The following is a report of a presentation given to branch representatives by Professor Nick Barber (professor of the practice of pharmacy, London university)
Some of the most difficult parts of the pharmacist's job were making value judgments, said Professor NICK Barber. Values were as important to pharmacists as they were to everyone. It was important to be aware of them, and to learn from other disciplines about them. The document "Developing pharmacy values: stimulating the debate", which was being launched at the BRM, was designed to stimulate the debate, not to be authoritative. A Core Values Group had been set up a year ago, and Alan Cribb (deputy director for public policy research at King's) had been asked to write a discussion paper to stimulate thought. He hoped the document would stand out among the professions as a piece of work which would move the debate forward.
|
Nick Barber: essential to understand values |
Dilemmas in health policy, issues about priority settings and new medicines, and the relationship with the patient were all areas in which pharmacists could become involved. The world was changing. In the United Kingdom there was a cultural and religious pluralism which had never been seen before. Society was becoming ambivalent about science and technology. Audit, appraisal and clinical governance were all being introduced.There were new forms of institutional and professional accountability and increasing regulation of the professions. Health policy issues involved everybody. There was increased consumerism in health care.
Before being drawn into the debate, it was essential to understand values. The document asked whether there were values. A good place to start talking about values was to know yourself better. The document suggested two options. First, values were at the margin of pharmacy, which was implausible. If values were at the core of pharmacy, they should be treated in an organised manner. A revision of the Code of Ethics was taking place currently, which improved the focus, but ethics were not the same as values; they were part of them. For example, in dealing with health policy a professional code of ethics was not much help. There was a general group of professional values, like being accountable for your actions, being trustworthy, and showing respect for people. There were also vocational values. Pharmacists were based in the material world. With the exception of radiographers, they were the only profession dealing with physical objects. One of the key elements was the stewardship of poisons. It was necessary to be meticulous, attentive and responsive to people's needs.
An area which was not talked about enough was the area of institutional values. The document asked for value literacy so that people were comfortable with the various terms used. Learning from experience was part of the process of accumulating values, and pharmacists needed to have a reflective awareness. They needed to be sensitive to ethical issues. Public attitudes moved on and professional ethics were often left behind, as demonstrated by the recent publicity about removal of babies' organs. Pharmacists needed mediation skills. One of the most difficult things was coping with uncertainty and indeterminacy. There were always issues of contention, which a science-based profession might be uncomfortable in handling. Perhaps there should be an undergraduate course in "Medicines, values and society". It was necessary to get the academics involved in the humanities, social sciences and philosophy.
The document was designed to stimulate debate and should be read in that light, with a pen in the hand. It should be taken back to branches for discussion and reflection. It was not enough to say one disagreed or agreed with the document; reasons why should be explored and explained. It was clear the future of pharmacy depended on engaging with values. This was the start of the process.
The President (Mrs Christine Glover) congratulated the previous President, Mr Hemant Patel, on having pushed for the production of such a document. This was an interesting area and one that had not been explored sufficiently in the past. Responses, she said, should be sent directly to Professor Barber at the School of Pharmacy, University of London, 29-39 Brunswick Square, London WC1N 1AX.