Recently the Pharmacist’s Pulse featured a post addressing proposed changes to the Oath of a Pharmacist. Not unlike many pharmacists, likely not unlike many professionals of any discipline, it had been a while since we saw or heard those words. All professionals, pharmacists included, know there is a code of standards for the profession and indeed we at some time, perhaps several times, recited that code. We may have printed a copy, framed it, and hung it on the wall next to our degrees and license. But how many of us really know the Oath of a Pharmacist beyond the words. The meanings of those words and their spirit should fill and guide you each time you check a prescription, calculate a dose, or counsel a patient.
Cynics may say, “Nobody actually practices like that. They’re fancy words somebody who doesn’t actually do any real work made up.” Naïve practitioners may say, “These words are the basis of my personal performance, to be part of something bigger than myself.” The reality lies somewhere between but can be summed up as “I cannot perform me duty unless I know my patients will be better for having me as a part of their team.”
The Oath of a Pharmacist was developed by the American Association of Colleges of Pharmacy (AACP), whose member institutions were encouraged by a May 1961 editorial by Irving Rubin in American Professional Pharmacist to prepare an oath that publicly taken at graduation, was a means of recognizing pharmacy as a profession. The Oath demonstrates our commitment to our patients, to other health professionals, and to the pharmacy profession. We vow that we are committed to providing and promoting patient health, maintaining our education and competence, supporting and improving the profession, and that we do all this ethically and within the laws and regulations that control our practice.
The newest changes under consideration are proposed to integrate diversity, equity, inclusion, and anti-racism (DEIA) into pharmacists’ core values. But what about what is already there? How and why were these tenets determined to be means of devoting ourselves to a lifetime of service to others? Let us examine each component of the oath.
I will consider the welfare of humanity and relief of suffering my primary concerns. One of the original lines of the Oath of a Pharmacist, this harkens from Oath of Maimonides, the inspiration for our modern Oath, which reads, “The eternal providence has appointed me to watch over the life and health of Thy creatures. … May I never see in the patient anything but a fellow creature in pain.” We treat all who come to us regardless of who, how, where, what color, what history, or what beliefs. We see only humanity and our only concern is one of relieving the patient of that which causes discomfort, ailment, or pain.
I will apply my knowledge, experience, and skills to the best of my ability to assure optimal outcomes for my patients. A pharmacist vows to always assure the optimal outcome, based on what they know through education and experience. There are no “best we can do under the circumstances” decisions, only “best we can do” decisions.
I will respect and protect all personal and health information entrusted to me. A recent addition to the Oath is our recognition of the sanctity of protected health information, formalizing the concept that health information is privileged information, and we will not violate our patients’ privacy or compromise their confidence by sharing their information without their consent and a valid reason.
I will accept the lifelong obligation to improve my professional knowledge and competence. Learning lasts a lifetime. That is especially true when our professional lifetime is defined by the medications we dispense to our patients and each year new drugs or new indications for old drugs are approved. In 2020, a relatively quiet year for new approvals, fifty-three approvals were granted by the FDA. Equally in importance of new drugs are the withdrawals, replacements, and refinements of previously approved and in-use medications. The availability of new drugs and biological products and advances in health care present many opportunities for pharmacists to participate in care, often in specialization and management of care, but medications are not the only means pharmacists provide their services. In addition to maintaining knowledge of medications we must also maintain competence in evaluating the use and effectiveness of the medications and in sharing that information.
I will hold myself and my colleagues to the highest principles of our profession’s moral, ethical and legal conduct. Also one of the oldest precepts of the Oath, this may be one of the most difficult to maintain. Although it would seem to be so obvious a principle of professionalism that it would be honored unquestioningly, we must be diligent we maintain a decorous presence and treat ourselves and others with the respect a professional is entitled, particularly in this age of unregulated social media. We have resources for pharmacists who suffer moral lapses through intemperate use of drugs and alcohol; we have means of reform for pharmacists who breach laws and regulations. Now we must ask how do we protect the profession from unethical behavior that is so easily participated in through ill advised, sometimes foolish posts on social media. A search of the “pharmacist” hashtag in any of the major sites will, among the legitimate posts of pride or service, advancement, or legitimate assistance and information, reveal many of our profession posing above captions that read “Finally got my license to push pills,” “Drug dealer out on the town” or complaining about patients, other pharmacists, and other health care providers. The “highest principles” do not include self-mockery or character attacks. We vow to be better than that.
I will embrace and advocate changes that improve patient care. Another more recent addition to the Oath, this ideal directs us to not only recognize and accept change in health care, but to actively encourage change when it is evident that improvements in patient care are necessary and possible. Note that it does not specify pharmacy care or drug or medication related patient care, but that we will embrace and advocate change in patient care however it affects our practice.
I will utilize my knowledge, skills, experiences, and values to prepare the next generation of pharmacists. Present from the first iteration of the Oath of a Pharmacist, we not only acknowledge that we will use our professional activities to the benefit of our patients, but to the benefit of future patients by using these concepts and all our experiences to teach those who follow us.
The Oath of a Pharmacist is a symbol of our professionalism and demonstrates our commitment to our patients and ourselves. We declare that we recognize our responsibility to maintain professionalism and we do so voluntarily. If we are going to be of value to the public we serve, we must know the values of our profession. These are they, and they are our direction to providing professional patient care.