Martine Kruijtbosch

52 Chap t e r 2 . 2 values have not been defined for the individual practices of the pharmacy profession (e.g. community pharmacy, hospital pharmacy, industry and government). 14 The awareness of professional values can help health professionals to make appropriate decisions and behave responsibly in their patients’ best interests. 24 Therefore, the aim of this study was to recognise the professional core values in moral dilemmas of pharmacists in community pharmacy and to customise the descriptions of these values for community pharmacy practice. METHODS Study design and setting During classes on professionalism and pharmaceutical ethics in the pre- and postgraduate education for Dutch PharmD students and early career pharmacists, the students and pharmacists were trained to recognise moral dilemmas. The training included studying literature on pharmaceutical care practice, pharmacy ethics and pharmacists’ professional values, followed by presentations by the trainers to deepen understanding of these topics. Examples of moral dilemmas were discussed in small groups to learn how to recognise a core problem and the professional values involved therein. As an assignment, the students and pharmacists were asked to write a narrative of a moral dilemma they had experienced in community pharmacy practice. The narrative had to be written shortly after they had experienced the dilemma, and they had to describe their own preferred ethical stances and values explicit therein. On the basis of the various definitions in the literature 25-29 , a moral dilemma was defined as a situation in which there is a choice between at least two courses of actions, neither of which is obviously morally preferable . In our previous study, we took a stratified random sample of 220 narratives written in 2010- 2012 and analysed the themes of the moral dilemmas described in these narratives. 30 The 128 moral dilemma narratives that were analysed as eligible in that study were used for the present study. Identification and coding of values The relevant portions of 128 written moral dilemma narratives that reflected the motives, arguments and considerations of the pharmacists were deductively coded with the professional values of the Dutch Charter of Professionalism of the Pharmacist. 23 Although professional autonomy is included in this Charter as a fifth core value, this value could not be analysed because the outcome of the moral dilemma was not always clearly described in all the