Assessment: Online Written response to ethics/legal/policy issues

Below is a hypothetical scenario.

Please discuss the scenario from an ethical, legal and policy point of view.

Scenario

You’re the pharmacist working at a rural community pharmacy in Victoria. Many of the people in the community are of a low socio-economic status. There is also a large proportion of people who are aged 70 or older and have retired. One day, the owner of the pharmacy comes in and asks you to come into the meeting room with him. He states that he wants you to sell at least one complementary product with every customer who gets a script dispensed, and every patient who you refer to the doctors.

He insists that ‘no one should walk out of the pharmacy empty handed’.

He also wants you to enforce generic substitutions on all patients unless the ‘No brand substitution allowed’ box is ticked. He also says that instead of ordering the same brand all the time, you should order the cheapest brand every time.

Immediately after your conversation with the owner, Mrs Smith comes in. She has been a regular customer for over 10 years and is on a regular medication for her diabetes. The owner talks with her and tells her that he is going to “do her a favour” by giving her the generic medication this time, which is “just the same as the one she normally gets, just less expensive”. You can see that Mrs Smith is very reluctant, as she has poor eyesight and tries to remember her medications by the colour of the boxes. The diabetic medication she usually takes comes in a green box, but the new generic the owner is giving her comes in a white box.

The following day you see a prescription for oxycodone, a strong opioid medication that is S8. You notice that the doctor’s signature is missing, and you question the legitimacy of the script. You try to call up the clinic, but it is closed. The customer who brought in the script says he is a friend of the pharmacy owner and he gets it dispensed here all the time. Looking up his dispensing history you notice that the customer has only been to the pharmacy twice and the owner has always been the one dispensing it. You then receive a phone call from the owner who tells you that the script is perfectly fine, and you can dispense it. A week later the owner comes back. He pulls you aside and tells you that he has been keeping a close eye on sales figures and that your companion sales figures are the lowest. The owner tells you that you need to “up your game” and that there are “plenty of young pharmacists who would like your job –you can leave if you don’t like it”.