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141-419: The scope of pharmacy practice includes more traditional roles such as compounding and dispensing of medications. It also includes more modern services related to health care including clinical services, reviewing medications for safety and efficacy, and providing drug information with patient counselling. Pharmacists , therefore, are experts on drug therapy and are the primary health professionals who optimize

282-548: A Catalan enclave close to Puigcerdà , is a museum: the building dates back to the 15th century and the museum keeps albarellos from the 16th and 17th centuries, old prescription books and antique drugs. Pharmacists practice in a variety of areas including community pharmacies, infusion pharmacies, hospitals, clinics, insurance companies, medical communication companies, research facilities, pharmaceutical companies, extended care facilities, psychiatric hospitals, and regulatory agencies. Pharmacists themselves may have expertise in

423-636: A medical specialty . A pharmacy (also known as a chemist in Australia , New Zealand and the British Isles ; or drugstore in North America ; retail pharmacy in industry terminology; or apothecary , historically) is where most pharmacists practice the profession of pharmacy. It is the community pharmacy in which the dichotomy of the profession exists; health professionals who are also retailers. Community pharmacies usually consist of

564-426: A certain manner by being wholeheartedly committed to this manner. Virtues contrast with vices , which are their harmful counterparts. Virtue theorists usually say that the mere possession of virtues by itself is not sufficient. Instead, people should manifest virtues in their actions. An important factor is the practical wisdom, also called phronesis , of knowing when, how, and which virtue to express. For example,

705-428: A certain standpoint. Moral standpoints may differ between persons, cultures, and historical periods. For example, moral statements like "Slavery is wrong" or "Suicide is permissible" may be true in one culture and false in another. Some moral relativists say that moral systems are constructed to serve certain goals such as social coordination. According to this view, different societies and different social groups within

846-399: A characterization of what is good and then define what is right in terms of what is good. For example, classical utilitarianism says that pleasure is good and that the action leading to the most overall pleasure is right. Consequentialism has been discussed indirectly since the formulation of classical utilitarianism in the late 18th century. A more explicit analysis of this view happened in

987-672: A compounded medication for reasons such as In hospitals, pharmacists and pharmacy technicians often make compounded sterile preparations (CSPs) using manual methods. The error rate for manually compounded sterile IV products is high. The Institute for Safe Medication Practices (ISMP) has expressed concern with manual methods, particularly the error-prone nature of the syringe pull-back method of verifying sterile preparations. To increase accuracy, some U.S. hospitals have adopted IV workflow management systems and robotic compounding systems. These technologies use barcode scanning to identify each ingredient and gravimetric weight measurement to confirm

1128-464: A compounding pharmacist might make a medicated lollipop that contains the drug. Patients who have difficulty swallowing the tablet may prefer to suck the medicated lollipop instead. Another form of compounding is by mixing different strengths (g, mg, mcg) of capsules or tablets to yield the desired amount of medication indicated by the physician , physician assistant , nurse practitioner , or clinical pharmacist practitioner . This form of compounding

1269-470: A diversity of viewpoints. A universal moral norm is seen as valid if all rational discourse participants do or would approve. This way, morality is not imposed by a single moral authority but arises from the moral discourse within society. This discourse should aim to establish an ideal speech situation to ensure fairness and inclusivity. In particular, this means that discourse participants are free to voice their different opinions without coercion but are at

1410-405: A drug therapy plan. Since the emergence of modern clinical pharmacy, ambulatory care pharmacy practice has emerged as a unique pharmacy practice setting. Ambulatory care pharmacy is based primarily on pharmacotherapy services that a pharmacist provides in a clinic. Pharmacists in this setting often do not dispense drugs, but rather see patients in-office visits to manage chronic disease states. In

1551-542: A drug used to treat calcium deficiencies and too much potassium in the blood. Implicated in these cases is the Rhodococcus bacteria, which can cause symptoms such as fever and pain. The FDA, among others, claims that larger compounding pharmacies act like drug manufacturers and yet circumvent FDA regulations under the banner of compounding. Drugs from compounding pharmacies can be cheaper or alleviate shortages, but can pose greater risk of contamination due in part to

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1692-479: A general standpoint of what is objectively right and wrong. In a slightly different sense, the term ethics can also refer to individual ethical theories in the form of a rational system of moral principles, such as Aristotelian ethics , and to a moral code that certain societies, social groups, or professions follow, as in Protestant work ethic and medical ethics . The English word ethics has its roots in

1833-632: A given patient's prescribing practitioner determines makes a "significant difference" for the patient. The FDA weighs the following factors in deciding whether it has authority to "exercise its discretion" to require approval for a custom-compounded drug product: The DQSA amended the FFDCA to create a new class of FDA-regulated entities known as "outsourcing facilities" whose compounding activities "may or may not" be patient-specific based on individualized prescriptions. Registered outsourcing facilities, unlike traditional compounding facilities, are subject to

1974-515: A lack of practical wisdom may lead courageous people to perform morally wrong actions by taking unnecessary risks that should better be avoided. Different types of virtue ethics differ on how they understand virtues and their role in practical life. Eudaimonism is the original form of virtue theory developed in Ancient Greek philosophy and draws a close relation between virtuous behavior and happiness. It states that people flourish by living

2115-623: A manuscript "Recipes for 52 Ailments", found in the Mawangdui , sealed in 168 BC. In Japan, at the end of the Asuka period (538–710) and the early Nara period (710–794), the men who fulfilled roles similar to those of modern pharmacists were highly respected. The place of pharmacists in society was expressly defined in the Taihō Code (701) and re-stated in the Yōrō Code (718). Ranked positions in

2256-549: A means to promote their self-interest. Ethical egoism is often criticized as an immoral and contradictory position. Normative ethics has a central place in most religions . Key aspects of Jewish ethics are to follow the 613 commandments of God according to the Mitzvah duty found in the Torah and to take responsibility for societal welfare . Christian ethics puts less emphasis on following precise laws and teaches instead

2397-611: A more general principle. Many theories of normative ethics also aim to guide behavior by helping people make moral decisions . Theories in normative ethics state how people should act or what kind of behavior is correct. They do not aim to describe how people normally act, what moral beliefs ordinary people have, how these beliefs change over time, or what ethical codes are upheld in certain social groups. These topics belong to descriptive ethics and are studied in fields like anthropology , sociology , and history rather than normative ethics. Some systems of normative ethics arrive at

2538-431: A patient is harmed, drugs made by compounders are seldom tested. In Texas, one of only two states that does random testing, significant problems have been found. Random tests by the state's pharmacy board over the last several years have found that as many as one in four compounded drugs was either too weak or too strong. In Missouri, the only other state that does testing, potency varied by as much as 300 percent. In 2002,

2679-550: A person should tell the truth even in specific cases where lying would lead to better consequences. Another disagreement is between actual and expected consequentialism. According to the traditional view, only the actual consequences of an act affect its moral value. One difficulty of this view is that many consequences cannot be known in advance. This means that in some cases, even well-planned and intentioned acts are morally wrong if they inadvertently lead to negative outcomes. An alternative perspective states that what matters are not

2820-401: A pleasurable experience has a high value if it has a high intensity and lasts for a long time. A common criticism of Bentham's utilitarianism argued that its focus on the intensity of pleasure promotes an immoral lifestyle centered around indulgence in sensory gratification. Mill responded to this criticism by distinguishing between higher and lower pleasures. He stated that higher pleasures, like

2961-512: A prescriber's specifications, is referred to as "traditional" compounding. The nature of patient need for such customization can range from absolute necessity (e.g. avoiding allergy) to individual optimality (e.g. ideal dose level) to even preference (e.g. flavor or texture). Hospital pharmacies typically engage in compounding medications for intravenous administration, whereas outpatient or community pharmacies typically engage in compounding medications for oral or topical administration. Due to

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3102-674: A prescription (503A pharmacies) cannot be required to obtain FDA approval for such products, as they will remain exclusively under state-level pharmacy regulation. At the same time, section 503B of the law regulates "outsourcing facilities" which conduct bulk compounding or are used as outsourcing for compounding by other pharmacies. These outsourcing facilities can be explicitly authorized by the Food and Drug Administration under specified circumstances, while being exempted from certain requirements otherwise imposed on mass-producers. In any pharmacy, compounding

3243-565: A remote professional relationship." The head of the FDA has recently requested the following authority from Congress: Various ideas have been proposed to expand federal US regulation in this area, including laws making it easier to identify misuse or misnomered-use and/or stricter enforcement of the longstanding distinction between compounding versus manufacturing . Some US states have also taken initiatives to strengthen oversight of compounding pharmacies. A major source of opposition to new Food and Drug Administration regulation on compounding

3384-565: A retail storefront with a dispensary, where medications are stored and dispensed. According to Sharif Kaf al-Ghazal, the opening of the first drugstores are recorded by Muslim pharmacists in Baghdad in 754 AD. Pharmacies within hospitals differ considerably from community pharmacies. Some pharmacists in hospital pharmacies may have more complex clinical medication management issues, and pharmacists in community pharmacies often have more complex business and customer relations issues. Because of

3525-431: A separate board certification. The official designation for pharmacists who pass the ambulatory care pharmacy specialty certification exam will be Board Certified Ambulatory Care Pharmacist and these pharmacists will carry the initials BCACP. Compounding involves preparing drugs in forms that are different from the generic prescription standard. This may include altering the strength, ingredients, or dosage form. Compounding

3666-790: A single principle covering all possible cases. Others encompass a small set of basic rules that address all or at least the most important moral considerations. One difficulty for systems with several basic principles is that these principles may conflict with each other in some cases and lead to ethical dilemmas . Distinct theories in normative ethics suggest different principles as the foundation of morality. The three most influential schools of thought are consequentialism , deontology , and virtue ethics . These schools are usually presented as exclusive alternatives, but depending on how they are defined, they can overlap and do not necessarily exclude one another. In some cases, they differ in which acts they see as right or wrong. In other cases, they recommend

3807-464: A situation, regardless of their specific role or position. Immanuel Kant (1724–1804) is one of the most well-known deontologists. He states that reaching outcomes that people desire, such as being happy, is not the main purpose of moral actions. Instead, he argues that there are universal principles that apply to everyone independent of their desires. He uses the term categorical imperative for these principles, saying that they have their source in

3948-425: A society construct different moral systems based on their diverging purposes. Emotivism provides a different explanation, stating that morality arises from moral emotions, which are not the same for everyone. Moral nihilists deny the existence of moral facts. They reject the existence of both objective moral facts defended by moral realism and subjective moral facts defended by moral relativism. They believe that

4089-404: A variety of preparations such as medications, dyes, incense, perfumes, ceremonial compounds, preservatives and cosmetics. In the medieval Islamic world in particular, Muslim pharmacists and chemists developed advanced methods of compounding drugs. The first drugstores were opened by Muslim pharmacists in Baghdad in 754. The modern age of pharmacy compounding began in the 19th century with

4230-557: A virtuous life. Eudaimonist theories often hold that virtues are positive potentials residing in human nature and that actualizing these potentials results in leading a good and happy life. Agent-based theories, by contrast, see happiness only as a side effect and focus instead on the admirable traits and motivational characteristics expressed while acting. This is often combined with the idea that one can learn from exceptional individuals what those characteristics are. Feminist ethics of care are another form of virtue ethics. They emphasize

4371-491: Is a complex process that requires adequate training of personnel, quality assurance of products, and adequate facilities. Several hospital pharmacies have decided to outsource high-risk preparations and some other compounding functions to companies who specialize in compounding. The high cost of medications and drug-related technology and the potential impact of medications and pharmacy services on patient-care outcomes and patient safety require hospital pharmacies to perform at

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4512-487: Is a moral obligation to refrain from lying. Because it relies on consent, contractualism is often understood as a patient-centered form of deontology. Famous social contract theorists include Thomas Hobbes , John Locke , Jean-Jacques Rousseau , and John Rawls . Discourse ethics also focuses on social agreement on moral norms but says that this agreement is based on communicative rationality . It aims to arrive at moral norms for pluralistic modern societies that encompass

4653-403: Is a way to create custom drugs for patients who may not be able to take the medication in its standard form, such as due to an allergy or difficulty swallowing. Compounding is necessary for these patients to still be able to properly get the prescriptions they need. One area of compounding is preparing drugs in new dosage forms. For example, if a drug manufacturer only provides a drug as a tablet,

4794-476: Is better than an unequal distribution even if the aggregate good is the same. There are disagreements about which consequences should be assessed. An important distinction is between act consequentialism and rule consequentialism. According to act consequentialism, the consequences of an act determine its moral value. This means that there is a direct relation between the consequences of an act and its moral value. Rule consequentialism, by contrast, holds that an act

4935-410: Is between naturalism and non-naturalism. Naturalism states that moral properties are natural properties accessible to empirical observation . They are similar to the natural properties investigated by the natural sciences , like color and shape. Some moral naturalists hold that moral properties are a unique and basic type of natural property. Another view states that moral properties are real but not

5076-911: Is developed by Hepler and Strand in 1990. Veterinary pharmacies, sometimes called animal pharmacies , may fall in the category of hospital pharmacy, retail pharmacy or mail-order pharmacy. Veterinary pharmacies stock different varieties and different strengths of medications to fulfill the pharmaceutical needs of animals. Because the needs of animals, as well as the regulations on veterinary medicine , are often very different from those related to people, in some jurisdictions veterinary pharmacy may be kept separate from regular pharmacies. Nuclear pharmacy focuses on preparing radioactive materials for diagnostic tests and for treating certain diseases. Nuclear pharmacists undergo additional training specific to handling radioactive materials, and unlike in community and hospital pharmacies, nuclear pharmacists typically do not interact directly with patients. Compounding In

5217-447: Is done for therapeutic use in a particular patient, and the compounded product is supplied on or from the compounding pharmacy. There are additional requirements for sterile compounding. Not only must a laminar flow cabinet [laminar flow hood] be used, but the environment in which the hood is located must be strictly controlled for microbial and particulate contamination and all procedures, equipment and personnel must be validated to ensure

5358-456: Is embedded in and relative to social and cultural contexts. Pragmatists tend to give more importance to habits than to conscious deliberation and understand morality as a habit that should be shaped in the right way. Postmodern ethics agrees with pragmatist ethics about the cultural relativity of morality. It rejects the idea that there are objective moral principles that apply universally to all cultures and traditions. It asserts that there

5499-617: Is found at community or hospital pharmacies or in-home administration therapy. Compounding pharmacies specialize in compounding, although many also dispense the same non-compounded drugs that patients can obtain from community pharmacies. Consultant pharmacy practice focuses more on medication regimen review (i.e. "cognitive services") than on actual dispensing of drugs. Consultant pharmacists most typically work in nursing homes , but are increasingly branching into other institutions and non-institutional settings. Traditionally consultant pharmacists were usually independent business owners, though in

5640-537: Is found in Jainism , which has non-violence as its principal virtue. Duty is a central aspect of Hindu ethics and is about fulfilling social obligations, which may vary depending on a person's social class and stage of life . Confucianism places great emphasis on harmony in society and sees benevolence as a key virtue. Taoism extends the importance of living in harmony to the whole world and teaches that people should practice effortless action by following

5781-586: Is makers of dietary supplements . Ethics Ethics is the philosophical study of moral phenomena. Also called moral philosophy , it investigates normative questions about what people ought to do or which behavior is morally right. Its main branches include normative ethics , applied ethics , and metaethics . Normative ethics aims to find general principles that govern how people should act. Applied ethics examines concrete ethical problems in real-life situations, such as abortion , treatment of animals , and business practices . Metaethics explores

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5922-736: Is no one coherent ethical code since morality itself is irrational and humans are morally ambivalent beings. Postmodern ethics instead focuses on how moral demands arise in specific situations as one encounters other people. Ethical egoism is the view that people should act in their self-interest or that an action is morally right if the person acts for their own benefit. It differs from psychological egoism , which states that people actually follow their self-interest without claiming that they should do so. Ethical egoists may act in agreement with commonly accepted moral expectations and benefit other people, for example, by keeping promises, helping friends, and cooperating with others. However, they do so only as

6063-651: Is not interested in which actions are right but in what it means for an action to be right and whether moral judgments are objective and can be true at all. It further examines the meaning of morality and other moral terms. Metaethics is a metatheory that operates on a higher level of abstraction than normative ethics by investigating its underlying assumptions. Metaethical theories typically do not directly judge which normative ethical theories are correct. However, metaethical theories can still influence normative theories by examining their foundational principles. Metaethics overlaps with various branches of philosophy. On

6204-479: Is not permitted for a drug product that is "essentially a copy" of a mass-produced drug product, however outsourcing pharmacies are subject to a broader definition of "essentially a copy". For traditional/patient-specific compounding, 503A's definition of "copy" retains its original focus on drug products or ultimate dosage forms rather than drug substances or active ingredients, and in any event it explicitly excludes from its definition any compounded drug product that

6345-413: Is not specific to pharmacy. Both disciplines are distinct. Those who wish to practice both pharmacy (patient-oriented) and pharmacology (a biomedical science requiring the scientific method) receive separate training and degrees unique to either discipline. Pharmacoinformatics is considered another new discipline, for systematic drug discovery and development with efficiency and safety. Pharmacogenomics

6486-446: Is one of the earliest forms of consequentialism. It arose in the 5th century BCE and argued that political action should promote justice as a means to increase the welfare of the people. The most well-known form of consequentialism is utilitarianism. In its classical form, it is an act consequentialism that sees happiness as the only source of intrinsic value. This means that an act is morally right if it produces "the greatest good for

6627-428: Is one of the main branches of philosophy and investigates the nature of morality and the principles that govern the moral evaluation of conduct , character traits , and institutions . It examines what obligations people have, what behavior is right and wrong, and how to lead a good life. Some of its key questions are "How should one live?" and "What gives meaning to life ?". In contemporary philosophy, ethics

6768-422: Is primarily concerned with normative statements about what ought to be the case, in contrast to descriptive statements , which are about what is the case. Duties and obligations express requirements of what people ought to do. Duties are sometimes defined as counterparts of the rights that always accompany them. According to this view, someone has a duty to benefit another person if this other person has

6909-530: Is received. Legislation requires the supervision of certain pharmacy technician's activities by a pharmacist. The majority of pharmacy technicians work in community pharmacies . In hospital pharmacies, pharmacy technicians may be managed by other senior pharmacy technicians. In the UK the role of a PhT in hospital pharmacy has grown and responsibility has been passed on to them to manage the pharmacy department and specialized areas in pharmacy practice allowing pharmacists

7050-438: Is right if it follows a certain set of rules. Rule consequentialism determines the best rules by considering their outcomes at a community level. People should follow the rules that lead to the best consequences when everyone in the community follows them. This implies that the relation between an act and its consequences is indirect. For example, if telling the truth is one of the best rules, then according to rule consequentialism,

7191-434: Is that codes of conduct in specific areas, such as business and environment, are usually termed ethics rather than morality, as in business ethics and environmental ethics . Normative ethics is the philosophical study of ethical conduct and investigates the fundamental principles of morality . It aims to discover and justify general answers to questions like "How should one live?" and "How should people act?", usually in

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7332-422: Is the only thing with intrinsic value is called ethical or evaluative hedonism . Classical utilitarianism was initially formulated by Jeremy Bentham at the end of the 18th century and further developed by John Stuart Mill . Bentham introduced the hedonic calculus to assess the value of consequences. Two key aspects of the hedonic calculus are the intensity and the duration of pleasure. According to this view,

7473-427: Is the study of genetic-linked variants that effect patient clinical responses, allergies, and metabolism of drugs. The World Health Organization estimates that there are at least 2.6 million pharmacists and other pharmaceutical personnel worldwide. Pharmacists are healthcare professionals with specialized education and training who perform various roles to ensure optimal health outcomes for their patients through

7614-437: Is to have a good will. A person has a good will if they respect the moral law and form their intentions and motives in agreement with it. Kant states that actions motivated in such a way are unconditionally good, meaning that they are good even in cases where they result in undesirable consequences. Divine command theory says that God is the source of morality. It states that moral laws are divine commands and that to act morally

7755-489: Is to obey and follow God's will . While all divine command theorists agree that morality depends on God, there are disagreements about the precise content of the divine commands, and theorists belonging to different religions tend to propose different moral laws. For example, Christian and Jewish divine command theorists may argue that the Ten Commandments express God's will while Muslims may reserve this role for

7896-411: Is usually divided into normative ethics , applied ethics , and metaethics . Morality is about what people ought to do rather than what they actually do, what they want to do, or what social conventions require. As a rational and systematic field of inquiry, ethics studies practical reasons why people should act one way rather than another. Most ethical theories seek universal principles that express

8037-421: Is wrong to break a promise even if no harm comes from it. Deontologists are interested in which actions are right and often allow that there is a gap between what is right and what is good. Many focus on prohibitions and describe which acts are forbidden under any circumstances. Agent-centered deontological theories focus on the person who acts and the duties they have. Agent-centered theories often focus on

8178-399: Is wrong. This observation is sometimes taken as an argument against moral realism since moral disagreement is widespread in most fields. Moral relativists reject the idea that morality is an objective feature of reality. They argue instead that moral principles are human inventions. This means that a behavior is not objectively right or wrong but only subjectively right or wrong relative to

8319-667: The Ancient Greek word êthos ( ἦθος ), meaning ' character ' and ' personal disposition ' . This word gave rise to the Ancient Greek word ēthikós ( ἠθικός ), which was translated into Latin as ethica and entered the English language in the 15th century through the Old French term éthique . The term morality originates in the Latin word moralis , meaning ' manners ' and ' character ' . It

8460-581: The Food and Drug Administration , concerned about the rising number of accidents related to compounded medications, identified "red flag" factors and issued a guide devoted to human pharmacy compounding, These factors include instances where pharmacists are: In October 2012 news reports surfaced of an outbreak of fungal meningitis tied to the New England Compounding Center, a pharmacy which engaged in bulk compounding. At that time it

8601-631: The International Pharmaceutical Federation (FIP), an NGO linked with World Health Organization (WHO). They are represented at the national level by professional organisations such as the Royal Pharmaceutical Society in the UK, Pharmaceutical Society of Australia (PSA), Canadian Pharmacists Association (CPhA), Indian Pharmacist Association (IPA), Pakistan Pharmacists Association (PPA), American Pharmacists Association (APhA), and

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8742-698: The Islamic Golden Age , themselves deriving their knowledge from earlier Greek Byzantine medicine . Pharmacy in China dates at least to the earliest known Chinese manual, the Shennong Bencao Jing ( The Divine Farmer's Herb-Root Classic ), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong . Earlier literature included lists of prescriptions for specific ailments, exemplified by

8883-464: The Islamic Golden Age . By the 9th century, these pharmacies were state-regulated. The advances made in the Middle East in botany and chemistry led medicine in medieval Islam substantially to develop pharmacology . Muhammad ibn Zakarīya Rāzi (Rhazes) (865–915), for instance, acted to promote the medical uses of chemical compounds. Abu al-Qasim al-Zahrawi (Abulcasis) (936–1013) pioneered

9024-949: The Malaysian Pharmaceutical Society (MPS). In some cases, the representative body is also the registering body, which is responsible for the regulation and ethics of the profession. In the United States, specializations in pharmacy practice recognized by the Board of Pharmacy Specialties include: cardiovascular, infectious disease , oncology , pharmacotherapy, nuclear, nutrition , and psychiatry . The Commission for Certification in Geriatric Pharmacy certifies pharmacists in geriatric pharmacy practice. The American Board of Applied Toxicology certifies pharmacists and other medical professionals in applied toxicology . Pharmacy technicians support

9165-794: The New England compounding center said that about 750 people were sickened, including 63 deaths, and that infections were linked to more than 17,600 doses of methylprednisolone acetate steroid injections used to treat back and joint pain that were shipped to 23 states. At that time, another incident was reported after at least 15 people at two Texas hospitals developed bacterial infections. All lots of medications dispensed since May 9, 2013, made by Specialty Compounding, LLC of Cedar Park, Texas were recalled. The hospitals reported affected were Corpus Christi Medical Center Bay Area and Corpus Christi Medical Center Doctors Regional. The patients had received intravenous infusions of calcium gluconate ,

9306-547: The United States , compounding pharmacies are licensed and regulated by states. National standards have been created by Pharmacy Compounding Accreditation Board (PCAB), however, obtaining accreditation is not mandatory and inspections for compliance occur only every three years. The Food and Drug Administration (FDA) has authority to regulate "manufacturing" of pharmaceutical products—which applies when drug products are not made or modified as to be tailored in some way to

9447-410: The active ingredients in these drug concoctions. Using fractionation or recrystallization , they separated an active ingredient from the crude preparation, and compounded a medication using this active ingredient. With the isolation of medications from the raw materials or crude drugs came the birth of the modern pharmaceutical company. Pharmacists were trained to compound the preparations made by

9588-483: The distillation of sea-water for drinking. In Europe , pharmacy-like shops began to appear during the 12th century. In 1240, emperor Frederic II issued a decree by which the physician's and the apothecary's professions were separated. There are pharmacies in Europe that have been in operation since medieval times. In Florence , Italy, the director of the museum in the former Santa Maria Novella pharmacy says that

9729-402: The medieval period , ethical thought was strongly influenced by religious teachings. In the modern period , this focus shifted to a more secular approach concerned with moral experience, reasons for acting , and the consequences of actions. An influential development in the 20th century was the emergence of metaethics. Ethics, also called moral philosophy, is the study of moral phenomena. It

9870-532: The 20th century, virtue ethics experienced a resurgence thanks to philosophers such as Elizabeth Anscombe , Philippa Foot , Alasdair MacIntyre , and Martha Nussbaum . There are many other schools of normative ethics in addition to the three main traditions. Pragmatist ethics focuses on the role of practice and holds that one of the key tasks of ethics is to solve practical problems in concrete situations. It has certain similarities to utilitarianism and its focus on consequences but concentrates more on how morality

10011-404: The 20th century, when the term was coined by G. E. M. Anscombe . Consequentialists usually understand the consequences of an action in a very wide sense that includes the totality of its effects. This is based on the idea that actions make a difference in the world by bringing about a causal chain of events that would not have existed otherwise. A core intuition behind consequentialism is that

10152-548: The 3rd or 4th century AD. Many Sumerian (4th millennium BC – early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine. Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC. In Ancient Greece , Diocles of Carystus (4th century BC) was one of several men studying

10293-575: The Board has been working to put a credentialing system in place. In 2011 the Pharmacy Board convened a Compounding Working Party to advise on revised compounding standards. Draft compounding guidelines for comment were released in April 2014. Pharmacists must comply with current guidelines or may be sanctioned by the Board. Both sterile and non-sterile compounding are legal provided the compounding

10434-758: The Emperor. There is a stone sign for a pharmacy shop with a tripod, a mortar, and a pestle opposite one for a doctor in the Arcadian Way in Ephesus near Kusadasi in Turkey. The current Ephesus dates back to 400 BC and was the site of the Temple of Artemis, one of the seven wonders of the world. In Baghdad the first pharmacies, or drug stores, were established in 754, under the Abbasid Caliphate during

10575-401: The FDA's oversight. In addition to being subjected to Food and Drug Administration inspections, registration, fees, and specified reporting requirements, other requirements of outsourcing facilities include: Poor practices on the part of drug compounders can result in contamination of products, or products that do not meet their stated strength, purity, or quality. Unless a complaint is filed or

10716-533: The U.S. federal health care system (including the VA, the Indian Health Service, and NIH) ambulatory care pharmacists are given full independent prescribing authority. In some states, such as North Carolina and New Mexico , these pharmacist clinicians are given collaborative prescriptive and diagnostic authority. In 2011 the board of Pharmaceutical Specialties approved ambulatory care pharmacy practice as

10857-483: The UK, this group of staff can sell certain medicines (including pharmacy only and general sales list medicines) over the counter. They cannot prepare prescription-only medicines for supply to patients. The earliest known compilation of medicinal substances was the Sushruta Samhita , an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to

10998-497: The United States many now work for a large pharmacy management company such as Omnicare , Kindred Healthcare or PharMerica . This trend may be gradually reversing as consultant pharmacists begin to work directly with patients, primarily because many elderly people are now taking numerous medications but continue to live outside of institutional settings. Some community pharmacies employ consultant pharmacists and/or provide consulting services. The main principle of consultant pharmacy

11139-430: The actual consequences but the expected consequences. This view takes into account that when deciding what to do, people have to rely on their limited knowledge of the total consequences of their actions. According to this view, a course of action has positive moral value despite leading to an overall negative outcome if it had the highest expected value , for example, because the negative outcome could not be anticipated or

11280-529: The agent. It is controversial whether agent-relative moral theories, like ethical egoism , should be considered as types of consequentialism. There are many different types of consequentialism. They differ based on what type of entity they evaluate, what consequences they take into consideration, and how they determine the value of consequences. Most theories assess the moral value of acts. However, consequentialism can also be used to evaluate motives , character traits , rules, and policies . Many types assess

11421-570: The basic assumptions underlying moral claims are misguided. Some moral nihilists conclude from this that anything is allowed. A slightly different view emphasizes that moral nihilism is not itself a moral position about what is allowed and prohibited but the rejection of any moral position. Moral nihilism, like moral relativism, recognizes that people judge actions as right or wrong from different perspectives. However, it disagrees that this practice involves morality and sees it as just one type of human behavior. A central disagreement among moral realists

11562-417: The best action for someone with a good salary would be to donate 70% of their income to charity, it would be morally wrong for them to only donate 65%. Satisficing consequentialism, by contrast, only requires that an act is "good enough" even if it is not the best possible alternative. According to this view, it is possible to do more than one is morally required to do. Mohism in ancient Chinese philosophy

11703-899: The complexity of medications including specific indications, effectiveness of treatment regimens, safety of medications (i.e., drug interactions) and patient compliance issues (in the hospital and at home), many pharmacists practicing in hospitals gain more education and training after pharmacy school through a pharmacy practice residency, sometimes followed by another residency in a specific area. Those pharmacists are often referred to as clinical pharmacists and they often specialize in various disciplines of pharmacy. For example, there are pharmacists who specialize in hematology/oncology, HIV/AIDS, infectious disease, critical care, emergency medicine , toxicology, nuclear pharmacy, pain management, psychiatry, anti-coagulation clinics, herbal medicine , neurology/epilepsy management, pediatrics, neonatal pharmacists and more. Hospital pharmacies can often be found within

11844-421: The consequences. A related approach is to characterize consequentialism not in terms of consequences but in terms of outcome, with the outcome being defined as the act together with its consequences. Most forms of consequentialism are agent-neutral. This means that the value of consequences is assessed from a neutral perspective, that is, acts should have consequences that are good in general and not just good for

11985-423: The deficient state of cowardice and the excessive state of recklessness . Aristotle held that virtuous action leads to happiness and makes people flourish in life. Stoicism emerged about 300 BCE and taught that, through virtue alone, people can achieve happiness characterized by a peaceful state of mind free from emotional disturbances. The Stoics advocated rationality and self-mastery to achieve this state. In

12126-480: The drug companies, but they could not do it efficiently on a small scale. So economies of scale , not lack of skill or knowledge, produced the modern pharmaceutical industry . With the turn of the 20th century came greater government regulation of the practice of medicine. These new regulations forced the drug companies to prove that any new medication they brought to market was safe. With the discovery of penicillin , modern marketing techniques and brand promotion,

12267-416: The drug manufacturing industry came of age. Pharmacists continued to compound most prescriptions until the early 1950s when the majority of dispensed drugs came directly from the large pharmaceutical companies. A physician may choose to prescribe a compounded medication for a patient with an unusual health need that cannot be met with commercially manufactured products. The physician may choose to prescribe

12408-428: The field are also pioneering. Living in the 10th century, he wrote The foundations of the true properties of Remedies , amongst others describing arsenious oxide , and being acquainted with silicic acid . He made clear distinction between sodium carbonate and potassium carbonate , and drew attention to the poisonous nature of copper compounds, especially copper vitriol , and also lead compounds. He also describes

12549-502: The field of pharmacy , compounding (performed in compounding pharmacies ) is preparation of custom medications to fit unique needs of patients that cannot be met with mass-produced products. This may be done, for example, to provide medication in a form easier for a given patient to ingest (e.g., liquid vs. tablet), or to avoid a non-active ingredient a patient is allergic to, or to provide an exact dose that isn't otherwise available. This kind of patient-specific compounding, according to

12690-413: The form of universal or domain-independent principles that determine whether an act is right or wrong. For example, given the particular impression that it is wrong to set a child on fire for fun, normative ethics aims to find more general principles that explain why this is the case, like the principle that one should not cause extreme suffering to the innocent , which may itself be explained in terms of

12831-519: The formation of character . Descriptive ethics describes the dominant moral codes and beliefs in different societies and considers their historical dimension. The history of ethics started in the ancient period with the development of ethical principles and theories in ancient Egypt , India , China , and Greece . This period saw the emergence of ethical teachings associated with Hinduism , Buddhism , Confucianism , Daoism , and contributions of philosophers like Socrates and Aristotle . During

12972-405: The future should be shaped to achieve the best possible outcome. The act itself is usually not seen as part of the consequences. This means that if an act has intrinsic value or disvalue, it is not included as a factor. Some consequentialists see this as a flaw, saying that all value-relevant factors need to be considered. They try to avoid this complication by including the act itself as part of

13113-429: The greatest number" by increasing happiness and reducing suffering. Utilitarians do not deny that other things also have value, like health, friendship, and knowledge. However, they deny that these things have intrinsic value. Instead, they say that they have extrinsic value because they affect happiness and suffering. In this regard, they are desirable as a means but, unlike happiness, not as an end. The view that pleasure

13254-501: The highest level possible. Pharmacists provide direct patient care services that optimize the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists care for patients in all health care settings, but the clinical pharmacy movement initially began inside hospitals and clinics . Clinical pharmacists often collaborate with physicians and other healthcare professionals to improve pharmaceutical care. Clinical pharmacists are now an integral part of

13395-421: The human mind and culture rather than as subjective constructs or expressions of personal preferences and cultural norms . Moral realists accept the claim that there are objective moral facts. This view implies that moral values are mind-independent aspects of reality and that there is an absolute fact about whether a given action is right or wrong. A consequence of this view is that moral requirements have

13536-415: The importance of interpersonal relationships and say that benevolence by caring for the well-being of others is one of the key virtues. Influential schools of virtue ethics in ancient philosophy were Aristotelianism and Stoicism . According to Aristotle (384–322 BCE), each virtue is a golden mean between two types of vices: excess and deficiency. For example, courage is a virtue that lies between

13677-612: The individual patient —regardless of whether this is done at a factory or at a pharmacy. In the Drug Quality and Security Act (DQSA) of 2013 (H.R. 3204), Congress amended the Federal Food, Drug, and Cosmetic Act (FFDCA) to clarify limits of FDA jurisdiction over patient-specific compounding, and to provide an optional pathway for "non-traditional" or bulk compounders to operate. The law established that pharmacies compounding only "patient-specific" preparations made in response to

13818-411: The intellectual satisfaction of reading a book, are more valuable than lower pleasures, like the sensory enjoyment of food and drink, even if their intensity and duration are the same. Since its original formulation, many variations of utilitarianism have developed, including the difference between act and rule utilitarianism and between maximizing and satisficing utilitarianism. Deontology assesses

13959-591: The interdisciplinary approach to patient care. They often participate in patient care rounds for drug product selection. In the UK clinical pharmacists can also prescribe some medications for patients on the NHS or privately, after completing a non-medical prescribers course to become an Independent Prescriber. The clinical pharmacist's role involves creating a comprehensive drug therapy plan for patient-specific problems, identifying goals of therapy, and reviewing all prescribed medications prior to dispensing and administration to

14100-416: The introduction of new therapeutics and methods for patient care. However, pharmacy is not a basic or biomedical science in its typical form. Medicinal chemistry is also a distinct branch of synthetic chemistry combining pharmacology, organic chemistry, and chemical biology. Pharmacology is sometimes considered the fourth discipline of pharmacy. Although pharmacology is essential to the study of pharmacy, it

14241-616: The isolation of various compounds from coal tar for the purpose of producing synthetic dyes . From this came the earliest antibacterial sulfa drugs , phenolic compounds made famous by Joseph Lister , and plastics . During the 1800s, pharmacists specialized in the raising, preparation and compounding of crude drugs . Crude drugs, like opium , are from natural sources and usually contain several chemical compounds . The pharmacist extracted these drugs using solvents such as water or alcohol to form extracts , concoctions and decoctions . They eventually began isolating and identifying

14382-786: The lack of oversight. "Non-traditional" compounders behave like drug manufacturers in some cases by having sales teams that market non-personalized drug products or production capability to doctors, by making drugs that are essentially the same as commercially available mass-produced drug products, or by preparing large batches of a given drug product in anticipation of additional prescriptions before actually receiving them. An FDA spokesperson stated, "The methods of these companies seem far more consistent with those of drug manufacturers than with those of retail pharmacies. Some firms make large amounts of compounded drugs that are copies or near copies of FDA-approved, commercially available drugs. Other firms sell to physicians and patients with whom they have only

14523-609: The level of ontology , it examines whether there are objective moral facts. Concerning semantics , it asks what the meaning of moral terms are and whether moral statements have a truth value . The epistemological side of metaethics discusses whether and how people can acquire moral knowledge. Metaethics overlaps with psychology because of its interest in how moral judgments motivate people to act. It also overlaps with anthropology since it aims to explain how cross-cultural differences affect moral assessments. Metaethics examines basic ethical concepts and their relations. Ethics

14664-407: The medicinal properties of plants. He wrote several treatises on the topic. The Greek physician Pedanius Dioscorides is famous for writing a five-volume book in his native Greek Περί ύλης ιατρικής in the 1st century AD. The Latin translation De Materia Medica ( Concerning medical substances ) was used as a basis for many medieval texts and was built upon by many middle eastern scientists during

14805-569: The moral rightness of actions based on a set of norms or principles. These norms describe the requirements that all actions need to follow. They may include principles like telling the truth, keeping promises , and not intentionally harming others. Unlike consequentialists, deontologists hold that the validity of general moral principles does not directly depend on their consequences. They state that these principles should be followed in every case since they express how actions are inherently right or wrong. According to moral philosopher David Ross , it

14946-477: The moral value of acts only depends on the pleasure and suffering they cause. An alternative approach says that there are many different sources of value, which all contribute to one overall value. Before the 20th century, consequentialists were only concerned with the total of value or the aggregate good. In the 20th century, alternative views were developed that additionally consider the distribution of value. One of them states that an equal distribution of goods

15087-504: The most valuable Islamic works on pharmacology, entitled Kitab al-Saydalah ( The Book of Drugs ), in which he detailed the properties of drugs and outlined the role of pharmacy and the functions and duties of the pharmacist. Avicenna , too, described no less than 700 preparations, their properties, modes of action, and their indications. He devoted in fact a whole volume to simple drugs in The Canon of Medicine . Of great impact were also

15228-431: The motives and intentions behind people's actions, highlighting the importance of acting for the right reasons. They tend to be agent-relative, meaning that the reasons for which people should act depend on personal circumstances. For example, a parent has a special obligation to their child, while a stranger does not have this kind of obligation toward a child they do not know. Patient-centered theories, by contrast, focus on

15369-476: The natural flow of the universe . Indigenous belief systems, like Native American philosophy and the African Ubuntu philosophy , often emphasize the interconnectedness of all living beings and the environment while stressing the importance of living in harmony with nature. Metaethics is the branch of ethics that examines the nature, foundations, and scope of moral judgments , concepts, and values. It

15510-419: The patient. The review process often involves an evaluation of the appropriateness of drug therapy (e.g., drug choice, dose, route, frequency, and duration of therapy) and its efficacy. Research shows that pharmacist led strategies reduce errors related to medication use. The pharmacist must also consider potential drug interactions, adverse drug reactions, and patient drug allergies while they design and initiate

15651-430: The people affected by actions and the rights they have. An example is the requirement to treat other people as ends and not merely as a means to an end. This requirement can be used to argue, for example, that it is wrong to kill a person against their will even if this act would save the lives of several others. Patient-centered deontological theories are usually agent-neutral, meaning that they apply equally to everyone in

15792-440: The person possesses and exercises certain capacities or some form of control . If a person is morally responsible then it is appropriate to respond to them in certain ways, for example, by praising or blaming them. A major debate in metaethics is about the ontological status of morality, questioning whether ethical values and principles are real. It examines whether moral properties exist as objective features independent of

15933-411: The person would want everyone to follow the same maxim as a universal law applicable to everyone. Another formulation states that one should treat other people always as ends in themselves and never as mere means to an end. This formulation focuses on respecting and valuing other people for their own sake rather than using them in the pursuit of personal goals. In either case, Kant says that what matters

16074-727: The pharmacy there dates back to 1221. In Trier (Germany), the Löwen-Apotheke is in operation since 1241, the oldest pharmacy in Europe in continuous operation. In Dubrovnik (Croatia), a pharmacy that first opened in 1317 is located inside the Franciscan monastery: it is the 2nd oldest pharmacy in Europe that is still operating. In the Town Hall Square of Tallinn (Estonia), there is a pharmacy dating from at least 1422. The medieval Esteve Pharmacy , located in Llívia ,

16215-479: The practice of selfless love , such as the Great Commandment to "Love your neighbor as yourself". The Five Pillars of Islam constitute a basic framework of Muslim ethics and focus on the practice of faith , prayer , charity , fasting during Ramadan , and pilgrimage to Mecca . Buddhists emphasize the importance of compassion and loving-kindness towards all sentient entities. A similar outlook

16356-551: The pre- Heian Imperial court were established; and this organizational structure remained largely intact until the Meiji Restoration (1868). In this highly stable hierarchy, the pharmacists—and even pharmacist assistants—were assigned status superior to all others in health-related fields such as physicians and acupuncturists. In the Imperial household, the pharmacist was even ranked above the two personal physicians of

16497-446: The premises of the hospital. Hospital pharmacies usually stock a larger range of medications, including more specialized medications, than would be feasible in the community setting. Most hospital medications are unit-dose, or a single dose of medicine. Hospital pharmacists and trained pharmacy technicians compound sterile products for patients including total parenteral nutrition (TPN), and other medications are given intravenously. That

16638-466: The preparation of medicines by sublimation and distillation . His Liber servitoris is of particular interest, as it provides the reader with recipes and explains how to prepare the "simples" from which were compounded the complex drugs then generally used. Sabur Ibn Sahl (d 869), was, however, the first physician to record his findings in a pharmacopoeia , describing a large variety of drugs and remedies for ailments. Al-Biruni (973–1050) wrote one of

16779-790: The proper dose amount. The workflow management systems incorporate software to guide pharmacy technicians through the process of preparing IV medications. The robotic systems prepare IV syringes and bags in an ISO Class 5 environment, and support sterility and dose accuracy by removing human error and contamination from the process. In Australia the Pharmacy Board of Australia is responsible for registration of pharmacists and professional practice including compounding. Although almost all pharmacies are able to prepare at least simple compounded medicines, some pharmacy staff undertake further training and education to be able to prepare more complex products. Although pharmacists who have undertaken further training to do complex compounding are not yet easily identified,

16920-409: The quality use of medicines. Pharmacists may also be small business proprietors, owning the pharmacy in which they practice. Since pharmacists know about the mode of action of a particular drug, and its metabolism and physiological effects on the human body in great detail, they play an important role in optimization of drug treatment for an individual. Pharmacists are represented internationally by

17061-468: The right to receive that benefit. Obligation and permission are contrasting terms that can be defined through each other: to be obligated to do something means that one is not permitted not to do it and to be permitted to do something means that one is not obligated not to do it. Some theorists define obligations in terms of values or what is good . When used in a general sense, good contrasts with bad . When describing people and their intentions,

17202-629: The rising cost of compounding and drug shortages, some hospitals outsource their compounding needs to large-scale compounding pharmacies, particularly of sterile-injectable medications. Compounding preparations of a given formulation in advance batches, as opposed to preparation for a specific patient on demand, is known as "non-traditional" compounding and is akin to small-scale manufacturing. Jurisdictions have varying regulations that apply to drug manufacturers and pharmacies that do advance bulk compounding. The earliest chemists were familiar with various natural substances and their uses. They compounded

17343-446: The role of counseling patients on the proper use of their medications. Some states have a legally mandated pharmacist-to-pharmacy technician ratio . Dispensing assistants are commonly referred to as "dispensers" and in community pharmacies perform largely the same tasks as a pharmacy technician. They work under the supervision of pharmacists and are involved in preparing (dispensing and labelling) medicines for provision to patients. In

17484-494: The safe preparation of sterile products. In non-sterile compounding, a powder containment hood is required when any hazardous material (e.g. hormones) are prepared or when there is a risk of cross-contamination of the compounded product. Pharmacists preparing compounded products must comply with these requirements and others published in the Australian Pharmaceutical Formulary & Handbook. In

17625-417: The same course of action but provide different justifications for why it is right. Consequentialism, also called teleological ethics, says that morality depends on consequences. According to the most common view, an act is right if it brings the best future. This means that there is no alternative course of action that has better consequences. A key aspect of consequentialist theories is that they provide

17766-401: The same ontological status as non-moral facts: it is an objective fact whether there is an obligation to keep a promise just as it is an objective fact whether a thing is rectangular. Moral realism is often associated with the claim that there are universal ethical principles that apply equally to everyone. It implies that if two people disagree about a moral evaluation then at least one of them

17907-423: The same time required to justify them using rational argumentation. The main concern of virtue ethics is how virtues are expressed in actions. As such, it is neither directly interested in the consequences of actions nor in universal moral duties. Virtues are positive character traits like honesty , courage , kindness , and compassion . They are usually understood as dispositions to feel, decide, and act in

18048-409: The structure of practical reason and are true for all rational agents. According to Kant, to act morally is to act in agreement with reason as expressed by these principles while violating them is both immoral and irrational. Kant provided several formulations of the categorical imperative. One formulation says that a person should only follow maxims that can be universalized . This means that

18189-595: The teachings of the Quran . Contractualists reject the reference to God as the source of morality and argue instead that morality is based on an explicit or implicit social contract between humans. They state that actual or hypothetical consent to this contract is the source of moral norms and duties. To determine which duties people have, contractualists often rely on a thought experiment about what rational people under ideal circumstances would agree on. For example, if they would agree that people should not lie then there

18330-455: The term evil rather than bad is often employed. Obligations are used to assess the moral status of actions, motives , and character traits . An action is morally right if it is in tune with a person's obligations and morally wrong if it violates them. Supererogation is a special moral status that applies to cases in which the agent does more than is morally required of them. To be morally responsible for an action usually means that

18471-659: The time to specialize in their expert field as medication consultants spending more time working with patients and in research. Pharmacy technicians are registered with the General Pharmaceutical Council (GPhC). The GPhC is the regulator of pharmacists, pharmacy technicians, and pharmacy premises. In the US, pharmacy technicians perform their duties under the supervision of pharmacists. Although they may perform, under supervision, most dispensing, compounding and other tasks, they are not generally allowed to perform

18612-450: The truth and keeping promises. Virtue ethics sees the manifestation of virtues , like courage and compassion , as the fundamental principle of morality. Ethics is closely connected to value theory , which studies the nature and types of value , like the contrast between intrinsic and instrumental value . Moral psychology is a related empirical field and investigates psychological processes involved in morality, such as reasoning and

18753-444: The underlying assumptions and concepts of ethics. It asks whether there are objective moral facts, how moral knowledge is possible, and how moral judgments motivate people. Influential normative theories are consequentialism , deontology , and virtue ethics . According to consequentialists, an act is right if it leads to the best consequences. Deontologists focus on acts themselves, saying that they must adhere to duties , like telling

18894-720: The use of medication for the benefit of the patients. An establishment in which pharmacy (in the first sense) is practiced is called a pharmacy (this term is more common in the United States) or chemists (which is more common in Great Britain, though pharmacy is also used). In the United States and Canada, drugstores commonly sell medicines, as well as miscellaneous items such as confectionery , cosmetics , office supplies , toys , hair care products and magazines , and occasionally refreshments and groceries. In its investigation of herbal and chemical ingredients,

19035-399: The value of consequences based on whether they promote happiness or suffering. But there are also alternative evaluative principles, such as desire satisfaction, autonomy , freedom , knowledge , friendship , beauty , and self-perfection. Some forms of consequentialism hold that there is only a single source of value . The most prominent among them is utilitarianism , which states that

19176-429: The work of pharmacists and other health professionals by performing a variety of pharmacy-related functions, including dispensing prescription drugs and other medical devices to patients and instructing on their use. They may also perform administrative duties in pharmaceutical practice, such as reviewing prescription requests with medic's offices and insurance companies to ensure correct medications are provided and payment

19317-467: The work of the apothecary may be regarded as a precursor of the modern sciences of chemistry and pharmacology , prior to the formulation of the scientific method . The field of pharmacy can generally be divided into various disciplines: The boundaries between these disciplines and with other sciences, such as biochemistry, are not always clear-cut. Often, collaborative teams from various disciplines (pharmacists and other scientists) work together toward

19458-545: The works by al-Maridini of Baghdad and Cairo , and Ibn al-Wafid (1008–1074), both of which were printed in Latin more than fifty times, appearing as De Medicinis universalibus et particularibus by ' Mesue ' the younger, and the Medicamentis simplicibus by ' Abenguefit '. Peter of Abano (1250–1316) translated and added a supplement to the work of al-Maridini under the title De Veneris . Al-Muwaffaq's contributions in

19599-563: Was also disclosed that the United States and Massachusetts state health regulators were aware in 2002 that steroid treatments from the New England Compounding Center could cause adverse patient reactions. It was further disclosed that in 2001–02, four people died, more than a dozen were injured and hundreds exposed after they received back-pain injections tainted with a common fungus dispensed by two compounding pharmacies in California and South Carolina. In August 2013 further reports tied to

19740-555: Was introduced into the English language during the Middle English period through the Old French term moralité . The terms ethics and morality are usually used interchangeably but some philosophers distinguish between the two. According to one view, morality focuses on what moral obligations people have while ethics is broader and includes ideas about what is good and how to lead a meaningful life. Another difference

19881-475: Was unlikely. A further difference is between maximizing and satisficing consequentialism. According to maximizing consequentialism, only the best possible act is morally permitted. This means that acts with positive consequences are wrong if there are alternatives with even better consequences. One criticism of maximizing consequentialism is that it demands too much by requiring that people do significantly more than they are socially expected to. For example, if

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