Martine Kruijtbosch

194 Chap t e r 5 lead to anger, fear, frustration, and even burn-out when health professionals are unable to execute theirmoral intentions and feel they provide suboptimal care for patients.Moral distress can lead to losing work satisfaction and may even cause pharmacists to exit the profession. Moral distress has not been studied among Dutch community pharmacists. Research should provide evidence to what extent Dutch pharmacists experience moral distress as a result of moral dilemma encounters. CONCLUSION This thesis has given new insights regarding the moral reflectivity of community pharmacists in the context of ethical decision-making and the professional values that play a role therein. Awareness of professional values is crucial for pharmacists to understand their moral dilemmas within their professional relationships. This awareness may enable pharmacists to reflect on these values and will help them to take appropriate decisions in the best interest of patients and society. However, pharmacists need support here. National pharmacists associations and policy makers should realise the preconditions for a health system and remuneration model wherein the healthcare role of pharmacists is adequately assured and by which pharmacists’ social role is promoted. A national strategy should be developed for implementation of the professional core values in all segments of the profession. The most relevant stakeholders to support pharmacists in this are the national pharmacists associations, universities, policy makers and payers. Part of this strategic plan should be incorporation of ethics education in pharmacists’ (lifelong) professional education. Stakeholders should structurally invest in empirical research that aims to measure progress in moral reflectivity of community pharmacists and the effect of it on the quality of pharmaceutical patient care. Pharmacists themselves must give time to moral reflection away from the hectic day-to-day practice and strengthen their inner moral compasses. Taking cue from Shakespeare, moral reflection is not reason’s labour, but calm repose. It is without saying that moral reflectivity is the key and should become a natural attitude of community pharmacists with the aim to achieve positive health outcomes for patients who are in need of pharmaceutical care.