Martine Kruijtbosch

62 Chap t e r 2 . 2 The dilemmas clearly show that the pursuit of the pharmacist to apply his or her pharmaceutical expertise to promote the appropriate use of medicines may conflict with other professional core values. In approximately half of the moral dilemmas, reliable and caring and pharmaceutical expertise played a role together with commitment to the patient’s well-being. Pharmacists experienced moral dilemmas because they could not apply their expertise when patients or other health professionals did not take them seriously. 30 For example, pharmacists described that they could not provide appropriate pharmaceutical care because physicians did not listen to their pharmacotherapy suggestions. Similarly, this was the case when patients became aggressive or showed claiming behaviour in such a manner that this undermined the trust-based relationship. The findings of this study show that professional core values play a role in community pharmacy practice. The findings can be used to train pharmacists in recognition and reflection on moral dilemmas. Clear descriptions of professional core values can support community pharmacists in their daily practice. Recognition and reflection on professional values involved in moral dilemmas will help pharmacists to act in the best interests of patients. The findings also may stimulate the dialogue on professional values of pharmacists in other sectors and worldwide. 6,8,9,10,14,40,41 This dialogue already exists in other healthcare practices, such as medicine 11,12,42,43,44 and nursing. 45 Common in these dialogues is the importance of shared professional values. This stimulates the development of a common professional identity. 12 In contrast with physicians and nurses, pharmacists’ identity is still often perceived by consumers (as well as policymakers 46 ) as dual: i.e. simultaneously being care professionals as well as entrepreneurs. 10,13,46 Health professionals, acting on the basis of shared professional values that aim to serve patients and the public, do justice in fulfilling the social mandate of that practice 9 ; it stimulates a shared accountability. 12 Patients and the public are more inclined to trust such professional practices. Pharmacy associations should raise awareness among policymakers, regulators and educators on the importance of the societal embeddedness of pharmacy practice. 41,46 All these stakeholders should equally understand pharmacists’ societal role and contribution. Each country should, however, work out the professional core values themselves as (community) pharmacists’ societal role and responsibilities vary per country. 3,10,21