Imagine you are a pharmacist working on an interdisciplinary team that is treating a patient for severe opioid dependence. The idea arises to treat the addiction by slowly replacing the active drug with an inert substance, such as lactose, without the consent of the patient. As the pharmacist, it is your responsibility to compound these capsules where the amount of active drug is slowly tapered until the capsules are entirely lactose. Is it ethically permissible for the pharmacist to knowingly deceive the patient to treat the underlying addiction? What duties to the patient come into conflict during this situation? 


Ethical dilemmas often arise when a person is seemingly required to perform two or more incompatible actions. These situations are not uncommon in health care and often professional students receive minimal training on how to navigate these complex issues. Taking a closer look at this particular case, it seems clear that on the one hand, most practitioners agree that deceiving patients and hindering their ability to make informed decisions violates the trust that is fundamental to any patient–practitioner relationship. But on the other hand, treating the patient’s addiction would potentially save their life, even if the treatment relies on 
deception. 


As an undergraduate student in my genetics class, I pondered if the subject would actually have applications in pharmacy school. Between memorizing the stop codons and making sure not to confuse meiosis with mitosis, genetics was a challenging class. While I enjoyed it, I never made the connection to how it applied to pharmacy practice because it largely focused on inherit genetic conditions. 


Fast forward to my third year of pharmacy school, sitting in the Translational Pharmacogenomics course. All of a sudden, the connection between genetics and pharmacy came together through pharmacogenomics. Pharmacogenomics looks at how genes influence an individual’s response to medications. During the semester, we learned about the basics of pharmacogenomics and how it affected drug metabolizing enzymes, transporters, and targets. The course then transitioned into the clinical applications for different drug classes using the Clinical Pharmacogenetics Implementation Consortium guidelines. We then focused on patient counseling skills, real-world implementation, and understanding ethical, legal, and social issues.