Code of Conduct
PART ONE: INTRODUCTION
|In the pharmacy profession, the health and welfare of the public has always been and will continue to be the foremost concern among practitioners. For this principle to be consistently placed above all other considerations in the practice of pharmacy, this Code of Conduct for Pharmacists and Bodies Corporate has embodied the minimum standards of proper conduct and professionalism for guidance of practitioners. These standards also serve as a reference when the Board considers cases of misconduct in a professional sense.
The pharmacy Board duly established under Section 3 of the Registration of Pharmacist Act, 1951 has by resolution at its 60th Meeting held on the 22nd day of December 1989 adopted this Code of Conduct for pharmacists and bodies corporate.
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2. USE OF TERMS
|For the purpose of this Code of Conduct-
"Act" means the Registration of Pharmacists Act 1951;
"allied profession" means any profession involved in the provision of health care to, or treatment of diseases or conditions of, man or animals;
"annual certificate" means an annual certificate issued under section 16 of the Act;
"the Board" means the Pharmacy Board established under section 3 of the Act;
"body corporate" means a body corporate whose name appears for the time being in the register kept under section 13 of the Act;
"the Code" means the Code of Conduct for pharmacists and bodies corporate;
"Dangerous drug" has the meaning assigned to it in the Dangerous Drugs Act, 1952;
"drug" has the meaning assigned to it in the Sale of Drugs Act, 1952;
"pharmacist" means a registered pharmacist in the Act;
"poison" has the meaning assigned to it in the Poisons Act, 1952;
"practitioner" means any pharmacist or body corporate or any employee or officer or any other person under the control or supervision of such pharmacist or body corporate;
"register" used with reference to a pharmacist or a body corporate means the register under the provisions of the Act applicable to the registration of pharmacists or bodies corporate respectively;
"the Regulations" means the Registration of Pharmacists Regulations, 1953;
"superintendent" means the superintendent of a body corporate described under section 7 of the Act.
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|3.1 The Board may initiate disciplinary proceedings against any registered pharmacist under the provisions of section 17 (1) (a), (b) and (c) of the Act which read:|
|"17 (1) The Board may cancel an annual certificate and order the removal from the register of the name of any registered pharmacist if it comes to the knowledge of the Board that such person-
(a) has obtained registration by a fraudulent or incorrect statement; or
(b) has been convicted of any offence (See Appendix I on "Convictions in a court of law"), which in the opinion of the Board renders him unfit to be on the register or of any offence (see Appendix I on "Convictions in a court of law") under the this Act or under any written law relating to poisons, dangerous drugs or therapeutic substances in force in Malaysia; or
(c) has been guilty of infamous or disgraceful conduct in a professional sense."
|3.2. The Board may initiate disciplinary proceedings against any body corporate under the provisions of section 13(7) and 13(8), (a) which read:|
|"13 (7) If-
(a) a body corporate canying on a business which comprises the retail sale of poisons, dangerous drugs or therapeutic substances has been convicted of an offence under this Act or under any written law relating to poisons, dangerous drugs or therapeutic substances in force in Malaysia; or
(b) any director or officer of or any other person in the employment of such body-
(i) has been convicted of an offence under this Act or the aforesaid written laws;
(iii) has been guilty of any misconduct which, in the opinion of the Board, renders him, or would if he were a pharmacist render him, unfit to be on the register;
the Board may inquire into the case and may, unless the body corporate satisfies the Board that the act or omission in question was not connived at or instigated by their superintendent or by any of their directors or managers, and that the person guilty thereof is no longer in their employment, refuse to register such body corporate or, in the case of a body corporate already registered, may remove such body corporate from the register and thereupon such body corporate shall cease to be entitled to use any title or description which a body corporate registered under this section is entitled to use.
13(8) The Board may remove the name of any body corporate from the register when -
(a) the registration of such body has been obtained by any fraudulent or incorrect statement; or"
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|For the purpose of Section 17 (1) (c) of the Act, any pharmacist found guilty of any breach of the Code by the Board after due inquiry under the Regulations, shall be deemed to be in the opinion of the Board, guilty of infamous or disgraceful conduct in a professional sense, and shall be liable to such disciplinary action by the Board as the Board deems fit under the provisions of the Act.
Similarly, for the purpose of Section 13 (7) (b) (iii) of the Act, any director, or officer of or other person in the employment of any body corporate found guilty by the Board of any breach of the Code, shall be deemed to be in the opinion of the Board, guilty of misconduct and such body corporate shall be liable to such disciplinary action by the Board as the Board deems fit under the provisions of the Act.
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|It must already be understood that the particulars which are given below do not constitute, and are not intended to constitute a complete enumeration of the professional matters, the breach of which may entail disciplinary proceedings by the Board. It does not in any way preclude the Board from considering and dealing with any form of infamous and disgraceful conduct in a professional sense and misconduct, although the subject matter may not appear to come within the scope or precise wording of any of the categories set forth in this Code. Circumstances may and do arise from time to time in relation to which there may occur questions on conduct which do not come within these categories. In such instances as in all others, the Board shall be considered the judge upon the facts brought before it.|
ARTICLE 1: NEGLECT OR DISREGARD OF PROFESSIONAL RESPONSIBILITY
|1.1 Responsibility for Standards of Professional Practice
1.1.1 A pharmacist shall maintain the highest professional standard in the discharge of his professional service to his patients or clients, in his conduct, and in his professional relations with members of his own profession and other allied professions. He shall render to his patients or clients the full measure of his ability as a member of the health care team.
1.1.2 A pharmacist, in his capacity as the superintendent of a body corporate, shall not agree to practice under any terms or conditions which interfere with or impair his control and management of the business of such body corporate, or the proper exercise of his professional judgement, skill or function.
1.1.3 A practitioner shall provide such means or facilities as may be necessary to enable a pharmacist to provide the highest standards of professional service and shall not, by act or omission, restrain or hinder the pharmacist in the proper discharge of his duties and responsibilities as superintendent and the fulfillment of statutory requirements.
1.1.4 An unqualified practitioner shall not engage himself publicly in the running of the business of a body corporate in such a manner as to throw doubt upon the status of the superintendent or other pharmacists in such body corporate.
1.2.1 In the provision of consultation or professional advice, a pharmacist shall, with due regard to the interest of the patient or client, strive to provide such information that is truthful, accurate, full, and without bias.
1.2.2 In conformity with his own sense of responsibility, a pharmacist shall refer a patient or client to members of other allied professions when, in the opinion of the pharmacist, the interest of the patient or client, is better served by members of that profession.
1.3 Relationship with pharmacists and members of the allied profession.
1.3.1 In his practice, a pharmacist shall not by words or deed or by inference thereof discredit or disparage the professional integrity, or judgement, or skill of another pharmacist or of a member of an allied profession.
When any doubt arises in the interpretation of a prescription accepted by a pharmacist, he shall consult the prescriber and shall not alter the prescription unless with the approval of the prescriber or in an emergency.
1.5 Improper delegation of duties
1.5.1 Employment of Unqualified or Non-registered Persons
The employment by practitioners, of any person not qualified or registered under the Act, and the permitting of such unqualified or non-registered person to perform any task, which vrould otherwise require the supervision of a pharmacist, or which requires the professional discretion or skill of a pharmacist, is in the opinion of the Board in its nature fraudulent and dangerous. All practitioners are required. to abstain from such fraudulent and dangerous practice.
In the event where persons other than pharmacists are required to perform any act which requires the supervision of a pharmacist, the pharmacist shall be available for immediate consultation and in full control of the person and the act performed.
All practitioners in the performance of any act which requires the supervision of a pharmacist shall only perform such act when the pharmacist is available for immediate consultation and the act is performed under the full control and permit of the pharmacist.
1.6 Pharmaceutical Research
In the scientific application of pharmaceutical research carried out on human beings it is the duty of the pharmacist to uphold the sanctity of human life.
1.6.1 A pharmacist shall not be a party to any research on human beings unless:
(i) each potential subject has been adequately informed of the aims, methods, anticipated benefits and potential hazards of the study and the discomfort it may entail;
(ii) the subject has been informed that he is at liberty to abstain from participation in the study and that he is free to withdraw his consent to participate at any time;
(iii) the subject of his own free will, has given written consent to participate in the study.
1.6.2 The pharmacist can combine scientific research with professional care, the objective being the acquisition of new knowledge, only to the extend that the research is justified by its potential value for the patient.
1.6.3 A pharmacist shall use great caution in divulging discoveries through non-professional channels.
1.7 Continuing Education
A pharmacist shall strive to keep abreast of new knowledge and advancement relevant to his practice by actively engaging himself in continuous study throughout his professional life in order to merit the confidence in his professional competence.
1.8 Relationship with the Pharmaceutical Industry
The pharmacist and the pharmaceutical industry have a common interest in the promotion and care of the health of the public. Although the closest co-operation between the pharmacist and the pharmaceutical industry is encouraged:
1.8.1 A pharmacist shall avoid a situation, whereby he, by accepting any financial or material inducement, would compromise his professional judgement on the choice of drug for his patient or client.
1.8.2 A pharmacist shall not participate in the promotion of a drug which involves the supply of such drug without discrimination to his patient or client or which by-passes his professional function.
1.8.3 To sustain public confidence in the profession, a pharmacist shall not only choose but also be seen to be choosing the drug which, in his professional judgement and having due regard to economy and rational drug use, will best serve the interest of his patient or client.
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|2.1 Abuse of Privileges Conferred by Law
2.1.1 Sale of Drugs and Medical Devices
The sale or supply of medical devices and drugs including drugs of dependence shall only be made in the course of bona fide treatment. No drugs should be sold or supplied in order to gratify the practitioner's own or ally other person's gratification.
A practitioner shall not sell or supply any drug or medical device where he has any reason to doubt its safety, quality or its therapeutic value, and shall not condone or assist in the dispensing promotion, or distribution of such drugs or devices.
A practitioner snail take Into due consideration the needs and welfare of his patient or client and shall not sell or supply drugs, medical devices or health products which are unnecessary or likely to be misused or abused or in such amounts which are excessive.
A practitioner who solicits patients or clients to purchase drugs, medical devices or health products commits a discreditable act.
2.1.2 Dangerous Drugs
2.1.3 Sale of Poisons
It is professionally discreditable and fraught with danger to the public when a pharmacist or body corporate employs an unqualified person who is left in charge of a shop selling or supplying poisons, under the cover of the qualifications of such pharmacist or any other pharmacist employed by such pharmacist or body corporate. No pharmacist or body corporate shall take part in whether by act or omission, or be a party to such discreditable and dangerous practice.
In the sale or supply of poisons, a pharmacist shall take reasonable precautions and measures to ascertain that such poisons sold or supplied are in fact sold or supplied and delivered to bone fide authorised person and for authorised purposes.
It is a privilege for a pharmacist to be a legal custodian of poisons and dangerous drugs. By conferring this privilege upon him, not only is he held accountable for such substances as required by law, but, from a moral and ethical point of view, he is expected to exercise professional accountability,
Concurrent with this, the Board is also of the opinion that a body corporate is equally bound to exercise the same degree of accountability as required of a pharmacist. This responsibility is trusted upon a body corporate in return for permitting it to carry on a business of keeping, retailing, dispensing and compounding of poisons, dangerous drugs and therapeutic substances.
2.1.6 Certificates and Documents of a Kindred Character
Practitioners may from time to time be called upon or requested to give certificates and other documents of a kindred character, signed by them in their practice for administrative purposes.
Practitioners are expected to exercise the most scrupulous care in issuing such documents and shall not sign or give under his name and authority any such certificate or document which is untrue, misleading or improper.
2.2 Abuse of Privileges Conferred by Custom
A good professional practice depends upon the maintenance of trust between practitioners and their patients or clients, and the understanding of both parties that proper professional relationship be strictly observed. The practitioner shall exercise great care and discretion in order not to injure this crucial relationship.
2.2.1 Abuse of Confidence
2.2.2 Undue Influence
A pharmacist may not exert improper influence upon a patient to lend him money or to obtain gifts.
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3.1 Respect for Human Life
3.2 Personal Behaviour
A pharmacist is expected at all times to observe proper standards of personal behaviour and decency not only in his Professional activities but at all times to uphold the high public reputation of the profession.
3.2.1 Personal misuse of Alcohol or Drugs
A pharmacist who performs any professional duty while in a state of intoxication by alcohol or under the influence of drugs commits a discreditable act. No pharmacist shall practice in such a state. Drug abuse by a pharmacist is professionally discreditable.
A practitioner shall be liable to disciplinary proceedings if he is convicted of criminal deception, forgery, fraud, theft or of any other offence involving dishonesty.
A practitioner shall not sell or supply with prior knowledge any drug or medical device which is defective or is incapable of serving the purpose it is intended for or is falsely or fraudulently labelled or presented.
A practitioner shall not act for improper motives. A practitioner's motive is considered improper if he sells or supplies any drug or medical device purely for his financial or material benefit, or if such act is motivated by his acceptance of an improper inducement from the supplier of the drug or medical device.
Fee-splitting or any form of kick back arrangements as an inducement to refer patients or clients to other members of the allied profession may be regarded as unethical. A practitioner shall not recommend a particular member of the allied profession or a medical practice unless so requested by his patient or client seeking medical advice.
3.2.3 Indecency and Violence
Any conviction for assault or indecency is derogatory to the dignity of the profession and thus regarded as a serious breach of conduct and will be viewed with particular gravity if the offence is committed in the course of a pharmacist's professional duties or against his patients or colleagues.
3.3 Conflict of Interest
The practitioner shall avoid any situation in which there is a conflict of interest with the patient.
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The practice by a practiticner of advertising, whether directly or indirectly, for the purpose of promoting his own professional advantage; or for such purpose of procuring or sanctioning, or acquiescing in, the publication of notices commending or directing attention to the professional skill, knowledge, services or qualifications, or depreciating those of others; or of being associated with such advertising or publication, is contrary to public Interest and discreditable to the profession. No practitioner shall therefore resort to any such practice.
4.1.2 The Board recognises that the profession has a duty to disseminate information about advances in pharmaceutical sciences and therapeutics provided it is done in an ethical manner.
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|Regulation 16 of the Regulations states:|
|"16 (1) Where the Board may under the provisions of the Ordinance hold an inquiry into any complaint or information respecting -
(a) irregular conduct in having obtained registration by a fraudulent or incorrect statement, or infamous or disgraceful conduct in a professional sense or the conviction of a registered pharmacist for any offence which, in the opinion of the Board, renders him unfit to be on the register; or
(b) the conviction of -
(i) a body corporate for an offence against the Ordinance or against the Dangerous Drugs Ordinance, 1952; or against the Poisons Ordinance, 1952 or
(ii) any director or officer of or other person in the employment of a body corporate for any offence against any of the aforesaid Ordinance or for any other criminal offence or any misconduct which, in the opinion of the Board, renders him, or would, if he were a registered pharmacist, render him, unfit to be on the register; or
(c) the conviction of any executor, administrator, or trustee who carries on the business of a deceased registered pharmacist, or of any person in the employment of such executor, administrator, or trustee for an offence against this Ordinance or against the Dangerous Drugs Ordinance, 1952, or against the Poisons Ordinance, 1952, or for any other criminal offence or any misconduct which, in the opinion of the Board, renders him, or would, if he were a registered pharmacist, render him, unfit to be on the register, such complaint or information shall be laid by a communication in writing addressed to the Secretary and, except where the complaint or informant is a public officer or a public body, shall be accompanied by one or more statutory declarations as to the alleged facts of the complaint or information.
(2) Every such statutory declaration shall state the address and description of the declarant and, where a fact stated in such declaration is not within the personal knowledge of such declarant, the source of his information and grounds for his belief in its truth shall be fully and accurately stated.
(3) The Secretary shall submit the complaint or information with the accompanying statutory declaration to the President, who (if he deems fit) shall require the registered pharmacist the body corporate, the director or officer or employee of the body corporate, or the representative who carries on the business of a deceased registered pharmacist (hereinafter called the person affected) who is affected by or against or concerning whom the complaint or information is laid to give, within a reasonable time, any explanation that he may have to offer.
(4) The complaint or intormation, including any such explanation, shall thereupon be referred to the Board who may direct that further evidence be obtained from the complainant or informant and may require the advice of the Board's Legal Adviser.
(5) (a) If the Board is of the opinion that a prima facie case has not be made out by the complainant or informant, the Board shall direct that no further action be taken on the complaint or information and the complainant shall be informed of the Board's decision.
(b) If the Board resolves that an inquiry is desirable, the Secretary shall institute such an inquiry in accordance with Regulation 17,"
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|Regulation 17 of the Regulations states:|
|"17 (1) Notice of the resolution of the Board to hold an inquiry into a complaint or information laid against the person affected shall be sent by the Board's Legal Adviser to the person affected and to the complainant or informant by registered letter addressed to the last known address of each such party.
(2) Such notice shall be in Form II in the Schedule, with such variations as the circumstances may require.
(3) The person affected or the complainant or informant may, for the purpose of his defence or reply (as the case may be) make, upon a request in writing signed by himself or his advocate and solicitor and under proper supervision, a copy of any statutory declaration, explanation, answer or other document sent to the Board on behalf of the other party. The Notice of Inquiry shall draw the particular attention of the person affected this Regulation.
(4) The person affected or the complainant or informant may at any time not less than seven days prior to the notified date of holding the inquiry serve on the other party a notice in writing, enquiring whether such other party is prepared to admit in writing any facts specified therein and which are material to the inquiry in order that the expense of calling a witness to prove such facts may be avoided.
Provided always that, should the President deem fit, the date of holding the inquiry may be postponed to allow either party sufficient time to prepare their defence in reply, as the case may be,"
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|Regulation 18 of the Regulation states:|
|"18 (1) The inquiry by the Board shall be held in private but at the discretion of the Board a statement may be issued for publication.
(2) The person affected or the complainant or informant may appear before the Board personally or be represented by his advocate and solicitor.
(3) The Board's Legal Adviser shall attend the inquiry, and the Secretary shall at the opening thereof read the Notice of Inquiry. If the person affected be not present or represented, the Board's Legal Adviser shall satisfy the Board that the Notice of Inquiry was duly sent to the person affected and to the complainant or informant.
(4) Where the complainant or informant appears personally or is represented by his advocate and solicitor the following shall be the order of procedure :
(a) the complainant or informant shall state his case and produce the evidence in support. At the conclusion of such evidence his case will be closed;
(b) the person affected or his advocate or solicitor shall state his case and produce the evidence in support. Such person may address the Board either before or at the conclusion of his evidence, but only once;
(c) at the conclusion of the case of the person affected the complainant or informant may, if the person affected has produced evidence, address the Board in reply;
(d) if the person affected has not produced evidence the complainant shall not without the special leave of the Board, address the Board in reply,
(5) Where there is no complainant or informant or where no complainant or informant appears the following shall be the order of procedure;
(a) the Board's Legal Adviser shall state the facts of the case and produce the evidence in support;
(b) the person affected or his advocate or solicitor shall then state his case and produce evidence in support. Such persons may address the Board either before or at the conclusion of such evidence, but only once;
(c) the Board's Legal Adviser may, if the person affected produced evidence be heard in reply.
(6) Evidence may be taken by oral statement or by written deposition or statement. Where a witness is produced by any party of the inquiry by the Board, he shall first be examined by the party producing him, then cross examined by the other party, and then re-examined by the party producing him, The Board may decline to admit the evidence of any deponent to a document, who is not present for or who declines to submit to cross-examination.
(7) Members of the Board may put, through the President such questions to the parties or witnesses as they may think desirable.
(8) On the conclusion of the hearing the Board shall deliberate in private and prepare a report on its findings which shall be in Form 12 in the Schedule with such variations as may be required.
(9) The Board may postpone its findings and appoint a later date for further consideration and may direct, as it shall think fit, that further evidence in relation to the evidence shall be received within such time as may be specified from either the person affected or the complainant or informant (as the case may be) provided that no further evidence presented or tendered by either party to the inquiry shall be received or considered by the Board unless a statement in writing thereof has been previously furnished to the Board's Legal Adviser and a copy thereof sent by him to the other party at least ten days before any resumption of the inquiry.
(10) The Registrar shall upon the direction of the Board that the name of any person affected be removed from the register send notice of such removal to the person affected to his registered or last known address and shall send information to the proper officer of any authority from which the persor-, affected has received his certificate of qualification in pharmacy.
(11) The President, in announcing the decision of the Board may add such terms of reprimand or admonishment as the Board may approve and may rule that the Board will not consider an appeal for restoration to the register until a specified period of time has elapsed."
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CONVICTIONS IN A COURT OF LAW
|In considering convictions the Board is bound to accept the determination of any court of law as conclusive evidence that the person was guilty of the offence of which he was convicted. Persons who face a charge should be mindful of this before they choose to plead guilty to the charge, or renounce appeal against conviction merely to avoid publicity or a heavier sentence. It is not open to a person who had been convicted of an offence to plead before the Board that he was in fact innocent. It is therefore unwise for a person to plead guilty in a court of law to a charge to which he believes that he has a defence.|
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DUTIES AND RESPONSIBILITIES OF A SUPERINTENDENT
|The provisions of Section 13 of the Act requires the business of a body corporate pertaining to the keeping, retailing, dispensing and compounding of poisons, dangerous drugs or therapeutic substances, to be under the control and management of a superintendent who is a registered pharmacist. It is legitimate to conclude that this statutory requirement exists to preserve the sanctity of professionalism in a retail pharmacy and to assure a reasonable standard of pharmaceutical services in such business.
It is therefore necessary to determine, and for the parties involved to know, the scope of jurisdiction a superintendent has in the running of a retail business. After deliberation on the various aspects of the retail business, the Board is of the opinion that the superintendent has sole authority over the following matters:
(1) The nature, quality and adequacy of amount of goods and services of all kinds reasonably necessary to enable an adequate pharmaceutical service to be provided, and choice of the supplier of such goods and services.
(2) In relation to the pharmaceutical service
(a) the control of staff and the allocation of duties to individual members;
(b) the observance of all legal and professional requirements including the ordering, purchase, sale, supply, import, export, storage, labelling, manufacturing, mixing, compounding and dispensing of dangerous drugs, poisons and therapeutic substances;
(c) the condition of the pharmacy.
(3) The settlement of all questions concerning the nature and extent of the pharmaceutical service or which involve in any way pharmaceutical knowledge or professional conduct.
The term pharmaceutical service means the furnishing of poisons, dangerous drugs, therapeutic substances and related diagnostic, medical and surgical products and appliances, whether on prescription or otherwise, and information and advice connected therewith.
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