10 October 2017
Dr Sara Fovargue shares details of her research project; 'Pharmacists' perceptions of ethical conflict and professional guidance in light of the revised General Pharmaceutical Council Standards of Conduct, Ethics and Performance.' The pilot study, a collaboration with Dr Mary Neal (University of Strathclyde) is being funded by a BA/Leverhulme Small Research Grant.

I have been working with my colleague Dr Mary Neal, from the University of Strathclyde, looking at conscientious objection (CO) in health care practice, including the permissibility and scope of CO, and the link between moral integrity and CO (M Neal, S Fovargue, ‘Conscience and agent-integrity: A defence of conscience-based exemptions in the health care context’ (2016) 24 Medical Law Review 544-570; S Fovargue, M Neal, ‘“In good conscience”: Conscience-based exemptions and proper medical treatment’ (2015) 23 Medical Law Review 221-241). Often in these debates, it is claimed that any conflict between private values and professional (public) values should be resolved in favour of the latter, and that ‘professional values’ are the only values which may permissibly influence the performance of health professionals’ roles.

Mary and I have been awarded funding under the British Academy/Leverhulme Small Research Grants scheme for a pilot study in which we will interview pharmacists working around the UK. We will ask pharmacy professionals about their experiences of, and views on, conflict between personal values and professional expectations, about their engagement with professional ethics guidance generally, and about their perceptions of the General Pharmaceutical Council’s (GPhC) newly-published Standards for Pharmacy Professionals (2017) and Guidance on religion, personal values and beliefs (2017).

The changes included in the draft guidance, sent out for consultation in December 2016, altered expectations on pharmacists whose personal beliefs conflict with elements of their professional roles, significantly shifting the balance in favour of the interests of those who use pharmacy services (GPhC, Consultation on religion, personal values and beliefs (2016)). However, under the published Standard 1, pharmacy professionals must provide ‘person-centred care’, and it is said that ‘People receive safe and effective care when pharmacy professionals recognise their own values and beliefs but do not impose them on other people’, and ‘take responsibility for ensuring that person-centred care is not compromised because of personal values and beliefs’ (GPhC, Standards for Pharmacy Professionals (2017)). In the specific guidance on religion, personal values and beliefs, the GPhC states that ‘Pharmacy professionals have the right to practise in line with their religion, personal values or beliefs as long as they act in accordance with equalities and human rights law and make sure that person-centred care is not compromised’ (GPhC, In practice: Guidance on religion, personal values and beliefs (2017)).

While these changes are taking place, proposals are being debated which would directly involve pharmacists in controversial practices, such as the ongoing efforts to legalise assisted dying (see, for example, the Assisted Dying Bill [HL] 2016-17) and proposals for ‘abortion on prescription’, connected with the campaign to decriminalise abortion. This makes our study both important and timely.

At present, in the UK, only two statutes specifically provide for CO: the Abortion Act 1967 and the Human Fertilisation and Embryology Act 1990. Under Article 9 of the European Convention of Human Rights, there is also a qualified human right to ‘freedom of conscience’. As well as this legal protection, there is a wealth of professional guidance which seems to support CO in other contexts (see, for example, General Medial Council, Good Medical Practice (2014), British Medical Association, ‘Expression of doctors’ beliefs’ (2016)).

To date, research in this area has largely focused on CO in relation to medical professionals. Our study will focus on pharmacists, however, in the light of the controversy surrounding the GPhC’s new Standards and Guidance, and we will interview up to 40 pharmacists across the UK asking about:

(i) their general impressions, thoughts and feelings about the revised GPhC’s Standards,

(ii) their perceptions of, and involvement in, the processes by which professional ethical guidance is created (including any factors making involvement less likely),

(iii) their sense of the role of values in their practice and the place of ethics guidance as a source of key values, and

(iv) their experiences of, and views about, conflict between their personal ethical commitments and the expectations associated with their professional roles.

Our intention is for this to be a pilot study for a larger project exploring the normative authority of professional ethics guidance in healthcare more generally.

Find out more about Sara's research here.