Martine Kruijtbosch

59 Pro f es s i ona l va l ues wi t h i n mo ra l d i l emmas TABLE 4: Moral dilemmas 5 and 6 Moral dilemma 5 (PHARM-1071) The pharmacist noticed that a patient with diabetes II was using much more insulin, test materials and needles than prescribed. When the pharmacist asked the patient about it, he stated that this regimen was advised by the hospital physician. The pharmacist, however, had seen the letter from the hospital physician to the GP, which stated a much lower dose. The patient had family living abroad and regularly visited them. Both the pharmacist and the physician suspected that the patient probably provided relatives or friends there with insulin. Customised professional core values: ‘The patient used three times the dose requirements of insulin a person with this weight should use.’ Pharmaceutical expertise ‘The earlier dispensed quantities had already cost Dutch society about 15.000 euros extra.’ Responsibility to society ( responsible for the societal consequences of his or her actions ) ‘On the other hand, the patient actually needed medication. There might have been even other explanations for the overuse.’ Commitment to the patient’s well-being Moral dilemma 6 (PHARM-109) A woman presents a prescription for the oncolytic melphalan for her father who lives in another country. The prescription is unclearly written and is in a foreign language. She explains that her father needs the drug but that it is not available in his country. Customised professional core values: ‘ I doubted about dispensing because I had no clear information about the indication, nor the dose and quantity of the drug to dispense. The potential toxicity of the drug made me even more careful. Also I did not know this patient nor the prescriber, and therefore I did not have the relevant patient data in order to dispense safely.’ Pharmaceutical expertise Reliable and caring ( acting meticulously and carefully ) Responsibility to society ( guaranteeing continuity of pharmaceutical care by collaboration with other health professionals ) Commitment to the patient’s well-being ‘ On the other hand, this patient, although living abroad, needed care.’ Responsibility to society ( guaranteeing access to pharmaceutical care ) Commitment to the patient’s well-being