Conscientious objection in pharmacist codes of ethics: An international comparison through document analysis

Background

Conscientious objection (CO) in pharmacy refers to the refusal to provide certain services based on moral or religious beliefs. Person-centred care helps to carve a way forward in balancing the duality of private conscience and public role expectations of the pharmacist. While individual conscience is a factor, pharmacists must also adhere to professional, legal, and regulatory standards. This interplay highlights the need for clear, context-sensitive guidance for both pharmacists and patients to ensure equitable access to services.

Objective

This review aimed to explore and understand the similarities, differences, and limits across international pharmacist codes of ethics in relation to CO clauses.

Methods

The document search focused on a list of OECD member countries. The International Federation of Pharmacists (FIP) website assisted with the identification of relevant regulatory pharmacist organisations (POs) within OECD countries. Information on Codes of Ethics and CO clauses published in English were gathered from POs' websites using specific keywords. Document analysis was employed to qualitatively examine individual Codes of Ethics.

Results

A survey of OECD countries (n = 38) identified 96 relevant documents pertaining to pharmacist Codes of Ethics or legislation on CO. Of these, 24 Codes of Ethics in English were identified, 12 of which explicitly mentioned CO. Among these, nine explicitly permitted CO, while six inferred it through moral, religious, or personal grounds. Most (n = 11) emphasized the importance of maintaining continuity of care to ensure patient access to services.

Conclusion

There are similarities and differences in Codes of Ethics governing pharmacists' CO worldwide, suggesting variability in practice norms. Consistent guidance across jurisdictions is needed to safeguard patients' rights to access treatment. Future studies on how pharmacists apply ethical codes in CO scenarios could provide valuable insights for updating professional regulatory standards.