PEBC Medical Ethics and Law 2 — Questions and Answers
Question 1: A patient refuses a life-saving blood transfusion on religious grounds. The pharmacist's primary ethical obligation is to:
- Override the refusal to save the patient's life
- Respect the patient's autonomous decision (Correct answer)
- Contact the patient's family to convince them otherwise
- Administer the medication without consent
Correct answer: Respect the patient's autonomous decision
Respect for patient autonomy means honouring a competent adult's informed refusal of treatment, even life-saving treatment.
Question 2: Under Canadian pharmacy law, which document authorizes a pharmacist to adapt a prescription by changing the dose?
- A verbal order from the prescriber
- Provincial pharmacy regulations permitting adaptation (Correct answer)
- The patient's written request
- A physician's standing order
Correct answer: Provincial pharmacy regulations permitting adaptation
Each province's pharmacy regulations define the scope of pharmacist adaptation authority, including dose changes.
Question 3: The ethical principle of justice in pharmacy practice primarily concerns:
- Keeping patient information confidential
- Distributing healthcare resources fairly and equitably (Correct answer)
- Acting in the patient's best interest
- Telling the truth to patients
Correct answer: Distributing healthcare resources fairly and equitably
Justice refers to fair distribution of benefits and burdens across patients and society, including equitable access to medications.
Question 4: A pharmacist discovers a dispensing error made by a colleague that did not harm the patient. What is the most appropriate action?
- Ignore it since no harm occurred
- Report it to the pharmacy manager and document it per incident reporting policy (Correct answer)
- Speak only to the colleague privately and take no further action
- File a complaint directly with the provincial college
Correct answer: Report it to the pharmacy manager and document it per incident reporting policy
Near-miss errors must be reported internally and documented to improve systems and prevent future harm.
Question 5: Which of the following best describes 'therapeutic privilege' in the context of informed consent?
- A pharmacist's right to substitute a generic drug
- Withholding information from a patient believing disclosure would cause harm (Correct answer)
- The prescriber's authority to override a pharmacist's recommendation
- A patient's right to access their own medical records
Correct answer: Withholding information from a patient believing disclosure would cause harm
Therapeutic privilege is a controversial doctrine where a clinician withholds information to prevent psychological harm, but it is rarely ethically justified.
Question 6: A patient asks a pharmacist not to share their HIV medication history with their family physician. The pharmacist should:
- Share the information anyway because the physician needs it for patient safety
- Honour the request unless there is an overriding public safety concern (Correct answer)
- Refuse to dispense the medication until the patient consents to disclosure
- Report the situation to the provincial college immediately
Correct answer: Honour the request unless there is an overriding public safety concern
Patient confidentiality must be respected; disclosure without consent is only justified in specific legally defined circumstances.
Question 7: When a pharmacist has a conscientious objection to dispensing a legally prescribed medication, the primary duty is to:
- Refuse the prescription without explanation
- Ensure the patient receives timely access to care through referral or transfer (Correct answer)
- Contact the prescriber and request a different medication
- Post a notice in the pharmacy about objected medications
Correct answer: Ensure the patient receives timely access to care through referral or transfer
While pharmacists may exercise conscientious objection, they must not abandon the patient and must facilitate access to the medication elsewhere.
PEBC Medical Ethics and Law 2
A patient refuses a life-saving blood transfusion on religious grounds.
The pharmacist's primary ethical obligation is to: