Mpharm 4 phar0037 law & ethics case studies
MPharm 4 PHAR0037 Law & Ethics Case Studies
The aim of this study is to develop your-problem solving skills when faced with legal and ethical problems in pharmacy practice.
Objectives Following your revision and completion of this background work you will be expected to:-
• Understand the legal requirements of the Medicines Act 1968 concerning the
appropriate supply of prescription only medicines
• Understand how the Misuse of Drugs Act 1971 restricts your ability to supply
• Apply a structured problem-solving approach to "real world" ethical
Please work through the following cases, most of which are real and not fictitious. You may find the ethical problem-solving structure that was presented to you in the 3' year helpful in providing a systematic approach. Talking through the cases with a
colleague is perfectly acceptable once your have given each case some initial thought.
Prepare answers to each case which will be discussed in the lecture in week 10.
Students will be drawn at random to present answers.
1. It is 12.45pm on Sunday rota, and you are due to close in 15 minutes. One of
your methadone addicts arrives wanting methadone as he forgot his "daily pickup" on Saturday. On examining his prescription, methadone is prescribed 40ml each day under supervised consumption with Sunday's dose "normally to be supplied on Saturday".
2. You are the owner of a small group of pharmacies. Business on Saturday
afternoons at one of your branches has progressively declined, to the point where the income from dispensing and sales of pharmacy medicines no longer covers the cost of paying a pharmacist. You are therefore considering keeping the branch open on Saturday afternoons without a pharmacist as a 'drug store', to sell non-medicinal goods and GSL medicines. You intend to instruct the
staff both verbally and in writing not to sell any pharmacy medicines or hand out prescriptions and would leave prominent notices to this effect for the customers to see.
Is what you are considering permissible?
3. Late on Saturday evening a supermarket pharmacy received a prescription for
5 Cyclimorph injections. The pharmacist checked the CD cupboard to find the only ones in stock had been returned unopened by the relatives of a deceased patient.
4. The mother of one of your Satuday assistants phones you and wants to know
what Dianette is for. She found a box in the daughter's bedroom that had been supplied by you a couple of weeks earlier.
5. You receive an FP10(HP) for 7 fluoxetine 20mg capsules one o.d. for an 11
year old. Fluoxetine is not licensed in the under 16s.
6. It is 5.20pm on a Saturday evening and an Australian lady comes into your
pharmacy wanting a bottle of flucloxacillin elixir 250mg /5ml for her 10 year old son who has cystic fibrosis and has an acute lower respiratory infection.
When giving a dose earlier in the afternoon she dropped and smashed the
bottle. The family are visiting the UK to attend a wedding, and the medicine was prescribed and dispensed in Melbourne two days earlier.
7. It is 11.30 on a Sunday morning and you are open for rota until 12 noon. A
nurse appears with a prescription for five Diamorphine 30mg ampoules and water for injections. The prescription is legally valid but you do not know the patient or GP. You do not have the item in stock but do have 15 Diamorphine
lOmg ampoules. What will you do? No other convenient pharmacy is open
8. On Saturday afternoon a lady telephones you saying she has a dental abscess
and wants to know if she could use some other husband's Amoxil antibiotics. The husband regularly suffers from abscesses associated with an impacted wisdom tooth and always has a reserve course of antibiotic to hand.
9 A patient presents you with a private prescription from an optician for
chloramphenical eye drops 0.5% and timolol eye drops 0.25 %.
Are you able to dispense this prescription? If this prescription had been written by a dentist would you be able to supply
10 A pre-registration pharmacist dispensed a prescription for Levonelle 2. She
asked the pharmacist to check the prescription. However, the pharmacist refused stating that she did not support the use of post-coital contraception as
What should the pre-reg do? . Was the pharmacist right in expressing her personal or religious views in this way?
11 A person you know is a doctor in a local hospital presents you with a
FP10(HP) prescription for 100 Temazepam Tablets l0mg made out to himself.
A local dentist presents you with a similar private prescription. Both prescriptions are written in accordance with the necessary legal requirements.
12 On 10th January 2000 Mrs Y entered a pharmacy owned by X Ltd. Her valid
private prescription, dated the previous day, for 21 butobarbitone 100mg tablets was dispensed by a young locum pharmacist, recorded in the
prescription book and handed back to Mrs Y without it being endorsed in any
way. Mys Y returned to the pharmacy on 24th January 2000 and presented the prescription to the pharmacist in charge, who dispensed the prescription,
endorsed it with the name and address of the pharmacy and the date of dispensing and retained it in the prescription file.
Mrs Y demanded her prescription back and the pharmacist in charge refused, but eventually agreed to write out a copy which Mrs Y could keep for reference. On 12th October 2000 Mrs Y returned to the pharmacy and presented the prescription copy to another locum pharmacist who dispensed
the tablets and endorsed the copy prescription 'repeated on 12.10.00' then
recorded this repeat in the prescription book before handing it back to Mrs Y.
What offences were committed under current legislation in making the above supplies?
Hessische Fachvereinigung für Diabetes e.V. (HFD) Sitz: Giessen Gründungsdatum: 14.08.1996 Vorsitzender: Prof. Dr. med. Hermann-Joachim Glaser Abteilung für Allgemeine Innere Medizin und Gastroenterologie Herz-Jesu-Krankenhaus Buttlarstr. 74 36039 Fulda Stv. Vorsitzende: Dr. med. Cornelia Marck Giessener Str. 12 35415 Pohlheim Schatzmeister : Michael Simonsohn Mainzer Landstr. 2
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