Pharmacists Need a Better Understanding of the Law

Pharmacists Need a Better Understanding of the Law

macy. Reading the law to a class is not teaching, nor does it create understanding. The law is alive, and the instruction of it must be as well. Clas...

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macy. Reading the law to a class is not teaching, nor does it create understanding. The law is alive, and the instruction of it must be as well. Class discussion is critical to promote understanding, and there will be many examples which students have experienced firsthand to enliven the proceedings. An example which seems to surface during each discussion of Constitutional rights regarding administrative inspections is the law of search and seizure when a person is pulled over on the highway by a police officer. May the officer search the trunk of the automobile without a warrant? How should those thus detained conduct themselves? What are their rights? Issues such as these may be related to pharmacy practice only tangentially, but ·they are legal issues' one must confront in life, and we have an obligation to educate students for life.

Creating an Understanding The Journal of the American Bar Association recently published two. articles, one in February 1984 and one in March 1984, addressing the issue of legal education of college students. In the first, President A. Bartlett Giamatti.of Yale University was reported to have told the Second Circuit Judicial Conference that "the first responsibility to educate about the law obviously lies with the centers of education," and expressed the view that the law should be part of every student's education. His view was shared' by James O. Freedman, President of the University of Iowa, who said that" American citizens urgently require an understanding of the law that is both richly practical and genuinely philosophical-and they must look to the legal profession and the educational system to provide that understanding." In the March issue, the journal reported that half the American public mistakenly believes it is the responsibility of accused persons to prove their innocence. Taking the remarks of the two university presidents along with the

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American Pharmacy Vol. NS25, No. 3, March 1985/135

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of the national survey, I conclude that we in pharmacy, and particularly those of .us in pharmaceutical education, have an obligation to assure that pharmacy students,-and practitioners, through continuing education programsreceive accurate legal information about their rights and responsibilities. Certainly there are courses in place in the pharmacy curricula around the country termed Pharmacy Law, Pharmaceutical Jurisprudence, and the like. But do these courses really create an understanding of the legal framework within which phannacists, both as citizens and as professionals, must operate?

A Solid Background In my view, one of the primary responsibilities of an educator is to prepare students for the future-despite the fact that no one can discern the future with any degree of certainty. Educators have a responsibility to provide that solid base of knowledge which will place the student in a position to be able to capitalize on future developments. In pharmaceutical education, we produce a product which has a use-

fullifetime of approximately 40 years, perhaps even longer, depending on the preferences of the individual practitioner. Who knows what will happen over the next 40 years? What will pharmacy practice be like in the year 2025? No one knows; yet we must give the students a solid background which will serve them well two decades into th~ next century. Just as this responsibility applies to all in pharmaceutical education, it applies to those who teach law to pharmacy students. It is not sufficient to instruct the students about how many copies of a Schedule II order form must be completed. Certainly that's important, but it is also important to create in the students an understanding of the distinction between a statute and a reg~lation, which is more easily challenged, and which provisions in the state pharmacy practice act appear on their face to the novice reader to be "law," but nonetheless are clearly unconstitutional. There needs to be understanding, not rote memory.

Problem-Solving Skills There is currently much discussion in pharmaceutical education about the need for teaching problem-solving skills, as well as an emphasis on giving students opportunities to exercise their communication skills, both oral and written. Class discussion helps address both problems, and law is a discipline which lends itself well to such discussion. In addition, law lends itself well to a testing format which is not multiple choice, the bane of modern education. Essay questions are quite appropriate in a law course to gauge understanding. In my 11 years of teaching, I have discovered one phenomenon which is quite perplexing to students, and I would like to share it with you. With some of my examination questions there is no one "correct" answer. It is sometimes · baffling to pharmacy students that there might not be only one "correct" answer to a question posed on an examination in the college of pharmacy. Pharmacy is often very exact, and

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the multiple-choice question format can lead students to the conclusion tha t the correct answer is there, if only it can be located. However, I use a problem-solving test format where I present a factual situation and ask the student to "decide the case." With such questions, various outcomes may in fact be correct. The variety results from attaching different weights to various factsa situation not unlike the reality of the law in everyday life where different courts may decide quite similar cases differently. In grading such questions, I focus little on who the student decided would "win;" rather, I look at the reasoning used by the student to arrive at his or her decision. Is it sound? Is the issue properly identified? Have the rules of law been appropriately applied? The focus is on the process, not the outcome. It has been my experience that while the students are somewhat confounded by this approach to examinations at the outset, they soon catch on. After all, ' these future pharmacists are astute! I point this out because it is a weakness in our system of higher education that we have exalted the multiple-choice question format. ~ Some instructors have moved to this , format because it can be graded by machine and thus spare precious time. Bu t it fails ' to give the instructor insight into the students' thought processes and it fails to provide exercise in writing a complete, yet concise, response to a question. We in academia are guilty of embracing the multiple-choice question format and then wondering why there are students who cannot string ten words together in a coherent sentence.

Pharmacy-Law Interface I also want to address another topic which is closely related, but somewhat different. To accompany my application for admission to law school, I had to submit the obligatory essay stating why I wanted to attend. The topic of my essay was problems existing at the interface of 8

The Iowa Pharmacists Association recently completed a drive lasting several years to secure the position of the pharmacist as the expert on dispensing of medication. APhA was involved in a situation in a Middle Atlantic state where a pharmacist started charging the public for professional consultation separate from sale of a product, only to be subjected to potential legal action by the state. These are just two examples of the areas of professional discretion exercised by, pharmacists which must be guarded against attempts to diminish them. '

Advancing the Profession A thorough knowledge of the workings of the law is required in order to assure the continued existence of these prerogatives. That same knowledge is required to continue to advance the profession into areas where the knowledge and ex-:pertise of the pharmacist can truly . benefit the public. pharmacy and law, and I described The law should be viewed as a the need within pharmacy for peotool to advance the profession, not ple with dual backgrounds to adas a millstone around its collective dress such issues. I continue to view neck. Advocacy of professional pothe problems at that interface as being -sitions or policies in legislative, regmajor ones for the profession. ulatory, or judicial forums is not Pharmacists have many prerogatives which must be protected from , merely necessary-it is ~ritical. interference by others, be 'they govWhile pharmacists are usually ernmental agencies, employers, or thoroughly familiar with the statuthose who finance health care tory and regulatory requirements th~ough various third -party propertaining to the drug handling and grams: APhA came forward to take dispensing process, their knowllegal steps to protect professional edge of the law pertaining to ' other prerogatives when it challenged FDA aspects of professional practice is in the methadone case. sometimes limited. What did the Think of the other areas where North Dakota case really mean? What pharmacists 'exercise discretion in is the true significance of the Virdaily practice-deciding whether a ginia case? medication prescribed for an unapOften, when landmark decisions proved indication or by an unapaffecting pharmacy are announced, proved route of administration will ' the chest-beating rhetoric of some unduly jeopardize the patient's professional organizations drowns health; evaluating prescriptions from out the true significance, which is limited practitioners such as densometimes more limited than some tists, podiatrists, and veterinarians would have us believe. to assure that use of the medication So I challenge those who work at falls within their scope of practice; the interface of pharmacy and law and making judgments about the to continue to communicate accuquantity of medication that may rate legal information to attorneys safely be dispensed when the paand, pharmacists, and to foster tient requests ,a quantity different knowledge and education pertainfrom that recommended by the preing to the rights and duties of pharscriber. macists. D

American Pharmacy Vol. NS25, No. 3, March 1985/136