PHARMACIST. – The pharmacist, physician (v.), shares with him, although in a subordinate position, the nobility and importance of the mission. The profession of the pharmacist is therefore also fraught with many responsibilities, especially today, given that the pharmacist’s principal activity is no longer, as in the past, to attend in his modest laboratory to the preparation of medicines, but to become a retailer of a mass of proprietary medicines and patented products that the pharmaceutical industry places on the market.
Two moral questions therefore arise for the pharmacist: is it lawful to replace proprietary medicines with equivalent products of his own manufacture? And how should he conduct himself with regard to advertising?
Regarding the first question, justice prohibits the fraudulent imitation of a product and its introduction into commerce under the patented name. Such counterfeiting is also punishable under the law (cf. Penal Code, arts. 473–474). The replacement of proprietary medicines with equivalent products of equal or perhaps greater therapeutic efficacy, on the other hand, cannot be deemed unlawful, at least when the person requesting the product does not present a medical prescription and is informed of the substitution. Indeed, this appears justified and commendable when, for example, the high cost of the proprietary medicine would lead the customer to forgo the purchase, and when the therapeutic value of the specialized product is shown to be slight or nonexistent. It is not in fact uncommon for imprudent and facile advertising, taking advantage of the public’s psychological dispositions, to proclaim medicines of little or no therapeutic value infallible (cf. G. Lami, Deontological Questions Concerning Proprietary Medicines, in Studium, 44 [1948], p. 25 ff.). It should therefore be the pharmacist’s concern to examine the composition of patented and specialized medicines in order to verify their actual composition.
Even when a request is made with a medical prescription, the substitution cannot automatically be declared unlawful when it is evident that the physician was concerned not so much with the name as with the efficacy of the remedy prescribed.
With regard to advertising (that directed immediately to the public), the pharmacist must always be guided by a high moral sense. 1) He must not therefore create fictitious needs. 2) He must on no account permit the advertising of medicinal instruments whose use is morally illicit, such as, for example, contraceptive and abortifacient means (cf. Consolidated Text of the Public Security Law, art. 112; Royal Decree of 31 May 1946, no. 567, art. 2; Penal Code, arts. 553, 555), venereal disinfectants, aphrodisiac products, barbiturates, etc. All the more is he forbidden to sell these products.
Applying the moral principles of cooperation in this regard, it should be recalled that the sale of something which can have only an evil end is always unlawful, whereas the lawfulness of selling instruments intended predominantly, but not exclusively, for an evil purpose is disputed.
It is lawful, however, to sell anything that is lawfully requested (E. Genicot-I. Salamans, Iustit. theol. mor., 14th ed., I, Brussels 1939, no. 238). If he has serious grounds for suspecting that the prescription is spurious, he will, also in conformity with the provisions of the law (cf. Consolidated Text of the Health Laws, art. 155), require the customer to produce proof of identity.
Apart from requests made with a prescription, the pharmacist must not supply the customer with harmful or dangerous products because, besides exceeding the bounds of his competence, he would also become complicit in possible abuses. Moreover, even when he is asked for preparations that are harmless in themselves, but seriously suspects that the person requesting them intends to use them for illicit purposes, before supplying them he must, if possible, ascertain their intended use and refuse them if it proves dishonest. In any event, the greater the presumption of an evil use, the more serious must also be the reason for cooperating in II.
He must also observe the prescribed tariffs (cf. Consolidated Text of the Health Laws, art. 125). He must warn the customer if, through ignorance or error, he has supplied him with something harmful and ineffective. As the physician’s collaborator, he must observe professional secrecy just as the physician does. The subject of secrecy, moreover, is everything that, by reason of his profession, the pharmacist learns from the physician, from the prescription, from the person concerned, or from third parties. This duty is also a grave one before the law (cf. Penal Code, art. 622), which nevertheless admits certain limitations, for example in cases of infectious disease (cf. Consolidated Text of the Health Laws, art. 254), poisoning (loc. cit., art. 156; Consolidated Text of the Public Security Laws, art. 155), procuring an abortion and, in general, any offense of which knowledge has been acquired in the exercise of the health profession (cf. Penal Code, art. 365), unless the report would expose the person assisted to criminal proceedings (Penal Code, art. 384).
He is likewise obliged to compensate for damages that he has caused through seriously culpable negligence or that, having inadvertently set the cause in motion, he could have prevented but failed to do so.
The pharmacist’s position in relation to the physician is particularly delicate. Professional propriety and the duty not to assume undue responsibilities require him not to substitute himself for the physician, even when expressly requested by the customer, unless the matter concerns ordinary remedies that require no special competence. He should seek to strengthen the patient’s confidence in the physician’s work and urge those who are reluctant to consult one when he judges this necessary and appropriate. On the other hand, he must not enter into illicit agreements with the physician for commercial gain.
In relations with colleagues, where the utmost propriety and cordiality are likewise required, two forms of unfair competition are particularly reprehensible: undercutting the established tariffs, a practice ordinarily carried out by defrauding customers with regard to the medicine (its weight and quality); and employing unqualified personnel both at the sales counter and in the laboratory.
Many laws (in Italy perhaps too many) regulate the profession of the pharmacist. More beneficial to him than the multiplicity of regulations, however, will be a lively sense of duty joined to solid moral formation.