Pogled splošne populacije na uveljavljanje ugovora vesti pri lekarniških farmacevtih

Kralj, Ana Marija (author), Horvat, Nejc (mentor)

Uveljavljanje ugovora vesti se nanaša na farmacevte, ki zavračajo izdajo zdravil na podlagi moralnih ali verskih prepričanj. Pri tem nastane etična dilema, saj pride do trka osebnega prepričanja z osnovnimi etičnimi načeli (avtonomnost pacienta, zaupnost, pravičnost, ne škoditi pacientu, koristiti pacientu). V Sloveniji je to področje še neraziskano. Naš namen je bil preveriti seznanjenost in odnos splošne populacije do uveljavljanja ugovora vesti pri lekarniških farmacevtih, proučiti pogled pacientov na zakonsko urejenost tega področja in ugotoviti, kakšne osebne izkušnje imajo z zavrnitvijo izdaje zdravil. Za pridobitve celostnega pogleda smo povzeli etične kodekse in zakone v Republiki Sloveniji, ki se nanašajo na ugovor vesti pri lekarniških farmacevtih. Po sistematičnem pregledu strokovnih člankov v podatkovni bazi Pubmed pa smo se lotili oblikovanja vprašalnika za spletno anketo. Statistično analizo smo izvedli s programom SPSS. Pacienti se sicer večinsko strinjajo s pravico farmacevta do ugovora vesti, hkrati pa bi si želeli stalne prisotnosti farmacevta brez ugovora vesti, kar pa predstavlja organizacijski problem za vodstvo lekarne. Tako lahko farmacevti, ki sicer imajo zakonsko pravico do ugovora vesti, to koristijo le, če jim jo delodajalec odobri. Predvidevanja, da je farmacevtov z ugovorom vesti zelo malo, pa so se potrdila z redkimi izkušnjami pacientov, ki so se ob zavrnitvi najpogosteje počutili presenečeno, zaskrbljeno, jezno in razočarano. Ugotovili smo tudi, da bi ateisti ob zavrnitvi izdaje zdravila pogosteje pravno ukrepali kot verniki, ter da pacienti z nižjo izobrazbo v večji meri pričakujejo, da bo farmacevt kljub svojemu ugovoru vesti v nujnih primerih izdal zdravilo. Statistična obdelava rezultatov je pokazala, da so pacienti z višjo izobrazbo in ateisti ugovoru vesti lekarniških farmacevtov manj naklonjeni, medtem ko spol in starost pacientov nimata statistično značilnega vpliva. Raziskava je pokazala potrebo po jasnejših smernicah in zakonih glede uveljavljanja ugovora vesti. To vključuje opredelitev okoliščin, v katerih je ugovor vesti dopusten, in postopke, ki jih je treba upoštevati, da ne bi bila ogrožena oskrba pacientov. Poleg tega je treba okrepiti komunikacijske in izobraževalne strategije za seznanjanje farmacevtov in splošne javnosti o tej tematiki. Zaželena bi bila tudi usposabljanja farmacevtov o njihovi etični odgovornosti in občutljivi komunikaciji s pacienti pri uveljavljanju ugovora vesti.

• Language: Slovenian
• Keywords: ugovor vesti, etična dilema, seznanjenost, smernice, zakonodaja, pravice
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2024
• PID: 20.500.12556/RUL-162467
• Publication date in RUL: 24.09.2024

Secondary language

• Language: English
• Title: General population's perspective on the practice of pharmacists conscientious objection

Abstract

Conscientious objection refers to pharmacists refusing to dispense medicines based on moral or religious beliefs. This creates an ethical dilemma as personal beliefs conflict with basic ethical principles (patient autonomy, confidentiality, fairness, non-maleficence, beneficence). This area remains unexplored in Slovenia. Our aim was to examine the general population's awareness of and attitudes towards pharmacists exercising conscientious objection; to investigate patients' views on legal regulation of this area; and to uncover their personal experiences with medication dispensing refusals. To obtain a holistic view, we summarized the codes of ethics and laws in the Republic of Slovenia relating to pharmacists' conscientious objection. After a systematic review of expert articles in the PubMed database, we designed a questionnaire for an online survey. Statistical analysis was performed using SPSS. While patients largely agree with pharmacists' right to conscientious objection, they prefer having a pharmacist without conscientious objection available at all times, posing an organizational challenge for management. Consequently, pharmacists with a legal right to conscientious objection can only exercise it if their employer permits. The assumption that few pharmacists claim conscientious objection was confirmed by patients' rare experiences. When refused, patients most often felt surprised, anxious, angry, and frustrated. We found that atheists were more likely to take legal action than religious individuals when denied medication. Additionally, less educated patients were more likely to expect pharmacists to dispense medication in emergencies despite conscientious objection. Statistical analysis showed that patients with higher education and atheists are less tolerant of conscientious objection, while gender and age have no statistically significant effect. The survey highlighted the need for clearer guidelines and laws on implementing conscientious objection. This includes defining admissible circumstances for conscientious objection and procedures to ensure uncompromised patient care. Communication and education strategies should be enhanced to inform pharmacists and the general public on the subject. Training pharmacists on their ethical responsibilities and sensitive communication with patients when exercising conscientious objection would also be beneficial.

• Keywords: conscientious objection, ethical dilemma, awareness, guidelines, legislation, rights