CLC / CAPSTONE RESEARCH LITERATURE REVIEW
Literature Research Review
APA citation of article:
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Greenberg, M. T., Weissberg, R. P., O’Brien, M.
U., Zins, J. E., Fredericks, L., Resnik, H., & Elias, pdfviewer/pdfviewer?
M. J. (2003). Enhancing school-based prevention vid=3&sid=bf7dbe23-d95c-412e-90f9-
and youth development through coordinated
social, emotional, and academic learning. The
American Psychologist, 58(6–7).
Lowenthal, W. (1988). Ethical dilemmas in
pharmacy. Journal of medical ethics, 14(1), 31-
34.
Retrieved from (website address):
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4b0b2e1566f2%40pdc-v-sessmgr04
https://jme.bmj.com/content/
14/1/31.short
Notes from article (summarized in YOUR OWN
WORDS):

- The article discusses the ethical dilemmas faced
by pharmacists, including disagreements on
ethical behavior and the application of ethical
principles between pharmacists and clients,
pharmacists and physicians, and among
pharmacists. The article notes that the increasing
complexity of healthcare systems and the
problem of legal liability affect the actions of
pharmacists and physicians. The flow of
information between professionals and patients
and issues of duty to inform, confidentiality, and
truthfulness are also discussed.
- The article presents the results of a survey of
pharmacy students and pharmacists in Virginia
regarding their responses to ethical dilemmas.
The survey questions were based on dilemmas
experienced by pharmacists in practice, those
discussed in the literature, and various codes of
ethics in pharmacy.
- The results indicate that a large majority of

Phokeo, V., Sproule, B., & Raman-Wilms, L.
(2004). Community pharmacists' attitudes toward
and professional interactions with users of
psychiatric medication. Psychiatric Services,
55(12), 1434-1436.
CLC / CAPSTONE RESEARCH LITERATURE REVIEW
https://ps.psychiatryonline.org/doi/
epdf/10.1176/appi.ps.55.12.1434
respondents in all three groups (third-year
students, fifth-year students, and practicing
pharmacists) chose alternatives that showed a
high degree of caring for patients and patient
rights, overriding economic issues or conflict with
the letter of the law. The article notes that
experienced pharmacists demonstrate greater
respect for patients and a better balance of
appropriate action, as well as an understanding of
physicians' rights and responsibilities and
economic realities.
- The article also discusses the use of placebo
products, which presents a difficult situation for
both physicians and pharmacists. The article
concludes that pharmacists need to understand
the ethical principles involved in pharmacy
practice and develop skills in ethical reasoning to
address ethical dilemmas in pharmacy.
- This research article examines the attitudes of
community pharmacists towards patients who use
psychiatric medication. The authors surveyed 283
community pharmacists in the Greater Toronto
area to assess their attitudes, comfort levels, and
professional interactions with patients who use
psychiatric medication compared to those who
use cardiovascular medication. The survey used
a 69-item questionnaire that assessed five
domains: attitudes, level of comfort when
counseling, barriers to providing professional
services, counselor role orientation, and
professional interactions. The results indicated
that despite generally positive attitudes,
pharmacists reported feeling more uncomfortable
discussing symptoms and medications with
patients who have mental illness than with

Rajiah, K., & Venaktaraman, R. (2019). The
effect of demographic and social factors on the
decision-making of community pharmacists in
ethical dilemmas. Journal of Research in
Pharmacy Practice, 8(3), 174.
CLC / CAPSTONE RESEARCH LITERATURE REVIEW
https://www.ncbi.nlm.nih.gov/pmc/
articles/PMC6830021/
patients who have cardiovascular problems.
Patients with mental illness also appeared to
receive fewer pharmacy services than patients
with cardiovascular disorders, and barriers to
receipt of counseling included a lack of privacy
and inadequate training. The authors suggest that
adequate training in mental health may be key in
improving the professional interactions of
community pharmacists towards patients who use
psychiatric medication.
- Community pharmacists are often faced with
ethical dilemmas and concerns in their everyday
practice. Many studies have been reported on
pharmacy ethics, but very few studies have been
reported on the ethical dilemmas faced by
community pharmacists.
- This study aimed to find out if the factors such as
age, gender, work experience, education
qualification, number of pharmacists per
pharmacy, and pharmacy location affect the
decision-making of community pharmacists when
confronted with ethical dilemmas during their
professional practice.
- A cross-sectional study was conducted in
Tirunelveli district, Tamil Nadu, using a validated
self-administered questionnaire from March 2016
to December 2017. A total of 1057 community
pharmacists were approached using probability
sampling methods, and the final participating
number was 742. The participants were selected
using a cluster sampling method.
- The study found that demographic and social
factors such as age, gender, work experience,
education qualification, and pharmacy location

Schommer, J. C., & Wiederholt, J. B. (1995). A
Field Investigation of Participant and
Environment Effects on Pharmacist-Patient
Communication in Community Pharmacies.
Medical Care, 33(6), 567–584.
Gardner, D. M., Murphy, A. L., Woodman, A. K.,
& Connelly, S. (2001). Community pharmacy
services for antidepressant users. International
CLC / CAPSTONE RESEARCH LITERATURE REVIEW
https://www.jstor.org/stable/pdf/
3766512.pdf?refreqid=excelsior
%3A40989be23344d8c087d62821f12
e143a&ab_segments=&origin=&initiat
or=&acceptTC=1
https://academic.oup.com/ijpp/article/
9/4/217/6139028?login=true
had a significant effect on the decision-making of
community pharmacists in ethical dilemmas. The
number of pharmacists per pharmacy did not
have a significant impact.
- This study provides insight into the factors that
affect the decision-making of community
pharmacists when faced with ethical dilemmas.
The findings of this study can be used to develop
guidelines for community pharmacists to handle
ethical dilemmas in a better way.
- The study examines factors that affect
communication between community pharmacists
and patients.
- Pharmacists' attitudes, perceived time pressures,
and perceived importance of communication
influence whether they transfer prescriptions to
patients, which can lead to communication.
- Patients' Role Orientation for Communication and
Importance of Information (pharmacy
environment) determine the length and content of
communication, explaining about 25% of the
variation.
- Other factors, such as patient cognitive abilities
and specific medications being discussed, may
also affect communication.
- Interventions and strategies for pharmacists,
patients, and the pharmacy environment are
needed to improve communication and promote
appropriate medication use, better quality of life,
and higher patient satisfaction.
- Professional standards emphasize importance of
communication between pharmacists and
patients.

Journal of Pharmacy Practice, 9(4), 217-224.
Laliberté, M. C., Perreault, S., Damestoy, N., &
Lalonde, L. (2012). Ideal and actual involvement
of community pharmacists in health promotion
and prevention: a cross-sectional study in
Quebec, Canada. BMC public health, 12(1), 1-
11.
CLC / CAPSTONE RESEARCH LITERATURE REVIEW
https://
bmcpublichealth.biomedcentral.com/
articles/10.1186/1471-2458-12-192
- Pharmacists can support optimal use through
monitoring response, tolerance, safety, and
addressing new concerns.
- Lack of privacy is a primary barrier to effective
communication between community pharmacists
and antidepressant users.
- Traditional dispensary layouts have failed to
address privacy issues, even with the rise of new
pharmacies in North America.
- Pharmacists have a responsibility to take a more
active role in optimizing therapy and monitoring
patients with depression.
- The article discusses the potential role of
community pharmacists in health promotion and
prevention, as well as the barriers and facilitators
to their involvement in these activities. The study
found that there is a gap between the ideal and
actual levels of involvement of pharmacists in
health promotion and prevention activities, with
many reporting barriers such as lack of time,
coordination with other healthcare professionals,
resources, compensation, and clinical tools.
However, studies have shown that integrating
pharmacists into public health programs can have
beneficial impacts, particularly in smoking
cessation, hypertension, dyslipidemia, diabetes,
and sexual health. The article suggests that future
public-health programs should focus on continuity
of care, maximizing the expertise of other
healthcare professionals, and overcoming
organizational barriers. Facilitators of practice
change in community pharmacy include
government policy, remuneration for service
delivery, communication and teamwork,

Roche, C., & Thoma, S. (2017). Insights from the
defining issues test on moral reasoning
competencies development in community
pharmacists. American Journal of
Pharmaceutical Education, 81(8).
Kruijtbosch, M., Göttgens-Jansen, W., Floor-
Schreudering, A., van Leeuwen, E., & Bouvy, M.
L. (2019). Moral dilemmas reflect professional
core values of pharmacists in community
pharmacy. International Journal of Pharmacy
Practice, 27(2), 140-148.
CLC / CAPSTONE RESEARCH LITERATURE REVIEW
https://www.ajpe.org/content/ajpe/
81/8/5913.full.pdf
https://academic.oup.com/ijpp/article/
27/2/140/6099748?login=true
leadership, task delegation, external support,
reorganization of the pharmacy, professional
satisfaction or competitiveness, communication
and collaboration with physicians, and patient
expectations.
- Professional dilemma situations occur when a
pharmacist has to choose between mutually
exclusive and jointly demanding options, and
none of them are ideal.
- Reasoning in such situations depends on the
pharmacist's competencies in identifying ethical
concepts in tension, justifiable actions, and the
impact on others.
- Pharmacists in Ireland are regulated by the
Pharmaceutical Society of Ireland (PSI) and
patient counseling is a legal requirement.
- Community pharmacists often work alone without
access to pharmacist peers.
- Accuracy and safety have been important values
for pharmacists, but the shift towards patient-
focused care requires reformulation of
professional values.
- Professional values are important for pharmacists
to develop professional behavior and a common
professional identity to improve patient outcomes.
- The professional core values of pharmacists
include commitment to patient well-being,
reliability and care, pharmaceutical expertise,
social responsibility, and professional autonomy.
- The study design included recognizing moral
dilemmas, studying literature on pharmaceutical
care practice, pharmacy ethics and pharmacists'
professional values, followed by discussions and
CLC / CAPSTONE RESEARCH LITERATURE REVIEW

writing a narrative of a moral dilemma.

- A moral dilemma is defined as a situation in which
there is a choice between at least two courses of
actions, neither of which is obviously morally
preferable.