JMIR Publications

ABSTRACT

Background:

Patients who access e-pharmacy appreciate its benefits, such as privacy and accessibility, but need to be aware of the health and safety risks they may face. These risks can be minimized by implementing sound legal and ethical frameworks. When working in e-pharmacy, the European pharmacists need to respect the legal framework that applies to selling medicines at a distance and the rules of professional ethics, considering the specific benefits and risks related to an online therapeutic relationship with patients.

Objective:

The objectives of the present work were 1) to analyze the codes of ethics of pharmacists in the European Union (EU) and European Economic Area (EEA) Member States to find out to what extent they address e-pharmacy, and 2) to propose an ethical framework for the European pharmacists in e-pharmacy, which could be useful for the development of their codes of ethics and their professional conduct in this context.

Methods:

We identified and collected pharmacists' codes of ethics and other relevant documents through documentary research on the websites of professional associations and other competent national regulatory authorities. We subjected these documents to a thematic analysis to find provisions related to e-pharmacy and the specific issues addressed. We proposed an ethical framework for the European pharmacists in e-pharmacy, based on the fundamental principles of biomedical ethics and following a reiterative process of reflection and discussion on their significance in the context of e-pharmacy.

Results:

Professional associations of European pharmacists and other national competent authorities have different approaches to e-pharmacy ethics, as reflected in the codes of professional ethics and other guidance documents for pharmacists they have adopted. In the majority of EU and EEA Member States pharmacists' codes of ethics do not contain rules addressing e-pharmacy. Only in eight countries, pharmacists' conduct in e-pharmacy is guided by more or less detailed rules aimed at ensuring that patients' rights are respected in the at a distance supply of medicines, other health products and services. Considering these findings, building a common ethical framework for the European pharmacists in e-pharmacy would be helpful for the development of ethics in their conduct on the internet. The framework we propose contains ethical issues that should be addressed by specific norms in the pharmacists' codes of ethics and/or other dedicated guidelines, ranging from giving patients the choice of e-pharmacy to showing solidarity in the global e-pharmacy environment.

Conclusions:

A comprehensive approach to e-pharmacy ethics in a shared framework for European pharmacists would contribute to a better understanding and valorization of the opportunities offered by the rapid evolution of new technologies to develop their online services, to improve patients' health in an environment of autonomy, equity and solidarity.