Navigating the Pharmacy’s Legal and Ethical Landscape: The Role of the Pharmacy Technician

Few healthcare environments deliver as many ethical dilemmas as the modern pharmacy. This is where professionals at all levels regularly encounter difficult questions and scenarios, ranging from confidentiality concerns to adverse drug reactions and even issues with around scope of practice.

Pharmacy technicians, in particular, regularly face ethical conundrums sparked, in part, by the sheer frequency of their interactions with patients. These issues are not to be taken lightly. Prior to entering this field, every aspiring technician should have an answer to the question: Why is ethics important in a pharmacy?

We provide a thorough explanation in this guide while detailing how pharmacy techs can conduct themselves ethically while serving the best interests of their patients.

Know How Ethics and Law Impact the Pharmacy

Pharmacy technicians hold a variety of distinct roles and responsibilities, ranging from customer service to administrative functions and, of course, dispensing medications. Beyond this, they (like every pharmacy professional) are charged with upholding strict ethical and legal standards.

In the face of so many complex requirements, it’s only natural to wonder: are ethical and legal responsibilities the same? There is no simple answer, so we’ll delve into an array of ethical and legal concerns below:

What Is the Difference Between Ethical and Legal Responsibilities?

Ethics and legal compliance often hold a great deal of overlap, but they are not one and the same. The former refers to the pharmacy technician’s need to behave in the best interests of the patient, even when not legally mandated to do so. These concerns are primarily guided by the Pharmacy Technician Code of Ethics[1] from the American Association of Pharmacy Technicians.

Legal responsibility refers to the myriad of rules and regulations that govern not only pharmacy operations but also the healthcare sector as a whole. Pharmacy techs have a legal responsibility to uphold these and can be held liable when they fail to do so.

What Is the Legal Responsibility?

Every pharmacy is subject to strict legal requirements, which are implemented by a variety of agencies at the state and federal levels. These include laws mandating how pharmacy technicians are trained, licensed and registered, plus rules about maintaining patient safety and confidentiality. A failure to uphold these requirements could result in harsh consequences not only for the pharmacy in question but also any individual technicians deemed at fault.

Know the Laws for Both Federal and State

Every pharmacy technician should be thoroughly familiar with healthcare legislation, including a variety of relevant rules and requirements at the federal and state levels. Federal laws worth examining include:

• Federal Food, Drug, and Cosmetic Act
• Controlled Substances Act
• Health Insurance Portability and Accountability Act
• Affordable Care Act
• Omnibus Budget Reconciliation Act of 1990

At the state level, it is vital for pharmacy technicians to be thoroughly familiar with all rules enacted by their local Boards of Pharmacy. An analysis published in the journal Innovations in Pharmacy[2] indicates “major variation in total regulatory burden” across states, most notably including differences in “professional practice standards and facility standards.” It is the pharmacy tech’s duty to understand and uphold these standards, no matter how (or why) they differ from those imposed in other states.

It is also essential to examine guidance from state-based boards and agencies to answer the question: What are the qualifications to be a pharmacy technician? These vary between states, as do procedures for getting licensed or registered. Technicians who are clearly eligible to practice in some states may not be legally allowed to do so in others.

Patient Confidentiality

Legally speaking, patient confidentiality is largely the purview of the Health Insurance Portability and Accountability Act (HIPAA). This dictates how patient information is handled electronically. Now that it’s common practice for modern pharmacies to submit digital claims, it is the pharmacy tech’s responsibility to keep protected health information (PHI) safe, secure and confidential.

Keeping Up-to-Date Records

Pharmacies must maintain thorough and accurate records demonstrating how medications are prepared and dispensed. Because pharmacy techs are largely responsible for dispensing and labeling these drugs, they must also ensure that records regarding these processes are created and maintained.

Timelines for retaining these records vary based on the category these occupy: patient records, health disclosures and details about errors must be retained for at least ten years, while retention guidelines highlight a minimum of two years for prescription details.

What Are the Ethical Responsibilities?

All pharmacy professionals must abide by strict ethical standards. These ensure that customers or patients receive the respect and compassion they deserve. Ethical considerations are far-reaching in this environment, extending not only to the consistent promotion of consumers’ physical and mental health and well-being but also to critical concerns such as privacy, confidentiality and basic dignity.

Knowing the Code of Ethics

Every pharmacy technician should thoroughly understand the Pharmacy Technician Code of Ethics. This provides a thorough and powerful framework for how pharmacy techs should conduct themselves on the job. Developed and approved by the American Association of Pharmacy Technicians (AAPT), this code touches on many essentials:

• Ensuring patients’ health and safety
• Respecting the abilities of pharmacists and other healthcare professionals
• Continually seeking opportunities to learn and improve
• Respecting patient confidentiality and only disclosing pertinent information when authorized
• Avoiding activities that might discredit the profession
• Taking care to never dispense or distribute medications that are not of exceptional quality

Promoting the Patient’s Best Interests and Well-Being

Ethical pharmacy techs should genuinely care about their patients and want the best for them. Every interaction must emphasize this core tenet. This will play out differently depending on the situation at hand but often centers around compassionate interactions, attention to detail in dispensing medications and ensuring that patients know how to properly take (and, if necessary, dispose of) prescribed medications.

Recognize Ethical Dilemmas in Pharmacy Practice

Unfortunately, there is sometimes a gap between core ethical concepts and real-world pharmacy practice. This may stem from a failure to recognize ethical concerns at play in the real world. As such, pharmacy techs must make a continual effort to learn how ethical principles are applied within the profession. They can also reflect on difficult or problematic interactions to determine where room for improvement exists.

How to Handle Medication Errors

According to the Academy of Managed Care Pharmacy (AMCP)[3], over 1.5 million people are harmed by medication errors every year. The National Coordinating Council for Medication Error and Prevention (NCC MERP)[4] defines this as “any preventable event that may cause or lead to inappropriate medication use or patient harm, while the medication is in the control of the health care professional, patient or consumer.”

While these errors often occur within clinics, hospitals and other healthcare facilities, pharmacy technicians can inadvertently increase their likelihood by improperly dispensing or labeling medications. Other oversights may include failures in patient identification or education. Prevention should be a priority, of course, but in the event of an error, effective mitigation is crucial.

Report and Document

As soon as a medication error becomes evident, this should be reported to relevant authorities. The pharmacy tech must first ensure that the responsible pharmacist is aware of the error. AMCP recommends[5] reporting errors to the Institute of Safe Medication Practices (ISMP) and the Food and Drug Administration (FDA) MedWatch system.

Furthermore, individual managed care organizations can be instrumental in evaluating and analyzing error data to gain actionable insights. As mentioned previously, errors should also be thoroughly documented for the pharmacy’s records. These reports should be retained for at least ten years.

What to Do With an Adverse Drug Reaction

Pharmacy techs play a crucial role in preventing and responding to adverse drug reactions. First, there is a strong need to distinguish between drug errors and adverse reactions. As the NCC MERP[6] explains, “All adverse drug reactions cause patient harm, but not all adverse drug reactions are preventable. Conversely, all medication errors are preventable, but not all medication errors cause patient harm.”

Both drug errors and adverse reactions must be reported and technicians should communicate these events to pharmacists. These reactions should be documented in the patient’s record, as this could influence future prescriptions or care. Additionally, practitioners must be notified, especially when reactions point to potentially urgent or dangerous situations. In these cases, patients should be advised to seek prompt medical attention.

Keep in mind, however, that from the tech’s perspective, all responses must be made within the scope of practice — and this typically means communicating and deferring to the presiding pharmacist.

Collaboration on Error Prevention

Pharmacy technicians, pharmacists, doctors and other professionals must work as a team to limit the potential for medication errors. This begins with clear communication and strict protocols. Increasingly, many pharmacy teams implement comprehensive strategies that include run charts, process mapping and other innovative quality improvement solutions. Technological solutions such as automated dispensing are also increasingly common, but high-level training remains imperative, as does exceptional maintenance and troubleshooting.

Continuing Education and Your Professional Growth With SJVC

As you prepare to take on the exciting yet highly demanding role of a pharmacy technician, it is crucial that you understand both the ethical and legal responsibilities that accompany this career track. Equipped with this knowledge, you could play a valuable role in promoting positive patient outcomes and supporting entire pharmacy teams.

At San Joaquin Valley College (SJVC), we are committed to giving you, the aspiring pharmacy tech, the tools and knowledge it takes to protect patients. Reach out today to learn more about our Pharmacy Technology program or to find out more about the process of becoming a pharmacy tech.

Sources:

1. www.pharmacytechnician.com/pharmacy-technician-code-of-ethics/
2. www.ncbi.nlm.nih.gov/pmc/articles/PMC8127111/
3. www.amcp.org/about/managed-care-pharmacy-101/concepts-managed-care-pharmacy/medication-errors
4. www.nccmerp.org/about-medication-errors
5. www.amcp.org/about/managed-care-pharmacy-101/concepts-managed-care-pharmacy/medication-errors
6. www.nccmerp.org/sites/default/files/nccmerp_fact_sheet_2015-02-v91.pdf