The issues are 2-fold in this (my last) columnprofessional and personal: (1) changes that have occurred in pharmacy law over the past 26 years and (2) why it is time to turn this column over to another writer.
(1) The forces that have influenced the content of case law over the past 26 years are many, but clearly the transition of many pharmacies from independent ownership to corporate employers is significant. Furthermore, the legal definition of the practice of pharmacy has changed in most states to include not just a dispensing function, but also patient counseling, drug utilization review, and, in some states, the administration of drugs and certain prescribing authority. This increased focus on the patient and on pharmaceutical care, rather than on the drug, has contributed to a whole new body of case law.
(2) On the personal front, I can still remember the day in 1979 when Irv Rubin, former editor-in-chief of Pharmacy Times, asked me to write a monthly column on pharmacy law. Little did I know that it would become a labor of love.Now that I am 60, however, I have entered into an interesting life passage with a restlessness for something different.
(1) I am continually struck by how admirably pharmacists perform their activities. I have scoured the legal literature for these 26 years to find cases to report in this column. Most lawsuits against pharmacists relate to dispensing the wrong drug or the wrong dose or giving the wrong directions. Most of these cases are settled prior to trial. When one considers the pressures of today's workplace and the billions of prescriptions dispensed, the number of lawsuits against the profession is very smalla tribute to all pharmacists.
(2) I have decided to gradually reduce my appointment at the university and spend more time with family, traveling, and serving others. I greatly enjoy my work with people wrestling with the effects of Parkinson's disease and my service to nonprofit organizations.
(1) The decade of the 1970s was a time when many courts analyzed the responsibility of the pharmacist versus that of the manufacturer in drug-liability lawsuits. Although there was considerable judicial confusion, the courts, fortunately, found that it did not make sense to hold the pharmacist liable along with the manufacturer in cases alleging defective commercially prepared products.
Many of the early cases reported in this column involved pharmacists being sued for false imprisonment of shoplifters, parking lot muggings, and other "customer-related"issuesas well as business lease, franchise, and contract casesbecause they owned the pharmacies. These suits still occur, but they are not detected when searching legal literature, because they involve the corporate employer instead.
The 1980s were a renaissance timethe changes in pharmacy education, the changing legal role of the pharmacist, and the attention paid to nondispensing activities generated considerable professional enthusiasm, notwithstanding the skepticism of those who felt trapped behind the prescription counter. With new professional duties and the use of computers and technicians, there came an accompanying change in the legal standard of care to which pharmacists are measured by the courts.
For example, the pharmacist's duty to counsel or warn a patient is a subject that garnered great attention during this time. The profession was eager to provide patient care. The courts were reluctant to impose new legal duties on pharmacists. Various decisions dissected the factual nuances that might affect liability, with a number of significant decisions holding that pharmacists do have an expanded responsibility. Yet, the profession still has to convince the courts that patient-care responsibility is as much a part of our practice as is dispensing the correct drug.
Cases in the 1990s clearly showed that pharmacists were primarily employees, not owners. Many lawsuits for wrongful discharge, discrimination, and other employment issues were reported. The pressures of the workplace were evidenced by cases alleging corporate negligence for workload-induced errors.
(2) When asked to continue teaching or writing this column, I think of the other things of significance that I might have the opportunity to do. It strikes me that my career will not define my life, but my relationships with others will. I credit my pharmacy preceptor, Jack Van Norman, RPh, of Swea City, Iowa. His sense of continued service is far greater than mine, as he just retired from the pharmacy where I trained in the 1960s.
Although I certainly owe my wife and children a great debt of gratitude, I dedicate this final column to my former students who remain a daily part of my life. They are an immense source of pride, and the good times we share are a tonic for the soul.
Larry M. Simonsmeier is Emeritus Professor of Pharmacy Law at Washington State University College of Pharmacy.
One study linked multiple pregnancies to an increased risk of developing atrial fibrillation later in life, and another investigated the association between premature delivery and cardiovascular disease.
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