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Professionalism

A discussion of Professionalism in context of Pharmacy

Date : 12/01/2015

Author Information

Mujeeb

Uploaded by : Mujeeb
Uploaded on : 12/01/2015
Subject : Citizenship Studies

Professionalism; a Self-Proclaimed Noblesse Oblige

"In many jurisdictions, students studying to enter the pharmacy profession must abide by a code of conduct from the pharmacy regulator, which holds them to a higher standard than their peers who are studying on non-professionally-accredited degree programmes. Discuss whether or not you think this situation is fair, and why".

During this essay I will try to convince you that, since differences exist in the nature of the roles of certain professions, it may be possible to justify differences in upholding different standards of conduct. However I will go on to argue that only in our present society, such a state that it is in, could a statement such as the one presented for this essay, even be debatable This will be achieved by trying to show that the real problem is the standard of ethics in society as a whole, and that to expect differences between certain groups is a very dangerous and harmful thing to do indeed. In essence; looking not at the differences that exist between professions but instead at the commonalities existing between humans. I will attempt to reduce the current model that we are taking, as a society to ethical conduct, and try to rebuild it in such a way that renders the proposed statement for the essay void. This essay will hopefully then lead to us to more important discussions about the essence of ethical conduct and where we are heading as a society as opposed to where we ought to be going. I will start by attempting to define certain concepts which will run through the essay. Any false presuppositions will inevitably be carried through the essay, so please forgive me if you observe such preliminary errors as these. I will focus mostly on the ethics of conduct but the arguments will, no doubt, move relatively effortlessly into other spheres. I have taken the GPHC as the regulating body, the GPHC's Medicine, Ethics and Practice Guide and more specifically, the Standard of Conduct, Ethics and Performance as the manual of standards expected for pharmacists.

"If we have no peace, it is because we have forgotten that we belong to each other"-Mother Theresa

The Oxford English Dictionary gives the following definitions: Law: [mass noun] (often 'the law') the system of rules which a particular country or community recognizes as regulating the actions of its members and which it may enforce by the imposition of penalties Ethics: [usually treated as plural] moral principles that govern a person's behaviour or the conducting of an activity Morals: concerned with the principles of right and wrong behaviour Action: [mass noun] the fact or process of doing something, typically to achieve an aim Behaviour: the way in which one acts or conducts oneself, especially towards others . the way in which an animal or person behaves in response to a particular situation or stimulus . the way in which a machine or natural phenomenon works or functions

The GPHC's code of conduct is designed to place a standard on those entering the pharmacy profession, for those who come from different social, cultural or religious backgrounds. These differences potentially create disparities in the perceptions of right and wrong-that is the moral values they hold. These disparities, of course, are approached of in the relative sense, and exist according to what we here, in Great Britain, find morally acceptable. This highlights the subjective nature of morals and their application. Also, the code does well to prevent the legal implications of immoral decisions by pharmacists, in that they could also be illegal. Although the law stipulates that certain conduct is expected of the people, not all immoral decisions are illegal and in some cases not all moral decisions may be legal, adultery being an example of the former and choosing not to follow certain orders in the army, an example of the latter. I make the claim that following an ethical choice has priority over following the law, if such a conflict should ever arise. Of course there are many nuanced passageways that have brought things to where they are now. I am not competent enough to go into the history and philosophy of the law, but for now, the concept of its moral fallibility is key to the argument. The knowledge of morals, that is to say of what is right and wrong, and the application of this knowledge, that is ethics, can be said to be the key aim in life. It could be said that this is indeed the principal intention of education, philosophy, law and religion. The seemingly subjective nature of these rights and wrongs trouble each of us every single day and of course muddy the water, but the author is a proponent of the idea that objective rights and wrongs exist, if only the reasoning mind and, slightly more ambiguous, spiritual conscience are properly called upon.

An industrial process of producing a good comes about as people and machines take up roles within a particular system, taking a product from the supplier to consumer. And so we have the medicinal chemist, the pharmacologists, the formulation scientist, the manufacturers, the accountants, the administrative staff, the logistics team, the marketing team, the pharmacists and the patients (and probably a lot more that I don't know about). At each of these stages, what is each contributor in this industrial chain of supply working with the intention of? Is each individual involved expected to believe in the value of his or her contribution and how this is ultimately affecting their patients? Are any of them more or less morally distanced from the good (or bad), that the produced item presents? The code of conduct is a document in ethics. Ethics is concerned with morals and its application. Morals is concerned with what is right and wrong. How can a single profession, the end in a complex web of many, have a monopoly on the regulation of the rights and wrongs relevant to the whole process? Is not everyone involved morally responsible for the product and process, (for the latter, each profession to their own specialism)? The only way to attempt a justification of the difference in ethical standards expected is if we can prove that there is difference between the professions involved..which we can. The pharmacists are of course the end point in a chain of professionals. They are at the interface where the patient invests, if not only money, at least a sense of trust in the process.

Vitally, the pharmacists are not only supplying the product, but offering a service. The difference being that the product has its own intrinsic value-surely the responsibility of the previous professional in the chain (usually represented as the pharmaceutical company), but the pharmacist has the choice whether to supply the product or not. They must do this using their knowledge, both intellectual and experiential, favouring an evidence-based approach. This element of informed choice brings a whole flurry of moral intricacies into play. The pharmacist is accountable for the appropriateness of the supply of the drug, whereas the professionals further back in the process (and the pharmacists to some extent), are responsible for the supplied item (for e.g. the quality, environmental impact etc.). There is also the fact there is a law surrounding the production and distribution of medicines which pharmacists are expected to know and implement in unison with personal ethical decision making, always remembering that to behave as one sees ethically fit, is the priority. To imply that some of us are more answerable than others for our actions, because of where in the chain we work, seems quite absurd. But we can un-absurd it if we work in terms of consequence; that is to say the end outcome. As we mentioned earlier, the difference between producing a product and delivering a service brings its own justifications for specific ethical standards to be in place, simply because of the possibility of making an incorrect choice-making the wrong decision and the consequences that could ensue. It is true that there are specific ethical issues that will only be raised in the pharmacy setting, but essentially they will rely on core moral principles to be drawn on by the pharmacist. So what is wrong with following the 7 Principles that are outlined in the GPHC Code of Conduct'? The code of conduct is a reprehensibly patronising document, reeking of superficial pragmatism that has become the norm for our corporate society. This is a strong statement and is coming from one who feels they have been brought up in a stable, loving and educated family, who feels that they were imbued with the core values at the heart of the principles that the GPHC are attempting to glaze onto the memories of these students. As a society our actions need to be motivated by real values, such as love and truth. Not fear of litigation or penalisation by regulators. I will argue that the problem is not what the GPHC is asking of us in their code of conduct, it is the social conditions that have caused these codes to become necessary. It is not the principles that they declare, but the fact that this is all they are asking. And why is it all they are asking? Is it because the legal team feels this is all that is necessary? That brings us to the concept of professionalism. As subjects of the United Kingdom, we are well renowned for our professionalism..our diplomacy ..our manners..our superficiality..our insincerity.. Professionalism is a way of life, not unlike the religious traditions, nor unlike cultural traditions. It is a tradition, a way of life born of capitalism. From the industrialism that capitalism has enabled, do we increase the distance between the commodities supplied from the supplier. Never in our history have we been more distanced from the sources of our consumed goods. The all too familiar phrase "it's not personal, it's business" says all we need to say about the compromises we've made. And it is a way of life that, (at best, attempts to), guarantee a consistent behaviour but does not guarantee the quality of the source. Whereas a religious tradition, founded on love, causes you to 'Make patients your first concern' or a cultural tradition, founded on justice, may cause you to 'Be honest and trustworthy', to be professional requires you to just behave in this way. Behaviour, as opposed to action, is usually without purpose, and merely a response to a set of conditions. I believe that memorising and acting in accordance with (solely), the code of conduct is a response to a set of conditions, those offered by the Ethics and Practice exam and potential future litigations, rather than action; purposive, intentional and a coherent manifestation of deeper origin. And so professionalism has given us access to 'ends' -the 7 princciples, that do not necessitate any valuable means of reaching them; a certain, agreed upon behaviour, not unlike the law, both requiring adherence. Professionalism here in our United Kingdom has taken a somewhat scientific method to reach the conclusions seen in the latest MEP. It focuses on 'how' to be ethical (scratching the surface even of this), rather than the 'why'..and of course not knowing why, not only offers up a scientific insufficiency, but also a very moral one. Being told to 'show respect for others' because if you don't you could be struck off, without being told what constitutes respect, or disrespect for that matter, or why we should respect people, is very short sighted and authoritarian, but it is pragmatic; an ideal quality for the virulent loveless-ness infecting our healthcare system, itself set quaintly in the depths of an increasingly ends-oriented society. The 7 Principles are examples of such ends. They forego the root causes that bring them, and so many other valuable principles, into being. For example-'love thy neighbour'-love is a root for so much good-including every single one of the 7 Principles. Empathy, compassion, truth and justice, peace and contentment, to mention a few will also have a prolific effect on an individual and take them on a journey much more valuable than those principles we've outlined for Pharmacists. But is it the responsibility of the regulating body to establish core ideals in the population. No, of course not. It is the responsibility of parents and teachers to encourage education-education in the broadest sense such as that prescribed by John White in his book The Aims of Education for example. As with many problems in our society, we come to the defects in our education system. We have done well thus far to promote the love of science but we have abandoned such important aspects of the human condition that has left us in the state we find ourselves in. Who should be regulated to what levels of conduct and by whom? This conduct, not necessarily stemming from any significant moral source, just conduct. Instead of memorising what the right thing to do is, we need to know why it is the right thing to do. To be automata is to do, to be human is to ask why. Only by asking why, can we see that the essay title put forward is a misnomer; it is unfair that some are held to higher ethical standards of conduct than others, but only because it is unfair that we, as a society, are not already held to higher standards worthy of what it means to be human. Only because we have forgotten our true nature, a nature worthy of bowing angels. How has it been possible to go this far; drowning as individuals because we have forgotten how to fly as a family.

If we did invest a real education into our children, everyone would be encouraged to be ethical as people, not just as professionals. For we were people before we were professionals, were we not? And we expect patients to be respectful to us do we not? As people, we are servants of each other and we need to stop hiding between our corporate facades, get rid of customer service and bring in core values that make a person human, not just a subordinate cog in a machine. We need depth to our characters, not the superficiality that we have become so accustomed to. We need love, not just happy-to-help badges. We need trust, not just disclaimers and small print. We need peace, not just socially but in our hearts and minds. Argument against; The 7 principles are not intended to be a comprehensive course in ethical and moral practice. It is intended to ensure that, despite the moral grounding of students, a minimum set of key conduct measures are explicitly laid out. The origin of such conclusive behaviours is of concern but simply have not been encouraged since we are not a philosophy institution, we are a pharmacist institution. The behaviours expected of pharmacists are required end points of each students own personal moral journey. All we are saying is that these few behaviours should be adhered to, not that any deeper understanding into their origin, or that of any other behaviour for that matter, is not acceptable. Nor the continuation of this outside of pharmacy practice.

Did we think that the process of dehumanising ourselves would leave no ill effect? Were we so unwise as to think that the preoccupation of guaranteeing our financial and material security, although providing basic physical health, would not lead to the neglect of other necessities, namely those not pertaining to the body? The rational moralist has been forsaken for the scientific egoist, the loving servant has given way to the arrogant master-who shall remain so until evidence proves things should be otherwise. If we have two people; one is no longer accountable for the state of their being; that is to say the source of their actions, but only their actions. The other is accountable to both. One is the medicinal chemist responsible for the production of the now withdrawn Rofecoxib (Vioxx), while the other is responsible for the production of Paracetamol. Both intended to do patients well with their drugs (within dose range), but who, if found necessary to, should be taken to account, and on what account? It is understood that abiding by the law, or following certain regulators principles, are conditional requests. If you want to live in this county, you must abide by these laws or if you want to enter and practice in this profession you are bound by these principles. This is accepting of the fact that people are not expected to be morally autonomous in the said institution.

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