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Introduction

Pharmacists and pharmacy technicians play pivotal roles in the continuum of health care provided to patients. The responsibility that comes with being an essential health resource is significant. To retain the high level of trust and respect that is given to pharmacists and pharmacy technicians by patients, the public and other health professionals, pharmacists and pharmacy technicians must be both competent and professional in all they do. As professionals, pharmacists and pharmacy technicians are challenged and expected to abide by a higher standard of conduct.

Ethics are the foundation for professional behaviour, actions and attitudes. The ACP Code of Ethics reflects what the pharmacist and pharmacy technician professions stand for and reinforces what is unique about the contributions of pharmacists and pharmacy technicians to patients, to society, and to their professions. Ethics reflect the soul of each profession. Consistent ethical behavior creates a positive image of the individual that extends to the image of the professions. In contrast, unethical practices and decisions create a negative image of and diminish trust and credibility about the individual and raise suspicion about the professions.

The Code of Ethics supports ACP in fulfilling its mandate to protect the public. The Code of Ethics enables ACP to provide direction to pharmacists and pharmacy technicians faced with ethical dilemmas. The Code of Ethics also allows ACP to provide guidance to universities and colleges for student curricula. The Code of Ethics serves as a benchmark for monitoring and addressing the conduct of pharmacists and pharmacy technicians.

Application

The Code of Ethics forms part of the law that governs the practice of pharmacy and the operation of pharmacies. The Code of Ethics cannot be read and applied in isolation. It must be read together with and in the context of the legislative and regulatory framework which includes the Health Professions Act, the Pharmacy and Drug Act, the regulations and standards made under those Acts, other provincial and federal legislation relating to drugs, and provincial and federal privacy legislation.

This Code of Ethics applies to all regulated members of ACP under the Health Professions Act. References to pharmacists in this Code must be read as including clinical pharmacists, provisional pharmacists, courtesy pharmacists, and pharmacy students. References to pharmacy technicians must be read as including pharmacy technicians, provisional pharmacy technicians, and pharmacy technician students. The Code of Ethics also applies to the operation of pharmacies and to the conduct of licensees and proprietors under the Pharmacy and Drug Act.

The principles and the guidelines in the Code of Ethics are binding and regulated members are required to comply with them. ACP recognizes that there may be circumstances where the practice of a member is limited by the legislative and regulatory framework or by a condition on a permit or licence with the result that a particular guideline may not apply to the practice of that member.

Principles

Pharmacists and pharmacy technicians use their knowledge, skills and resources to

  • serve patients,
  • contribute to society, and
  • act as stewards of their professions.

Patients

To uphold this principle, I:
  1. Act in the best interest of each patient.
  2. Provide appropriate treatment and care.
  3. Actively seek out information to make informed decisions.
  4. Advocate for appropriate drug therapy that meets each patient’s values and health goals.
  5. Provide drugs, non-prescription medicines or health-related products that are from safe and proven sources.
  6. Dispense, distribute or promote drugs, non-prescription medications or health-related products that are of good quality only.
  7. Safeguard the well-being of each patient and in particular any patient who is vulnerable.
  8. Prevent harm to each patient; but, should harm occur, disclose it to the patient, and initiate steps to mitigate/treat the harm.
  9. Do not exploit a patient for personal advantage.
  10. Avoid conflict of interest and declare any personal or professional interests to any patient who may be affected.
  11. Resolve any conflict of interest that may arise in the interest and for the well-being of the patient affected.
  12. Do not allow my professional judgment to be impaired by personal or commercial benefits such as monetary or financial gain or incentive targets. I do not ask for or accept gifts, inducements, hospitality or referrals that may affect or be perceived to affect my professional judgment.
  13. Do not enter into any arrangement with a patient where I provide an inducement to the patient that is conditional on the patient obtaining a drug or professional service from me.
  14. Cooperate with colleagues and other health professionals to assist a patient to achieve the patient’s health care goals.
  15. Consult with other health professionals to benefit a patient as appropriate.
To uphold this principle, I:
  1. Listen to each patient and the patient’s caregivers and seek to understand the patient’s values and health goals.
  2. Meet the individual communication needs of each patient.
  3. Provide each patient with any information that the patient needs to make informed decisions about the patient’s health and health care and discuss that information with the patient.
  4. Properly inform each patient about drug therapy and reasonable alternatives.
  5. Respect the right of a competent patient to accept or reject any treatment, care or other professional services.
  6. Respect the autonomy of a patient who is a minor and who is able to make decisions about the patient’s health and health care and is able to consent to care.
  7. Avoid discriminating against any patient on grounds such as age, gender, marital status, medical condition, national or ethnic origin, physical or mental disability, political affiliation, race, religion, sexual orientation or socioeconomic status. (This does not restrict the right to refuse to accept an individual as a patient for legitimate reasons.)
  8. Respect the intentions of a patient who is not competent where those intentions were expressed before the patient became incompetent (e.g., through directions provided in a personal directive or through the appointment of an agent under an advance directive).
  9. Give each patient access to information in that patient’s record unless restricted by law or unless it is not in the patient’s best interest.
To uphold this principle, I:
  1. Actively engage each patient and work with the patient in a manner that builds a relationship and confidence in my professional abilities.
  2. Treat each patient politely and considerately.
  3. Maintain proper professional boundaries in relationships with each patient, taking special care when dealing with a vulnerable individual.
  4. Limit treatment of myself or members of my immediate family only to minor conditions, emergency circumstances or when another appropriate health professional is not readily available.
To uphold this principle, I:
  1. Inform each patient about the use that will be made of the patient’s personal information, unless otherwise authorized by law.
  2. Disclose a patient’s personal information only pursuant to the patient’s consent or for the purpose of providing care to the patient, unless otherwise authorized by law.
  3. Inform the patient to whom and for what purpose the patient’s personal information will be disclosed, unless otherwise authorized by law.
  4. Use information obtained in the course of professional practice only for the purposes for which it was obtained, unless otherwise authorized by law.
  5. Seek only information that is necessary to make informed decisions about the patient’s health and the treatment alternatives that align with the patient’s treatment goals, unless otherwise authorized by law.
  6. Protect each patient’s privacy during any consultation.
To uphold this principle, I:
  1. Continue to provide professional services until they are no longer required or wanted, until another suitable pharmacist or other regulated health professional has assumed responsibility for the patient or until the patient has been given reasonable notice of my intent to terminate the relationship.
  2. Take appropriate action in emergency situations to provide care and reduce risks to my patients and the public, taking into account my competence and other options for assistance or care available.
  3. Assist each patient to obtain appropriate pharmacy services from another pharmacist or health professional within a timeframe fitting the patient’s needs if I am unable to provide the pharmacy service or will not provide the service due to a conscientious objection.
  4. Arrange the condition of my practice so that the care of my patients will not be jeopardized when I will not provide certain pharmacy services due to a conscientious objection.
  5. Do not abandon the professional relationship with my patient in situations where the patient is unable to pay. (However, there is no obligation to provide drugs and services for free.)
  6. Recognize my limitations and, when indicated, refer my patient to other health professionals whose expertise can address the patient’s need.

Society

To uphold this principle, I:
  1. Participate in programs to educate the public about being healthy and preventing disease.
  2. Incorporate practices that prevent the growth and transmission of pathogens.
  3. Act as a steward for the environment by providing safe disposal of drugs, non-prescription medications and health-related products and support other environmental initiatives related to pharmacy.
  4. Advance knowledge by conducting, participating in or promoting appropriate research projects.
  5. Participate in research only if it is evaluated both scientifically and ethically and is approved by a research ethics board that meets current standards of practice.
To uphold this principle, I:
  1. Seek cost-effective therapies that ensure quality care.
  2. Create a work environment that allows pharmacists and pharmacy technicians to comply fully with the law governing the practice of pharmacy and the operation of pharmacies.
  3. Maintain the appropriate human resources to ensure that the law governing the practice of pharmacy and the operation of pharmacies is complied with and patient health needs are met.
  4. Incorporate technologies and systems into practice that improve effectiveness and efficiency in the delivery of healthcare.
To uphold this principle, I:
  1. Maintain access to pharmacist services and care.
  2. Am accessible and make resources available to care for patients and to mitigate further risk during public emergencies.
  3. Serve patients who seek care unless limited by competence or the lack of information or resources necessary to do so.

Profession

To uphold this principle, I:
  1. Continuously improve my level of professional knowledge and skill.
  2. Take responsibility for maintaining a high standard of professional competence.
  3. Evaluate my individual practice and assume responsibility for improvement.
  4. Keep informed about new pharmaceutical knowledge.
  5. Respond constructively to the outcomes of competence assessments and practice visits, as well as other appraisals and reviews of my professional performance and undertake further training when necessary.
  6. Restrict my practice within the limitations of my personal competence.
To uphold this principle, I:
  1. Comply with both the letter and the spirit of the law that governs the practice of pharmacy and the operation of pharmacies.
  2. I am honest in dealings with
    1. patients;
    2. other pharmacists, pharmacy technicians, health professionals and the college; and
    3. contractors, suppliers and any others encountered in business dealings related to the practice of my profession or the operation of a pharmacy.
  3. Seek and expect fair remuneration for drugs, devices and professional services.
  4. Am accurate and transparent in the fees that are charged, consider the ability of the patient to pay and, where appropriate, discuss options with the patient.
  5. Am accurate and impartial when teaching others.
  6. Am accurate and impartial when providing or publishing information to ensure that others are not misled or that any claims made can be justified.
  7. Do not enter into any arrangement with a prescriber of drugs that could reasonably be perceived as affecting the prescriber’s independent judgment in the prescribing of drugs.
  8. Do not participate in efforts to deceive a patient.
  9. Do not condone unethical or unprofessional conduct by colleagues, co-workers or other health care professionals and report any unethical or unprofessional behaviour to the appropriate authorities.
  10. Respond honestly, openly and courteously to complaints and criticism.
  11. Share formulations that are important to the care of a specific patient.
To uphold this principle, I:
  1. Seek help from colleagues and appropriately qualified professionals for personal problems that might adversely affect the provision of service to patients, society or the profession.
  2. Protect and enhance my personal health and well-being.
  3. Practice only when fit and competent to do so.
  4. Promptly declare to appropriate individuals any circumstances that may call into question my fitness to practice or bring the pharmacy profession into disrepute, including ill health that impairs my ability to practice, criminal convictions and findings by other regulatory bodies or organizations.
  5. Do not misuse or abuse substances.
  6. Take appropriate steps to prevent and act upon the misuse or abuse of substances by patients, co-workers, colleagues or other health professionals.
  7. Challenge the judgment of colleagues and other health or social care professionals if I have reason to believe that their decisions could compromise the safety or care of others.
To uphold this principle, I:
  1. Practice only under conditions where the freedom to exercise professional judgment is not compromised.
  2. Maintain professional relationships with colleagues and other health care professionals.
  3. Contribute to the future of the profession by participating in the education of provisional pharmacists and technicians and students, including multi-disciplinary and collaborative experiences.
  4. Raise concerns if policies, systems, working conditions or the actions, professional performance or health of others may compromise patient care or public safety.
  5. Take appropriate action if something goes wrong or if others report concerns to me.
  6. Recognize that self-regulation of the profession is a privilege and that each pharmacist and pharmacy technician has a continuing responsibility to merit this privilege and to support their professional institutions.