Ethical questions arise in all areas of our Hospital. Our faces of ethics feature highlights different roles/departments in our organization and how ethics is relevant to their work.

What does your department do?

The pharmacy department is responsible for supplying medications to all patient care areas in the hospital. Pharmacy can be divided in to the operational functions of drug distribution such as procuring, manufacturing, compounding, and dispensing medications as well as clinical services such as clinically reviewing every order for appropriateness, dosing and monitoring antibiotics and total parenteral nutrition, medication reconciliation, drug therapy monitoring, and adjusting doses based on renal function to name but a few.

What ethics questions come up in your area?

Various ethical issues come up in our area. Pharmacy is often seen as the ‘gatekeepers of the drug supply’. This has been especially true during the pandemic where supplies of certain medications, specifically new therapeutics for COVID-19 have been limited. Balancing individual patient needs with our responsibility to work within provincial eligibility requirements is a common resource allocation scenario.

Matters of conscience & personal choice (autonomy) also come up for us in the decision to participate in Medical Assistance in Dying (MAiD). Pharmacist are involved in processing and checking the accuracy of the orders as well as dispensing the products to the physician and submitting documentation to health Canada, while technicians are involved in the physical preparation of the medications.

As health care providers who specialize in medications, substance use disorder and addictions are also a growing source of patient referrals. At times the health care system can seem set up to treat the symptom (e.g. cellulitis, sepsis, endocarditis, overdose, physical traumas) and offer little to no evidence based treatment for substance use disorder. Supporting access to comprehensive addictions medicine services and resources is a growing need in our community and advocating for these resources raises many ethical questions.

Ethics affects us all. Anyone struggling with an ethics question can contact the Bioethicist for support or access decision-making resources on the intranet.

Bioethicist: Michelle Allain – allainm@tbh.net, Ext. 6538