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Bangladesh Journal of Bioethics 2018; 10 (1): 1-5 

 

 

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Ethics Education for Contemporary Clinical Pharmacy Practice in Nigeria: 

Shortfalls and Needs  

 

Roland N. Okoro 

Department of Clinical Pharmacy and Pharmacy Administration,  

Faculty of Pharmacy, University of Maiduguri, Nigeria,  

Email: orolandn@gmail.com  

 

Abstract: The past decade has witnessed a shift in the ambitions of pharmacists away from the 

core role of dispensing medicines towards more interesting and rewarding relationships and 

responsibilities with other healthcare providers and patients. The patient-centred role of 

pharmacists has allowed ethical issues experienced in medical practice to surface in pharmacy 

practice, resulting in an increase in the number and variety of ethical dilemmas that pharmacists 

face in their routine pharmacy practice. Pharmacy education prepares pharmacy students for 

practice and must be in tune with the professional dynamics. Many countries that provide 

patient-centered pharmacy services have redesigned pharmacy ethics education while others are 

in various stages of revision of their curriculum in order to adequately equip future pharmacists 

with the rudiments required to handle ethical issues in clinical pharmacy practice. In contrast, in 

Nigeria, little or no pharmacy ethics is taught to pharmacy students and the challenge lies with 

the curriculum design and method of teaching. 

Key words: Curriculum, Ethics Education, Nigeria, Clinical Pharmacy, Patient-centred 

 

Introduction: Pharmacy as a profession has 

undergone several dramatic changes over 

recent years. Pharmaceutical care has 

allowed the ethical issues experienced in 

medical practice to surface in pharmacy 

practice1. These ethical issues include 

decisions on choices related to drug 

therapies, uses of drugs for unapproved 

indications, patient confidentiality, financial 

relationships with the drug industry, 

allocation of scarce resources, pain 

management, death and dying, and so on2,3.  

Ethical issues significantly impacts on 

patients’ quality of life; therefore, 

pharmacists are obliged to utilize ethical 

principles (autonomy, beneficence, justice, 

non-maleficence), theories (such as 

utilitarianism, deontology) and/or codes of 

ethics when necessary. Disappointedly, 

many pharmacists are unable to detect, 

discuss and resolve value and ethical issues 

in pharmacy practice. Moreover, the 

increasing collaborative and patient-centred 

roles of contemporary pharmacists have 

heightened the need for effective pharmacy 

ethics education. Hence, pharmacy 

education curriculum should be adequate to 

prepare future pharmacists for clinical 

practice and to teach them skills needed to 

address ethical challenges that may arise in 

real-world pharmacy practice4. 

Current situation of pharmacy ethics 

education in Nigeria: The Nigerian 

University Commission (NUC) which is the 



Bangladesh Journal of Bioethics 2018; 10 (1): 1-5 

 

 

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apex regulatory authority of education in 

Nigeria has described pharmacy ethics in a 

2-credit hour forensic pharmacy and 

pharmacy ethics single course in the just 

newly approved Doctor of Pharmacy 

(PharmD) programme5. However, the 

University of Benin PharmD curriculum 

described pharmacy ethics as a component 

of a 2-credit unit pharmacy law and ethics 

single course with same contents as 

approved by the NUC (Table 1)6. 

Ascertaining what is currently covered in 

this course will paint a picture of what is 

being taught and will help to identify needs. 

Table 1 reveals ethics of pharmacy 

profession in Nigeria, and ethics and good 

business practice as the only ethics topics 

covered in the PharmD programme 

Shortfalls of the Nigerian pharmacy 

ethics syllabus: The curriculum content and 

method of teaching affect knowledge, 

critical thinking and learning skills. To the 

best of the knowledge of the author, there is 

still no formal pharmacy ethics syllabus 

being seriously implemented in Nigerian 

pharmacy schools for both PharmD and 

Bachelor of Pharmacy (B. Pharm.) 

programmes. Though pharmacy ethics exists 

as a component of forensic pharmacy and 

pharmacy ethics course in the curriculum, 

ethics syllabus is very weak, shallow, not 

well developed, and grossly inadequate for 

the present-day clinical pharmacy practice. 

Pharmacy law and ethics single course has 

traditionally been taught didactically as if it 

were solely consist of a set of specific rules 

to be learned and obeyed. Additionally, the 

combination of pharmacy law and pharmacy 

ethics as a single course has given room for 

these deficiencies, and pharmacy law 

predominance.  

In order to reemphasize the professional 

code of ethics, the Pharmacists Council of 

Nigeria (PCN) during pre-induction 

programmes deems it necessary to give pre-

induction orientation talk on the code of 

ethics for pharmacists to about to be 

inducted pharmacists. Though, knowledge 

of the code of ethics alone cannot 

necessarily translate to a commensurate 

level of ethics knowledge7. The implications 

of the lack of ethics education for clinical 

pharmacy practice are critical since the 

absence of internal control provokes 

external control. In addition, the 

improvement in pharmacy education in the 

area of research ethics will go a long way to 

improve the scope of ethics in clinical 

pharmacy research. Graduates or even post 

graduate students as in the case in other 

climes who find themselves in various 

Ethics Review Boards will be adequately 

trained for this role. 

Reinventing Nigerian pharmacy ethics 

education for future pharmacists: 

According to the guideline of the 

Accreditation Council for Pharmacy 

Education (ACPE), “teaching professional 

behaviour, principles and ethical issues 

related to the prescription, use of drugs, 

delivering patient-centred care, performing 

clinical research, team work, dealing with 

ethical dilemmas, and conflict of interest 

among others are essential to the 

development of pharmacists” 8. These issues 

are not covered in the current Nigerian 

pharmacy ethics syllabus.  

Current global best clinical pharmacy 

practice attaches great importance to the 

practice ethics, and students need to be 

educated on various aspects of pharmacy 

practice ethics. Therefore, some schools and 

colleges of pharmacy in other climes have 

developed enriched standalone ethics course 

with mixed methods of teaching such as 

didactic lectures, case studies, class 

discussions/debates, team-based learning 

and presentations among others in their 

curricula. This innovative strategy is to 

vouch for a minimum level of pharmacy



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Table 1: NUC approved forensic pharmacy and pharmacy ethics syllabus for pharmD programme 

Course descriptions (2 credit unit) 

 History of pharmacy in Nigeria 

 Ethics of pharmacy profession in Nigeria 

 Ethics and good business practice 

 Laws related to the National Agency for Food and Drug Administration and Control (NAFDAC), National Drug Law 

Enforcement Agency (NDLEA), Standard Organization of Nigeria (SON), Pharmacists Council of Nigeria (PCN), 

WHO/FAO Codex Allimentarium Commission, United Nations Narcotic Commission, Federal Environmental 

Protection Agency (FEPA), etc; 

 Food, drug and cosmetics laws including regulation, inspection, registration, advertising, manufacture, and 

sale/distribution. 

 Poison, dangerous drugs and pharmacy Acts; Essential Drugs List (EDL); Fake and counterfeit drug laws; Consumer 

protection council law 

 Policy and Legal Framework – Legal procedure; Information service; Intellectual property rights and patenting of 

inventions; Risk and insurance; Legal aspects of employment; Taxation 

 All other relevant laws related to the practice of pharmacy including those of the Pharmacists Disciplinary Committee 

and Assessors rules, Pharmacists registration rules, Dispensing of Drugs, Patent and Proprietary Medicines, etc.  

 Legislation on animal health products.  

 National Health Insurance Scheme (NHIS) and other health policies, and National Drug Policy. 

 

 

 

Table 2: Pharmacy ethics syllabus of the College of Pharmacy, University of Texas, US for the PharmD programme 

Course description 

Ethics and values in pharmacy 

 Introduction to ethics, values, and moral reasoning 

 Models for ethical problem solving 

 Model for ethical problem solving     

 Values in health and illness 

 Sources of moral judgments   

 Conceptual framework review – elements, principles, and processes 

 Models for ethical problem solving 

 Team case presentations 

 The “Georgetown Mantra” – ethical principles 

 Interprofessional case discussion panel 

Ethical principles in pharmacy ethics 

 Topic clarification: beneficience, non-maleficience, autonomy, and justice 

 Team case presentations 

 Principle application cases: sources of moral judgments – role of professional codes 

 Team case presentations 

 Interprofessional case discussion panel 

 Professional duties of practitioners – applying principles to patient situations 

 Team case presentations 

Honesty, truth telling, and avoidance of killing 

 Dealing honestly with patients 

 Ethical issues in pain management  

 Interprofessional case discussion panel 

Sensitive patient scenarios – application of ethical principles and decision-making models 

 Abortion, sterilization, and contraception  

 Mental health issues    

 Right of refusal 

 Research ethics 

 Principle application cases: avoidance of killing 

 Principle application cases: application of ethical principles in sensitive patient situations 

 Right of refusal and patient autonomy 

 Team case presentations 

 



Bangladesh Journal of Bioethics 2018; 10 (1): 1-5 

 

 

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ethics knowledge, competencies, skills and, 

even the character of their graduates. Hence, 

the overall goals of the pharmacy ethics 

education are to endow students with a set of 

cognitive and behavioural skills for ethical 

reasoning that will allow them to recognize 

ethical dilemmas in pharmacy practiceand 

research, and equip them to make 

appropriate, justifiable socio-culturally 

sensitive decisions to those dilemmas.  

Against this background, this paper proposes 

a curricular modification with respect to 

pharmacy ethics to reflect the current reality 

of global best patient-centred pharmacy 

practice in Nigeria. Syllabus content, 

teaching and assessment methods should be 

reconsidered and developed to foster deep-

level learning, and achievement of the 

objectives of this course. In view of this, a 

model pharmacy ethics syllabus can be 

adapted from that of the college of 

pharmacy at University of Texas (Table 2). 

Unlike the current Nigerian model, the 

proposed model is more patient-centred 

because it explores ethical issues 

pharmacists face as a member of the 

healthcare team and provide a framework 

for addressing ethical dilemmas. This is so 

because the proposed model will help 

students to identify the importance of 

morality and ethics in healthcare and their 

role in the provision of pharmacist-directed 

patient care. It will demonstrate competency 

in the application of bioethical principles to 

patients’ situations. Also, it will equip 

students with skills required to apply 

appropriate decision-making strategies in 

providing care for patients. Lastly, it has the 

potential to build interprofessional 

collaborative practice in developing 

effective interpersonal communication skills 

required of a pharmacist and reap the 

benefits of discussing ethical dilemmas with 

other healthcare team members.  

Conclusion : Today, pharmacy ethics 

contents of the Nigerian pharmacy education 

curriculum of is grossly inadequate and the 

teaching method too didactic to adequately 

prepare future pharmacists for the more 

challenging patient-centred roles with 

practice environment full of ethical 

dilemmas. Curriculum design and methods 

of teaching are critical to renewal and 

progress in any profession. Therefore, there 

is an urgent need to develop an enriched 

standalone pharmacy ethics course that will 

include all relevant ethical issues 

encountered in routine clinical pharmacy 

practice in Nigeria. Finally, varieties of 

teaching methods such as classroom 

discussions/debates, case studies, and team-

based learning approaches should be 

adopted for effective delivery of this course 

to the students.  

References: 

1. Tekiner H. Why Teach Pharmacy Ethics 

Through Literary Fiction? World J Pharm Sci. 

2017; 5(6):203-206.  

2. Buerki RA, Vottero LD. Ethical Responsibility 

in Pharmacy Practice. 2nd ed. Madison: 

American Institute of the History of Pharmacy. 

2002. 

3. Wingfield J, Bissell P, Anderson C. The Scope 

of Pharmacy Ethics: Ann Evaluation of the 

International Research Literature, 1990–2002. 

Soc Sci Med. 2004; 58(12):2383-2396.  

4. Hasan S. Teaching Ethics to Pharmacy Students 

Using a Team-Based Learning Approach. 

Pharmacy Education. 2011; 11(1):99-106. 

5. Benchmark Minimum Academic Standards for 

Undergraduate Programmes in Nigerian 

Universities, Pharmaceutical Sciences. Nigerian 

University Commission. 2018. 

6. Undergraduate and Postgraduate Programmes 

Prospectus 2000/2001 Academic Session, 

Faculty of Pharmacy, University of Benin, Benin 

City, Edo State, Seevon Prints, Nigeria, 2001 pp. 

49-50. 



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7. Fadare JO, Desalu OO, Jemilohun AC, 

Babatunde OA. Knowledge of medical ethics 

among Nigerian medical doctors. Niger Med J. 

2012; 53(4):226-230. 

8. Accreditation Council for Pharmacy Education. 

Accreditation (ACPE) Standards 2016 - 

Accreditation Council for Pharmacy Education. 

Available from: https://www.acpe-

accredit.org/pdf/Standards2016FINAL.pdf. 

Accessed July 11, 2018. 

 

 Author contribution: Author conceive the 

idea, done literature review and wrote the manuscript 

and check the manuscript meticulously.  

Conflict of interest: The author declares no 

conflict of interest. 

 


