National Medicines Information Training Course

Law and Ethics workshop

Scenario 1

You receive a call in MI from the local police. During the course of an investigation the police officers have arrested a women and she is being held for questioning. She is not very co-operative and she is not answering any questions in connection with the crime under investigation.

Unfortunately, she us also not answering questions regarding some tablets that were found on her. These tablets are in an unlabelled bottle, and the police officer on the phone describes them to you and asks you to tell him what they are. The markings are fairly distinctive and together with the colour and shape you reckon there is a good chance Tic-Tac will identify them for you.

 Would you comply with a request from the police to identify these tablets?

 What are the implications in this case of identifying the tablets?

Maggie Fitzgerald January 2010 You put the phone down without agreeing to answer the query, but you do agree to call back after discussion with another member of your team.

You’re curious about what the tablet might be so you look on Tic-Tac anyway – the tablets are unequivocally identified as a generic form of carbamazepine.

 Would you comply with a request from the police to identify these tablets? Is so, how much information will you give?

 What are the implications of not identifying the tablets?

Maggie Fitzgerald January 2010 National Medicines Information Training Course

Scenario 2

A member of the public contacts you by telephone. He asks about how long drugs stay in the body. On questioning, the drug in question is cannabis which he smokes at weekends. He has an interview tomorrow (Tuesday) and knows they will ask for a urine sample to test for drugs.

1) Summarise the key legal and/or ethical issues in this case

2) As a Pharmacist how would you deal with the situation?

Scenario 3 A young woman phones you in Medicines Information to ask for your help. She has been taking Danol for “heavy periods” and discovered 2 weeks ago that she is pregnant. Her doctor has told her that the baby will be malformed and that she must have an abortion. She asks you to explain what Danol does to the baby and whether there is any chance that the doctor could be wrong.

On further questioning, you find out that she has seen two other doctors in the practice and they have also said that she must have an abortion; she has even attended a clinic as arranged by her doctor and found out that it was a “termination” clinic.

She is not married and there are problems with her boyfriend who feels that she shouldn’t have the baby if it is going to be damaged.

Scenario 4

A mother phones asking for identification of a tablet that she has found down the side of a sofa at home. She thinks that it is her daughter’s and knows that her daughter is taking a course of erythromycin. She has asked her daughter if this is her tablet and her daughter says that it is one of her erythromycin tablets.

The mother says that the tablet is white and round with a letter “e” stamped on it. She doesn’t believe her daughter and suspects that it might be ecstasy as her daughter mixes with a rather unsuitable crowd at the school

Scenario 5

A solicitor calls asking whether cimetidine can interfere with a breathalyser test. He has a client who is being charged with a drink-driving offence and he thinks that the medication may have resulted in a false positive test result.

Scenario 6 You are a ward Pharmacist on a general medical ward. One of the patients on the ward is being treated for a chest infection with amoxicillin, ciprofloxacin and erythromycin and is puzzling the doctors as he is not responding to treatment. The doctors are due to present this case at a meeting the following day and have asked you to talk to the patient to get a medication history.

During the course of this conversation, the patient tells you in confidence behind the curtains, that he has a problem. While at a conference six months ago, he went to a gay bar as a joke with a friend and ended up in bed with some guy. The patient fears that he is HIV positive. He asks you not to tell anyone as he is terrified of losing his wife and job. He is married with three children and is a practising dentist

Scenario 7

A member of public telephones MI towards the end of the day. It is a gentleman who initially starts to ask you about the side effects of an antidepressant he is taking, prescribed by the doctor, but you quickly realise all is not well. As the conversation progresses, you can hear that the caller is very distressed. His sentences are interrupted by what appears to be muffled sobs, and you suspect that he is crying on the phone. While you are trying to decide how to handle the call, the caller finally asks, “Also, what dose might kill me?”

 What is going through your mind at this point?

 Consider the factors that come into play in this scenario under each of the bioethical principles:

o Beneficence

o Non-maleficence

o Autonomy

o Justice

 Would you give the answer? Why or why not?

Maggie Fitzgerald January 2010 The callers last question has left you reeling – its the last thing you expected. However, he then proceeds to tell you he is severely depressed and that in a moment of desperation, he has taken a large quantity of his tablets only minutes ago. Indeed, he thinks he can begin to feel the effects, and hence his questions.

He is now desperate to know whether he needs to get help and where from. He is sorry that he took the overdose and wants to remedy the situation.