PEBC Medical Ethics and Law 4 — Questions and Answers
Question 1: A prescriber instructs a pharmacist via phone to dispense a controlled substance. Under most provincial regulations, the pharmacist must:
- Dispense immediately based on the verbal order alone
- Obtain a written or faxed prescription within the regulated timeframe (Correct answer)
- Decline because verbal orders for controlled substances are never permitted
- Dispense only half the prescribed quantity until written confirmation arrives
Correct answer: Obtain a written or faxed prescription within the regulated timeframe
Most provinces permit emergency verbal orders for controlled substances but require written confirmation within a specified period.
Question 2: The ethical principle of non-maleficence in pharmacy practice is best illustrated by:
- Ensuring equitable access to medications for all patients
- Screening for drug interactions before dispensing (Correct answer)
- Informing patients of all treatment options
- Advocating for patient rights in the healthcare system
Correct answer: Screening for drug interactions before dispensing
Non-maleficence — 'do no harm' — is demonstrated by proactively identifying and preventing harm such as drug interactions.
Question 3: A pharmacy student on rotation witnesses a preceptor pharmacist dispensing without completing a required counselling step. The student's best course of action is to:
- Ignore it to avoid jeopardizing the placement
- Raise the concern with the preceptor privately, then escalate if needed (Correct answer)
- Immediately file a complaint with the provincial regulatory college
- Complete the counselling themselves without informing anyone
Correct answer: Raise the concern with the preceptor privately, then escalate if needed
Professional responsibility requires addressing observed safety issues directly and respectfully before escalating through formal channels.
Question 4: Under Canadian privacy law, which of the following is a valid reason to disclose patient information without consent?
- A family member requests the information for caregiving
- A law enforcement officer presents a valid court order (Correct answer)
- The patient has not visited the pharmacy in over one year
- Another pharmacist in a different pharmacy chain asks for it
Correct answer: A law enforcement officer presents a valid court order
A valid court order or subpoena is a legally recognized basis for disclosing patient information without prior consent.
Question 5: A patient wants to purchase a large quantity of pseudoephedrine. The pharmacist's obligation under the Controlled Drugs and Substances Act (CDSA) is to:
- Refuse the sale entirely regardless of quantity
- Follow sale limits, record the transaction, and refuse if diversion is suspected (Correct answer)
- Require a prescription for any amount of pseudoephedrine
- Sell freely because pseudoephedrine is an OTC product
Correct answer: Follow sale limits, record the transaction, and refuse if diversion is suspected
The CDSA and provincial regulations limit pseudoephedrine sales, require records, and allow pharmacists to refuse sales suspected for illicit manufacture.
Question 6: Which of the following actions by a pharmacist would constitute a breach of confidentiality?
- Sharing a patient's medication list with their treating specialist
- Discussing a patient's medications with their employer without consent (Correct answer)
- Providing emergency information to paramedics treating an unconscious patient
- Reporting a patient's communicable disease to public health as required by law
Correct answer: Discussing a patient's medications with their employer without consent
Disclosing a patient's medication information to their employer without consent violates privacy legislation and professional ethics.
Question 7: A terminally ill patient asks a pharmacist about obtaining medications to end their life under Medical Assistance in Dying (MAID) legislation. The pharmacist should:
- Refuse to discuss the topic under any circumstances
- Provide accurate information about MAID eligibility and direct the patient to appropriate resources (Correct answer)
- Advise the patient that MAID is illegal in Canada
- Dispense the required medications without a MAID prescription
Correct answer: Provide accurate information about MAID eligibility and direct the patient to appropriate resources
MAID is legal in Canada under federal and provincial frameworks, and pharmacists have a duty to provide accurate information and refer appropriately.
PEBC Medical Ethics and Law 4
A prescriber instructs a pharmacist via phone to dispense a controlled substance.
Under most provincial regulations, the pharmacist must: