Martine Kruijtbosch

189 Gene ra l d i s cu s s i on A major part of Dutch pharmacists’ moral dilemmas are related to the behaviour of patients with potential drug addiction and drug misuse problems or patients who behave aggressively. Therefore, special attention should be given to increase knowledge of and develop moral sensitivity for human behaviour and specific patient characteristics in the context of mental illnesses, drug addiction and dependency. Also, iatrogenic stigmas in the context of these characteristics should be taught. Similarly, moral sensitivity and communication with other patient groups that may need specific attention should be reinforced. For example, patients with impaired cognitions, low literacy, parents of young children and pregnant women may have specific medication related needs. In order to increase understanding of the perspectives and values of patients and other parties such as physicians, health insurers, government, pharmaceutical industry, regulating bodies, science, society, (early career) community pharmacists could perform role-plays. In these they have to defend the values and perspectives of such parties which often are involved in moral dilemmas. Role plays may deepen moral sensitivity. It may stimulate identifying and respecting values and perspectives of pharmacists in relation to these of other parties in the context of the care for patients in moral dilemmas. Specific attention in professional ethics education should as well be given to the difference between reasoning from a professional ethics perspective as compared to reasoning from a rules and regulations or business orientation perspective. The possible effect on decisions based on either of these MRPs on patient outcomes should be illustrated. Moral reasoning tests such as used in situations of drug shortages (Chapter 3.2 and 3.3) can be used to monitor convergence towards a professional ethics moral reasoning perspective as a result of the professional ethics education and used learning methods. Simultaneously, (post)academic professional ethics education should address the difference between clinical and moral reasoning and teach how these complement each other to resolve moral dilemmas in the best possible way for patients. 103 Experiential learning methods such as collecting dilemma cases in practice and discussing these can support pharmacists to understand such differences. In order to teach professional ethics competencies to students and early career pharmacists, role models are essential. Special attention should therefore be given to ethics education for more senior pharmacists, who will supervise students and early career pharmacists. During workplace learning - and this is recommended in the context of students as well as early career pharmacists apprenticeships - the trainee can learn and demonstrate ethical competencies and