Martine Kruijtbosch

51 Pro f es s i ona l va l ues wi t h i n mo ra l d i l emmas INTRODUCTION Historically, accuracy and safety in the compounding and dispensing of medicines have been the most important values for pharmacists. 1,2 Because pharmacists’ focus shifted from product to patient, 3,4,5 the professional values of the profession need reformulation. 3,6,7,8,9 Professional values are the foundation of a professional practice and are thus specific to a practice. 10 The practice of pharmaceutical care implies that pharmacists take responsibility for definite outcomes of drug therapy that improve patients’ quality of life. 6 To realise this practice, pharmacists should develop professional behaviour and a common professional identity that goes beyond their personal values and self-interests. 10,11,12 Therefore, clearly described professional values are needed to support pharmacists in this development. 13,14,15,16,17 However, since the introduction of the ‘pharmaceutical care practice’ in the nineties, research on professional values in pharmacy is scarce. 6 The following values have been suggested as foundational to pharmacy practice as well as any other healthcare practice: self-determination, compassion, justice, respect for persons, commitment to integrity and ethical practice, and commitment to excellence. 14,16 Qualitative studies on the understanding of ‘patient-centred professionalism’ also emphasise that professional values are important to advance healthcare practices and to achieve definite positive health outcomes in patients. 15,17 In medicine and nursing, experts have raised awareness that professional values should be taught to starting professionals in order to create a shared culture of practice and stimulate a commitment to the profession’s values. 12,18 Such a commitment may improve patients’ health outcomes, as was found in a recent study among nurses. 19 Despite limited research, professional values of pharmacy practice appear, often implicitly, in pledges of professionalism. For example, in many countries, pharmacists take public oaths, mostly at the graduation ceremonies of pharmacy schools. 3,20,21 These pledges are often inspired by oaths such as the Hippocratic Oath. 3 The International Pharmaceutical Federation (FIP) recently reached consensus on a new oath based on existing documents 22 to emphasise the professional commitment among pharmacists worldwide. In 2012 the Royal Dutch Pharmacists Association (KNMP) adopted a Charter defining the professional core values through consensus with pharmacists who work in all different practices (e.g. community and hospital pharmacy, industry, research, development and government). These values included: (1) commitment to the patient’s well-being, (2) reliability and care, (3) pharmaceutical expertise, (4) social responsibility and (5) professional autonomy. These core values should guide every pharmacist, irrespective of the practice setting. 23 Thus far, it has not been studied whether and how these professional core values of pharmacists play a role in their specific professional practices. 21 Moreover, the professional