Martine Kruijtbosch

192 Chap t e r 5 continue their lobby for the availability of clinical information such as laboratory values and indication for prescribing for pharmacists. This information can help pharmacists in their clinical role and may prevent moral dilemmas e.g. in case of doubt when physicians are not available to share such medical information. Moreover, parties that collaborate in patient care should have dialogues with each other and work out the difficulties that hamper appropriate care. Sometimes difficulties may have a mere technical nature such as incompatible information systems, but different interpretation of regulations such as the General Data Protection Regulation of the European Union on data protection and privacy 106 may also play a role. Professional bodies should stimulate thatmoral case deliberation (MCD) becomes anobligatory item within lifelong learning of community pharmacists. They could additionally stimulate that pharmacists take part in MCD together with primary care physicians, for example as part of joint pharmacotherapy audit meetings, also called quality circles or peer review groups. 107,108 The advantage is that MCD is clearly structured, which may result in improved standards of practice. 109 Moreover, MCD with other primary health care professionals may help them to recognise each other’s values and perspectives towards care in patients’ best interest. Hence, also medical professional bodies could stimulate MCD in primary care along with community pharmacists. Finally, policy makers could line up with professional bodies to build a public communication strategy that promotes pharmacists as health professionals that can aid patients beyond solely dispensing medicines. Recommendations for research This thesis contains the first studies into the ethical competencies of Dutch community pharmacists. The studies have proven the importance of professional value awareness and moral reflectivity in the processes of moral sensitivity, reasoning and intention in ethical decision-making in situations of moral dilemmas. There is, still ample opportunity for continued research. Future research should focus on (1) the longitudinal moral development of students and pharmacists throughout their career, (2) the effectivity of interventions that aim to improve ethical competencies, (3) barriers and facilitators that influence the professional (ethical) behaviour in the best possible interest of patients, and (4) the extent of moral distress and the consequences of such distress among pharmacists.