A right way, and a wrong way, to promote the role of the pharmacist

The right way:

The Ethical Implications of Rexall’s Dubious Homeopathic Offerings

From ethicist Dr. Chris MacDonald, a column on Rexall’s recent advertisements promoting homeopathy:

The problem, of course, is there’s no reliable evidence that homeopathy works, nor any plausible reason to think that it even could work. In commercial contexts, that’s pretty bad. And it’s worse still when the company selling the stuff is a company people rely on for competent health advice, and when that company leverages the credibility of a licensed health profession to promote bogus wares.

And importantly:

The commercial world is full of scams, and all too often people with something to sell have unwarranted faith in their products. Greed and ignorance are nothing new, but that doesn’t mean they are excusable. Companies that claim not just to provide a product, but to educate and take care of consumers, ought to do better. They should do their best to sell only those products that they, and their customers, are justified in believing in.

More here.

I’ve written about the ethics of selling homeopathy before.  As XKCD said about pharmacies selling homeopathy,

 Telling someone who trusts you that you’re giving them medicine, when you know you’re not, because you want their money, isn’t just lying–it’s like an example you’d make up if you had to illustrate for a child why lying is wrong.

A Strong Message to Pharmacists about IgG Food Sensitivity Testing

From the Canadian Society of Allergy and Clinical Immunology:

The Canadian Society of Allergy and Clinical Immunology (CSACI) is very concerned about the increased marketing of food-specific immunoglobulin G (IgG) testing towards the general public over the past few years, supposedly as a simple means by which to identify “food sensitivity”, food intolerance or food allergies. In the past, this unvalidated form of testing was usually offered by alternative or complementary health providers, but has now become more widely available with direct-to-consumer marketing through a nationwide chain of pharmacies.

Food intolerance blood tests have no place in the pharmacy

Imagine your pharmacy features a blood pressure measurement device. It has never worked correctly. Sometimes it give incorrect high results, suggesting hypertension. In other patients it misses hypertension completely. You’ve been advised by hypertension experts that this particular model isn’t accurate and shouldn’t be offered to consumers. Despite this, you continue to promote it to your patients, and you use the test results to recommend supplements to treat conditions that may or may not not exist.

Does this meet the professional standards expected for pharmacists? From an ethical perspective, does it respect patient autonomy?  My sense is that consumers, ethicists, regulators, and other health professionals would say “no”. Pharmacists have an ethical and professional responsibility to base advice on the best scientific evidence – in this case, to ensure that a service being offered is reliable, accurate, and relevant for making health decisions.

That’s why I’m surprised to see Canadian and American pharmacies are now selling IgG food intolerance tests. Because if you agree that knowingly offering faulty blood pressure measurement tests is unacceptable, you should have just as much concern about food intolerance blood tests. These tests have been available for some time in the United Kingdom. Now they’re in North America. Rexall, the Canadian pharmacy chain, recently started selling the “Hemocode” test which is purported to test for 250 food intolerances: