Re: Squabble over scripts

THE EDITOR, Madam:

The headline and tone of your article ‘Squabble Over Scripts’ on May 24 are regrettable. While the issue raised is important, framing it as a professional clash distracts from the real concern: patient safety. The media plays a powerful role in shaping public discourse and should promote thoughtful, balanced engagement especially in matters of public health.

This issue isn’t just about profit or exploiting a gap in the law – it’s about ensuring the Jamaican people receive safe, ethical, and coordinated care from both professions. The distinction between prescribing and dispensing isn’t arbitrary. It’s a longstanding public health safeguard. Doctors diagnose, prescribe and initiate treatment; pharmacists, as medication experts, review prescriptions, identify drug interactions, confirm appropriate dosing, and ensure proper labelling and counselling.

When roles are blurred, patients are put at risk. Pharmacists dispensing medications for major medical conditions without a prior medical assessment can lead to missed diagnoses and delays in treatment. Likewise, when doctors regularly dispense medicines themselves or delegate this task to untrained staff, there is greater risk of missed interactions, improper labelling, and lack of counselling, all of which can compromise patient care.

While cost and convenience are often stated as reasons for physician dispensing, these must be weighed against public health safeguards. The over 500 shops registered as pharmacies in Jamaica under the Pharmacy Act are subject to regular inspections and audits to ensure proper storage, labelling, and dispensing of medications. Pharmacists are held accountable for what they dispense. In contrast, the Medical Council of Jamaica does not have an inspectorate or the manpower to monitor how medications are handled in doctors’ offices. That lack of systematic oversight is important to consider. There is a greater risk of spoilage due to improper storage conditions or sale/dispensing of expired products.

The Food and Drug Act and Regulations allow doctors to give sample medications to begin treatment. So stockpiling medications to sell was never the intention of the legislation. There are many physicians in Jamaica who adhere to this best practice, i.e., the issuance of samples to initiate treatment along with a written prescription for continuing care. The separation between prescribing and dispensing is also reflected in the Ministry of Health’s structure.

Rather than framing this issue as a squabble, journalists should be calling for dialogue. Bringing together pharmacists, physicians, regulators, and policymakers can foster shared understanding and strengthen safeguards. This is where interdisciplinary ethics offers guidance. It’s a growing field that helps healthcare professionals navigate overlapping roles by encouraging collaboration through mutual respect, communication and accountability.

SHEREEN COX, PHD

MA (Healthcare Law and Ethics)

Dr Cox is a bioethicist and pharmacist currently employed to the Centre for Medical Ethics, University of Oslo, Norway and adjunct lecturer at the University of the West Indies. coxshereen@gmail.com