Ethical dilemmas in pharmacy practice: a cross-sectional study of attitudes and perceptions among pharmacists in...

This study aimed to assess pharmacists' perceptions and attitudes toward selected ethical dilemmas, as well as their views on professional and business-related conduct within pharmacy practice.

A cross-sectional study was conducted among licenced pharmacists in Palestine using a self-administered questionnaire distributed through convenience sampling. The questionnaire comprised three sections: socio-demographic and professional characteristics, responses to ethical scenarios, and perceptions regarding unethical business practices and generic substitution.

Of the 355 pharmacists contacted, 267 participated. The average ethical attitude score was 71.1%. No significant differences in ethical attitudes were found based on age, sex, work experience, or geographic location (P > .05). However, marital status and professional role were significantly associated with ethical scores: married pharmacists scored higher than single counterparts (19.5 ± 3.08 vs. 18.5 ± 2.93; P = .017), and pharmacy owners scored higher than employed pharmacists (19.94 ± 3.29 vs. 18.73 ± 3.11; P = .025). The most frequently cited pharmacy business practices that participants considered unethical and wished to eliminate included unfair competition concerns, including predatory pricing and unauthorized price reductions (38.6%), followed by unfair treatment of staff (20.2%). Additionally, 65.2% of respondents viewed generic substitution as an ethical and legal practice.

This study provides novel insights into the ethical attitudes and challenges faced by pharmacists in Palestine. The findings emphasize the urgent need for Palestinian health authorities and the Palestine Pharmacists' Association to develop and implement a comprehensive, contextually relevant code of ethics and promote professional accountability in the pharmacy sector.