This document clearly states that Dutch pharmacists are trained to execute their pharmaceutical expert role on the basis of the highest pharmaceutical, scientific and ethical standards as formulated in the Dutch Charter of Professionalism. 21 Training is aligned with the postacademic education curriculum for pharmacists to become specialists. 102 It means that all Dutch pharmacy (post) academic institutions are dedicated to teach (future) pharmacists on the basis of the Charter and the therein included professional values. All master degrees in the Netherlands have attention for ethical education in their curricula and the postgraduate community pharmacist specialisation program in the Netherlands reserves classroom courses to professional ethics training. 102 There are different approaches, but reflection on professional values and dilemma case discussions, partly on the basis of self- collected and experienced moral dilemmas, is generally included. These institutions should jointly monitor the implementation of the usage of the Charter in the curricula and its effects on students’ moral reflectivity, and learn from each other’s methods to teach the ethical competencies in line of it. Professional ethics education should firstly include developing moral sensitivity which means professional value awareness and recognition of moral dilemmas. It should provide experiential reflective learning methods, such as writing narratives about self-experienced dilemma cases, and hypothetical and self-experienced moral dilemma case discussions with peers. These discussions can be informal as well as formal and structured like in moral case deliberation. In these methods the development of moral reflection as well as Rest’s four cognitive-affective processes involved in ethical decision-making (moral sensitivity, reasoning, intention and character) should all be integrated. 22,32 Furthermore, professional bodies can stimulate moral case deliberation (MCD) sessions for (community) pharmacists. A short MCD format could be developed for such educational purposes and as a tool for quick moral reflection and judgement in daily practice. To generate attention for the ethical aspects of the pharmacy profession, professional bodies could regularly share moral dilemmas through newsletters or professional journals.