The updated Pharmacy Council mission statement for 2018
Our primary role is to protect the
health, safety and wellbeing of the publicprofits by ensuring pharmacistsare competent and fit to practisecan sell any quackery they like.#FixedThatForYou
From their About Us page:
The Pharmacy Council is established under the Health Practitioners Competence Assurance Act 2003 (HPCAA) and has a duty to protect the public and promote good pharmacist practice.
The Pharmacy Council used to have a reasonably good Code of Ethics (CoE 2011) that would prevent pharmacists from selling products with health claims that had no credible evidence. It was a broad and suitable for its purpose from the requirements set out in section 118(i) of the Health Practitioners Competence Assurance Act.
The Society for Science Based Healthcare(SBH) had started placing complaints to the Pharmacy Council about pharmacies selling products (homeopathy) that has no credible evidence.These pharmacies were clearly in breach of the Code of Ethics as it stood at that time.
Rather than uphold their own Code of Ethics the Pharmacy Council updated these to weaken the requirements and off load that responsibility to the Pharmacies they are supposed to be responsible for.
There are 2 main thoughts that I have on this.
- What happens when a pharmacy is now found to be not abiding by the new rules?
- What can we do from here?
What are the consequences?
Key points of interest in the new Code of Ethics 2018:
Principle 1: A pharmacist makes the health and wellbeing of the patient their first priority.
Clause H : Before recommending, supplying or promoting a medicine, complementary and/or alternative medicine or other healthcare product or service, considers available evidence, and only supplies a product when satisfied that it is appropriate, and the person understands how to use it correctly and safely.
Principle 4: A pharmacist acts with honesty and integrity and maintains public trust and confidence in the profession.
Clause H : Ensures that when providing any medicine, complementary and alternative medicine, or other healthcare product or service, that the health and wellbeing of the patient or consumer is the primary consideration, and that the benefit of use outweighs the risk.
Clause I : Does not engage in advertising, promotion or supply of goods or services that could include misleading or unsubstantiated claims, and/ or undermine public trust in the profession.
Looking at Principal 1 Clause H we end up with a scenario where the pharmacist and any customer facing staff are now required to become knowledgeable in pseudoscience in order to sell things like Homeopathy. If the process of "considering available evidence" was carried through to a rational conclusion things like Homeopathy would not be stocked at all. Due to the wording on the updated Code of Ethics 2018 this responsibility is upon the Pharmacist to make the call.
Principal 4 Clause H should result in alternative medicines being removed as anything that has not been proved to work, but still has a risk, will cause the risk/benefit ratio to be so high as to always put that into the "Nope" category. Risk, in this context, comes in many forms also. The risk of not treating something that may actually be a real thing that needs treatment and the risk of reinforcing the idea that alternatives to actual medicine are a real thing to name but a few.
Principal 4 Clause I is going to be problematic too. If alternatives to actual medicine are presented on the shelves alongside medicines that have credible evidence based on good quality research then they are going to have an advertising/promotion impact just by their proximity to real medicine.
What can we do from here?
I can see a few avenues going forward.
Testing pharmacies against the new Code of Ethics
Put the pharmacies to the test.
Have people go in and look for alternatives to actual medicine and grade them based on how they respond.
The SBH Seal of Approval
I think that the SBH could step in here. There's all sorts of accreditations that we see on business websites and windows these days. Having one that declares that "We won't sell you lies" is one that could be desired. Especially if it was done in conjunction with The New Zealand Medical Association and The Pharmacy Guild of New Zealand. While the updated Code of Ethics allows for alternatives to actual medicine to be sold there is still no reason that the Pharmacy Council couldn't also support this new accreditation.
Upheaval within the Pharmacy Council
Could a credible case be made against the Pharmacy Council that the new Code of Ethics puts them in breach of the Act? They have a "duty to protect the public and promote good pharmacist practice" under the Health Practitioners Competence Assurance Act 2003 (HPCAA). Could a reasonable argument be made that they are failing at this duty by "softening" the Code of Ethics they way they have?