University of the Immaculate Conception

Fr. Selga Street, Davao City

Dear Respondents,
Praised be Jesus and Mary!
We are students from BS Pharmacy 2B who are currently conducting a
survey about the Level of Awareness of the University of the Immaculate
Conception BS Pharmacy Second Year Students A.Y. 2014-2015 on the
Violation of the Code of Ethics Committed by Registered Pharmacists in Drug
Stores.
Related with this, we prepared this questionnaire to collect data we
needed for our thesis paper.
Therefore, we are asking your cooperation to answer the following
questions honestly. Any information that is obtained in connection with this
survey and that can be identified with you will remain confidential and will be
disclosed only with your permission.
Thank you!
The Researchers
Name(optional);_________________________
Year & Section:_____________
1. Are you aware of the existence of the Pharmacy Code of Ethics that seeks
to be exercised and followed by each pharmacist?
`
____yes
_______no
2. Are you aware of the violations of the Pharmacy Code of Ethics by
Pharmacists in drug store?
____yes
_______no
3. The occurrence of violations depends on what factor?
___ Incompetence of the Pharmacist
___Patients Interests
___Others, please specify
4. Was there an instance where you witnessed and/or experienced a
violation of the Pharmacy Code of Ethics?
_____yes

______no

If yes, among the listed violation on the Pharmacy Code of Ethics, choose
only ONE that you have witnessed and/or experienced.

____ A pharmacist fails to help individuals achieve optimum benefit from their
medications, fails to be committed to their welfare, and fails to maintain their
trust.
___A pharmacist fails to serve the patient in a private and in confidential
manner and inconsideration for the needs stated by the patient as well as
those defined by health science.
___A pharmacist fails to promote and recognize individual self-worth by
encouraging patients to participate in decisions about their health. A
pharmacist fails to communicate with patients in terms that are
understandable. A pharmacist fails to respect personal and cultural
differences among patients.
___A pharmacist fails to act with honesty and integrity in professional
relationships.
___A pharmacist fails to fulfill the duty to maintain knowledge and abilities as
new medications, devices, and technologies become available and as health
information advances.
___A pharmacist fails asks for the consultation of colleagues or other health
professionals or refers the patient. A pharmacist fails to acknowledge other
health professionals may differ in the beliefs and values they apply to the care
of the patient.
___A pharmacist fails to serve individual, community, and societal needs.
___A pharmacist is not fair and equitable, incompetent in balancing the needs
of patients and society.
5. As a pharmacy student, among the choices, what can you contribute to
minimize/ lessen the violation on the Pharmacy Code of Ethics? CHOOSE
ONLY ONE.
___Report to the authority any violation you witnessed/ experienced from a
pharmacist.
___To involve oneself in activities that promote the fundamental basis of roles
and responsibilities of pharmacists. This includes symposiums, seminars,
trainings and etc.
___Be enthusiastic in studying as it will affect ones performance in the future.
___ If others, please specify. ______________________________________
______________________________________________________________