The ethics we live and die by

As some of you may know, I have of late been struggling with the ethics of my profession.  Strange as it may seem, there has been a ’bout’ of incidences that have pushed me with my back against the wall.  I have had to look deep within myself for guidance and strength and there has been one or two occasions where I have been surprised at what I had found during these episodes.  Introspection is never easy, more so when you find something there that does not sit well with you.

I would like to take this opportunity to tell you about one of these incidences and also what the subsequent introspection threw up.  To get the full effect of this narration, treat yourself to JS Bach’s Suite for Cello Solo No 1 in G (Prelude) as played by Yo-Yo Ma.

It was an early autumnal Saturday morning when I was confronted by a very irate customer, whom I had never seen before.  Turns out that she has her medicines dispensed by another pharmacy down the High Street, who had in all their wisdom decided some weeks ago not to trade on Saturdays.

Turns out that the customer is leaving for a holiday early the next Monday, and had come into town for the express purpose of picking up her antidepressants.  Having found herself in front of closed and locked doors, she thought to avail herself of my services.  Here is her introduction, verbatim: ‘My pharmacy has cocked up, I need my antidepressants before Monday, they have cocked up, what are you going to do about it?’ And what am I going to do about it? I kid you not.

Firstly, this is SO not the way to approach me if you need my assistance, and secondly, your health is your responsibility.  The second point was borne out by her inability to identify the exact product she was after, nor was she able to provide any proof in the form of either a repeat request or an old labeled box.  She was however able to inform me that she ‘thinks’ that the tablets were 75mg strength and that the name started with a ‘V’.

Being aware of my responsibility, new-found as it was, towards the patient, I explained to her that the only way open for her was to either visit the local Walk-In Centre or to get into contact with the local after hour medical service, where she would be able to request a prescription from the on-duty doctor.  Not knowing the telephone number of the local after hour service, I provided it to her.  At this point I was then subjected to yet another ‘moment’.  ‘Here is my phone, you talk to the doctor.’ NO MAM, your health, you talk.  Even though I have a reasonable good idea which tablet you are after, I certainly am not going to put words into your mouth, nor am I going to talk to the doctor on your behalf, requesting something that I have no evidence you are on.  At least that is what I was thinking.  I stood my ground, and had her speak to the doctor.

Once again she used the word ‘cock-up’ twice in the conversation that followed, and without providing any evidence she got 14 days supply of Venlafaxine!

Ok, so here is the problem, did I do the right thing?  Did I serve this patient to the best of my ability? Should I have done something differently?  Why did I allow her to get under my skin, so to speak?  Am I allowing my professional judgement to be clouded by my personal belief that each individual is responsible for their own health?

I am convinced in my own heart that I did the right thing, so why am I left with a bitter after taste?

It has now been more than two weeks, and this incident is still haunting me, why? I invite you to comment.