Professional autonomy in pharmacists: Independence within interdependence

As the duties of pharmacists evolve it can be difficult for many to foster and maintain professional autonomy within both new and core roles. However, it is important for us to understand what autonomy actually means. Autonomy is a common word in every-day use describing a philosophical concept concerning an agent's capacity for self-determination. Professional standards typically try to ensure the required level of individual professional autonomy necessary for pharmacists to deliver care in the best interests of patients. Professional autonomy is a key factor in achieving job satisfaction, meaningful work, and flourishing in a professional role, and when inhibited can lead to negative career experiences and outcomes. Autonomy can however be understood both in this individual sense, linked to liberty and independence, but also in a collective sense, linked to relationships and societal empowerment. This paper examines how pharmacists have understood these differing conceptual views of professional autonomy to date, describing the theoretical basis for each, and then sketching a series of short scenarios that illustrate how the professional autonomy of individual pharmacists can be heavily influenced by many interdependent factors, including relational factors, employment factors, professional factors, and societal factors. Finally, the paper considers the principles and skills needed for pharmacists to create a more stable professional autonomy, both individually and collectively.