Martine Kruijtbosch

97 Mo ra l r eason i ng pe r spec t i ves i n s i t ua t i on s o f d rug s ho r t ages the problem. 3,6,7,9,11,13,14,17 The aspect of moral reasoning during drug shortage situations has not been addressed. The aim of this study is to explore the moral reasoning perspectives of Dutch community pharmacists in situations of drug shortages. TABLE 1: Moral reasoning development theorized by Rest et al 32 and Kohlberg 42,43 Rest’s moral reasoning perspectives Kohlberg’s six stages of cognitive moral development Post-conventional moral reasoning perspective (Universal principles, beyond personal interest and norms) Stage 6. Morality of universal ethical principles Stage 5. Morality of contract and of democratically accepted law Conventional moral reasoning perspective (Maintaining norms) Stage 4. Authority maintaining morality Pre-conventional moral reasoning perspective (Personal interest) Stage 3. Being-good morality of maintaining good relations, approval of others Stage 2. Naive instrumental hedonism, and equal exchange Stage 1. Punishment and obedience orientation METHODS An electronic survey was completed by Dutch community pharmacists. The survey explored respondents’ intended actions and moral reasoning perspectives in three drug shortages. Respondents In November 2019, approximately 2900 community pharmacists were registered in the Netherlands. They were invited and reminded once to participate in the study by completing a survey through the weekly digital membership newsletter of the Royal Dutch Pharmacists Association (KNMP) with a membership of approximately 95% of all community pharmacists. To increase the response rate we also sent digital invitations and reminders for the survey through two other professional channels: the Utrecht Pharmacy Practice Network for Education and Research (UPPER), 44 and the largest pharmacy chain BENU Apotheken. Through these three professional channels both community pharmacists and early career pharmacists working in community pharmacy were reached. The survey was accessible from November 6 until December 9, 2019.