Tutorial+1+Case+4

= Tutorial 1 Case 4 =

//A regular methadone client Bob presents daily to your pharmacy for his dose as usual. Bob has been a client at your pharmacy for over two years and has been stable on 25mg of methadone for over a year now. He has no take‐away dose entitlements and his prescription expired yesterday. Bob presents at 5.45pm and requests his regular dose. He tells you that he is unable to get a new script because his doctor is on holidays at the moment. Bob claims that the discomfort of not having his dose will not enable him to look after his two year old son tonight. You try to contact the doctor to verify whether he is on holidays, but the medical clinic closes after 5.30pm.//

Ethical Issue
Dispensing methadone without a script

Not giving methadone
__Reasons why:__ - cannot dispense without a prescription - patient should know policies (should have come in at an earlier time) - patient does not have dose entitlements (not trustworthy enough) - methadone is long acting, one missed dose may not affect instantly (may be debatable) - doctor may have warned him previously about his holiday - pharmacist may be seen as easy to manipulate (to the other methadoners) if methadone was dispensed

__Outcomes:__ - good consequences for the pharmacist (did not break the rules, not seen as easily manipulated) - bad consequences for the patient and child (withdrawal symptoms, danger for child, may use heroin instead)

Giving methadone
__Reasons why:__ - regular customer, therefore trustworthy - ensure child is safe (not on withdrawal) - ensure patient does not resort to taking heroin (whole point of the methadone program) - satisfy/serve customers needs

__Outcomes:__ - patient is happy, child is look after better - pharmacy is a target for methadone patients (for being manipulated into dispensing methadone without a script), pharmacy board (for breaking the rules)

Resources
[|Pharmacist's Obligation]