What’s the pharmacist’s role when patients act against their own health?

Misinformation is impacting health care and community health in a way we’ve never experienced before, turning a once mostly agreeable topic into a highly political one. In the age of misinformation, it has become more common for patients to advocate against their own health interests – often relying on information acquired from social media instead of evidence-based data from credible sources.

Pharmacists know how to provide optimal direct health care for all patients while operating under their professional code of ethics, but how should members of the profession act when they see or hear their patients acting against their own health; how should pharmacists handle the situation?

A commentary article published in the Journal of the American Pharmacists Association titled, “Politics, patients, and the role of the pharmacist: addressing social and political issues that affect health care,” explores the potential impact of social and political issues on pharmacy patients.

Co-authored by Heather A. Johnson, PharmD, an alum of The Ohio State University College of Pharmacy Residency Program and clinical assistant professor at West Virginia University School of Pharmacy, and E. Michael Murphy, PharmD, assistant professor of pharmacy practice and science at the Ohio State College of Pharmacy, the commentary also serves as a call-to-action for pharmacy practitioners to address the ethics of responding to social and political issues in the health care setting.

The article uses refusal to wear a protective mask as an example where patients use unsubstantiated evidence to defend their decision. And as we’ve seen during the COVID-19 pandemic, this social issue turned political with multiple states and cities creating laws banning mask requirements, which have had negative effects on public health, especially in schools.

Pharmacists are the most accessible and one of the most trusted health care professionals, and have a responsibility to act and educate, the article states.

While there is no formal requirement in the pharmacist’s code of ethics to tackle social and political misinformation that affects health care, Drs. Johnson and Murphy argue that adding this to the code of ethics is important for pharmacists to continue to provide optimal health care.

The American Medical Association previously issued guidance on political communication in their code of ethics and encourages medical professionals to stay informed and involved in advocacy and discuss with their patient when it is appropriate. The American Nurses Association encourages nurses to engage in education, public debate and open discussion to address barriers to health in their ethical and professional obligations.

Pharmacists, however, do not currently have this guidance.

Drs. Johnson and Murphy argue that pharmacists should include guidance on facilitating conversations with patients who act against their own health because the profession is responsible for optimizing patient and community health.

“As misinformation and disinformation become more prominent, it would be beneficial for the profession to come to a consensus on the pharmacist's role in educating their patients on issues that may have an indirect impact on their health,” Dr. Murphy said.

Political and social issues will continue to be intertwined in the patient-practitioner relationship, the commentary states.

“Discussing social and political issues with patients may no longer be taboo,” Dr. Johnson said. “We must learn how to have these conversations and help our patients clearly see what may harm their health and the health of their community.”