PHARMACIST. - The pharmacist, the natural collaborator of the physician (v.), shares with him, albeit in a subordinate role, the nobility and importance of the mission. The pharmacist's profession is therefore also fraught with many responsibilities, especially today, given that the pharmacist's principal activity is no longer, as in the past, that of attending, in his modest laboratory, to the preparation of medicines, but that of becoming a retailer of a flood of specialties and patented products that the pharmaceutical industry puts on the market.
Two moral questions therefore arise for the pharmacist: is it lawful to substitute other products of his own manufacture of equal quality for the specialties? And how must he conduct himself with regard to advertising?
On the first point, justice forbids the fraudulent imitation of the product and its introduction into commerce under the patented name. Such counterfeiting is also punishable under the terms of the law (cf. Penal Code, arts. 473-474). The substitution, on the other hand, of products of equal, or perhaps greater, curative efficacy for the specialties cannot be called unlawful, at least when the requester does not present a medical prescription and is informed of the substitution. This appears even justified and commendable when, for example, the high cost of the specialty would induce the customer to forgo the purchase, and when the therapeutic value of the specialized product is shown to be slight or nil. Indeed, the case is not rare of an imprudent and facile advertising that, taking advantage of the psychological dispositions of the public, announces as infallible medicines of little or no curative value (cf. G. Lami, Questioni deontologiche in tema di specialità medicinali, 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 in the case of a request with a medical prescription, the substitution cannot be declared outright unlawful when it appears that the physician was not concerned so much with the name as with the efficacy of the remedy prescribed.
With regard to advertising (that directed immediately at the public), the pharmacist must always be inspired by a high moral sense. 1) He must therefore not create fictitious needs. 2) He must absolutely not permit the advertising of instruments or medicines whose use is morally illicit, as, for example, of contraceptive and abortifacient means (cf. Consolidated Text of the law on public security, art. 112; Royal Decree of 31 May 1946, no. 567, art. 2; Penal Code, arts. 553, 555), of venereal disinfectants, of aphrodisiac products, of barbiturates, etc. All the more is he forbidden to sell these products.
Applying to this matter the moral principles of cooperation, it must be recalled that the sale of what can have only a bad end is always unlawful, whereas the lawfulness of the sale of instruments that have a predominantly, but not exclusively, bad destination is debated.
It is lawful, on the other hand, to sell everything that is lawfully requested (E. Genicot-I. Salsmans, Iustit. theol. mor., 14th ed., I, Brussels 1939, no. 238). If he doubts with serious probability that the prescription is apocryphal, conforming also to the provisions of the law (cf. Consolidated Text of the health laws, art. 155), he will require from the customer an identification document.
Apart from a request with a prescription, the pharmacist must not supply the customer with harmful or dangerous products because, besides exceeding his competence, he would also become complicit in possible abuses. Moreover, even when he were asked for preparations harmless in themselves, but seriously doubted that the one requesting them intended to use them for illicit purposes, before dispensing them he must, if possible, ascertain the use and refuse them if this should prove dishonest to him. In any case, the greater the presumption of a bad use, the more serious must also be the reason for cooperating with it.
He must furthermore respect the fixed tariffs (cf. Consolidated Text of the health laws, art. 125). He must warn the customer when, through ignorance or error, he had administered something harmful and ineffective. As a collaborator of the physician he must respect, like the latter, professional secrecy. The object of secrecy 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 grave also before the law (cf. Penal Code, art. 622), which however admits certain limits, as, for example, in cases of infectious disease (cf. Consolidated Text of the health laws, art. 254), of poisoning (loc. cit., art. 156; Consolidated Text of the laws on public security, art. 155), of procured abortion and, in general, of any crime whose knowledge was acquired in the exercise of the health profession (cf. Penal Code, art. 365), unless the report exposes the person assisted to criminal proceedings (Penal Code, art. 384).
He is likewise obliged to make reparation for damages that he had caused through gravely culpable negligence or that he had not prevented, when able to do so, after having inadvertently caused them.
Particularly delicate is the pharmacist's position in relation to the physician. Professional correctness and the duty not to assume undue responsibilities impose on him not to take the physician's place even when he were expressly requested to do so by the customer, unless it is a matter of ordinary remedies that do not require particular competence. He must endeavor to increase the patient's trust in the physician's work and to exhort the reluctant to have recourse to him when he judges it necessary and opportune. On the other hand, he must not, out of commercialism, enter into unlawful contracts with the physician.
In relations with colleagues, where likewise the greatest correctness and cordiality are required, two forms of unfair competition are particularly deplorable: that of undercutting in relation to the established tariffs, an undercutting that is ordinarily carried out by defrauding on the medicine (weight and quality); and that of employing unqualified personnel both at the sales counter and in the laboratory.
Many laws (in Italy perhaps too many) regulate the pharmacist's profession. More, however, than the multiplicity of norms, a lively sense of duty united with a solid moral formation will benefit him.